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Guidelines for medical home demonstrations released by major physician groups

Washington Four physician membership organizations today released Guidelines for Patient Centered Medical Home Demonstration Projects.

The four groups the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Physicians (ACP) and the American Osteopathic Association (AOA) represent nearly 350,000 physicians. The pediatrician, family physician, internist and osteopathic physician members of the four organizations provide the majority of primary care services to children, adolescents, and adult patients in the United States.

"The patient-centered medical home concept brings together the preventive and primary services that are the foundation of efficient, high quality health care," said Ted Epperly, M.D., president of the American Academy of Family Physicians. "People who have a medical home receive whole-person care that is integrated and coordinated by a health care team. The patient-centered medical home also provides greater access to needed services through same day, extended hours and new options for communication, such as letting patients ask questions or check their lab results online."

"The medical home guidelines importance is to ensure an apples-to-apples comparison across projects and to avoid contamination by non-medical home projects, e.g. disease management programs," Epperly added.

David T. Tayloe, Jr., MD, FAAP, president of the American Academy of Pediatrics, said, "If projects are consistently and appropriately evaluated, it will indeed facilitate more meaningful interpretation and understanding of the lessons learned as we move forward to full implementation of medical home nationally."

The new set of guidelines has also been endorsed by the Patient-Centered Primary Care Collaborative (PCPCC), a coalition of more than 400 major employers, consumer groups, patient quality organizations, health plans, labor unions, hospitals, physicians and many others who have joined together to develop and advance the patient-centered medical home (PCMH).

The guidelines contain 16 recommendations that should be part of any project that is testing the PCMH model of care, the groups say. They include recommendations about who should collaborate on the projects; how they should choose practices to participate; what kind of support should be provided to participating practices; how participating practices should be reimbursed; and what each project should to do to analyze and distribute their results.

Under all of the recommendation areas there are specific guidelines that together form the key components necessary to thoroughly and effectively test elements of the PCMH model of care. Specifically, the guidelines state that any project must ensure that the leaders of local primary care professional organizations have been briefed on the project and given the opportunity to provide input.

The guidelines also specify that any project should use the National Committee for Quality Assurance (NCQA) Physician Practice Connections (PPC)-PCMH tool, or a similar consensus-based recognition process, to qualify practices for participation. The new document calls for all demonstration projects to include additional reimbursement for participating practices to adequately compensate for the increased physician and administrative staff time necessary to provide care under the PCMH model. And, it calls for projects to broadly and publically disseminate their results after the data have been gathered and analyzed.

"We believe that these new guidelines are necessary to help define what constitutes an adequate test of the patient-centered medical home model," said Joseph W. Stubbs, MD, FACP, president of the American College of Physicians. "We now have a road map for demonstration projects and a way to determine whether the design of any project is consistent with these guidelines adopted by our medical societies and the Patient-Centered Primary Care Collaborative."

These guidelines were developed as a companion to the "Joint Principles of the Patient-Centered Medical Home" that were released in 2007. Those principles broadly describe the characteristics of the PCMH model of care. The new guidelines help provide direction to demonstration projects in the planning phase, to ensure these new projects are successfully testing the key elements of the PCMH. The Joint Principles are available online at:

"It is essential that we conduct uniform studies of the PCMH in an effort to determine best practices and identify potential shortcomings. The information we gather will provide valuable insight into efforts aimed at refocusing our nation's health care system on the value of primary care," concluded Carlo J. DiMarco, DO, president of the American Osteopathic Association


Contact: David Kinsman
American College of Physicians

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