Patient-Centered Medical Home (PCMH)
With the passage of the Affordable Care Act, the Patient-Centered Medical Home (PCMH) has emerged as a popular concept and model for providing comprehensive health care. Many health care providers are currently preparing, or have already obtained, PCMH recognition from various private accreditation agencies. Although the market or financial benefits of accreditation are still unknown, there is wide support that adopting the principals of PCMH will help provide patients greater access to and better coordination of quality health care services.
In 2007, a consensus statement was released by the American Academy of Pediatrics to highlight the critical elements of the PCMH concept. This statement, known commonly as the “Joint Principles,” included the following elements:
- Personal physician — linking patients to a personal medical provider.
- Physician directed medical practice — establishing a medical team directed by the medical provider.
- Whole person orientation — taking responsibility for the comprehensive health needs of patients.
- Care is coordinated and/or integrated — helping patients navigate their health care needs across a complex health care system and access any required community services.
- Quality and safety — using evidence-based practices, establishing quality improvement plans, ensuring patient satisfaction, using information technology, accountability, etc.
- Enhanced access — ensuring patients can get the care they need when needed.
- Payment — should reflect the unique elements of the PCMH model and include incentives for outcomes and benchmarks.
One of the elements identified by the “Joint Principles,” recommends that health care practices undergo a voluntary recognition process by a non-government agency in order to demonstrate the ability to provide patient-centered care in alignment with the PCMH model. Since these recommendations were released, several agencies have established their own recognition criteria and process. These agencies include:
- Accreditation Association for Ambulatory Health Care, Inc.
- The Joint Commission
- National Committee for Quality Assurance (NCQA)
PCMH and SBHCs
Many school-based health centers (SBHCs) have long implemented several of the PCMH elements identified by the “Joint Principles.” For example, continuity of the patient-provider relationship, creating a medical team of providers, medical assistants, health educators, etc., addressing the needs of patients even beyond the traditional concept of health, and integrating physical health with mental health as well as community services, have been common practices for many SBHCs. However, as the need for PCMH recognition continues to grow it is important for SBHCs to think about how they can address the specific criteria established by accreditation agencies. The California School-Based Health Alliance is committed to working with SBHCs in order to demonstrate their value and role in the PCMH recognition process.
Resources for Practice
Patient Centered Medical Home: How California School-Based Health Centers are Relating to this New Model of Care—An overview of how 11 SBHCs across California are implementing PCMH practices, including recommendations for SBHCs to move closer to a PCMH model of care.
The Puzzle: Piecing Together Patient-Centered Medical Care and School-Based Health Centers – An online guide from the national School-Based Health Alliance to aid SBHCs in adopting key performance and quality improvement strategies that align with national and state-specific PCMH measures and standards.