13 specialty health care organizations endorse joint principl...(stablishment of PCMH demonstration proje...),Health

The Joint Principles define key characteristics of the PCMH:

• Personal physician each patient has an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care.

• Physician directed medical practice the personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care of patients.

Whole person orientation the personal physician is responsible for providing for all the patients health care needs or taking responsibility for appropriately arranging care with other qualified professionals. This includes care fro all stages of life; acute care; chronic care; preventive services; and end of life care.

Care is coordinated and/or integrated across all elements of the complex health care system (e.g., subspecialty care, hospitals, home health agencies, nursing homes) and the patients community (e.g., family, public and private community-based services). Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.

The Joint Principles state that quality and safety are hallmarks of the PCMH. The statement features eight sub-points highlighting specific responsibilities, education, decision making, technology, participation and other necessary elements to improve quality and safety.

The Joint Principles also spell out a proposed payment framework for the PCMH. This framework would reflect the value of physician care management work that falls outside of a face-to-face visit. It would pay for services associated with coordination of care, support adoption and use of health information technology for qualit
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