Medical Home Guidelines – Comparing National Programs

By Lauren Simpson

The Medical Group Management Association (MGMA) recently created a comparison tool of four Patient-Centered Medical Home Programs:

1. The Accreditation Association for Ambulatory Health Care: 2011 Medical Home Standards
2. The Joint Commission: Primary Care Medical Home 2011 Standards and Elements of Performance (Available July 1, 2011)
3. The National Committee for Quality Assurance (NCQA) Patient Centered Medical Home 2011 Standards
4. URAC: Patient Centered Health Care Home (PCHCH) Practice Achievement Version 1.0 (newly available as of June)

The tool addresses how each of the 4 large accreditation programs meet PCMH guidelines as set by the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Physicians (ACP) and the America Osteopathic Association (AOA).

Although the programs are similar in many ways, there are some key differences worth highlighting:

• The NCQA and URAC programs have more of a focus on measurable quality improvement, although high quality care is key to all for programs.
• All programs ensure the incorporation of patient-centered care (for instance, building relationships with your own personal physician, patients participating in care plan development, etc.), but NCQA’s and URAC’s programs also stress the importance of family-centered care.
• The Joint Commission and AAAHC programs only partially meet the guidelines for “aligning standards, elements, characteristics, and/or measures with Meaningful Use.” Although their metrics and standards do not directly align with Meaningful Use, it is likely that organizations applying for Meaningful Use would meet the Joint Commission’s and AAAHC’s requirements for electronic data management. That said, if an organization wants to kill two birds with one stone, URAC’s and NCQA’s metrics and measures are directly aligned with Meaningful Use.
• The Joint Commission and URAC programs have systems in place to foster innovation and best practices (JCAHO’s “Leading Practice Library” and URAC’s “Annual Best Practice Awards”).
• NCQA is more documentation-based than the other three programs and is a self-evaluation. The other programs require a site visit.
• The Joint Commission program is the most costly, but that’s because it’s done on top of their ambulatory care accreditation. In general, the other program costs hover around $4,000.

Right now, NCQA seems to be the popular choice for PCMH recognition. Then again, URAC and Joint Commission are new to the Medical Home scene. It will be interesting to see which programs begin to pop up in contractual agreements and grant funding, and hopefully, regardless of which programs that organizations choose, we’ll start seeing a greater transformation toward patient-centered care.