Recognition & Beyond – Taking Your PCMH from Marketable to Functional

Many healthcare providers considering or in the process of implementing the patient centered medical home (PCMH) struggle with whether they should seek review of their program (accreditation, certification, and / or recognition) from a third party like the Accreditation Association for Ambulatory Health Care (AAAHC), the National Committee for Quality Assurance (NCQA), or The Joint Commission (TJC). While many adopters of the PCMH feel that validation by a third party will increase the prestige of their practices in the eyes of patients and payers others feel that the current standards set by these accreditors are unlikely to lead to any meaningful differentiation amongst Primary Care Providers. At this point, both opinions seem to be correct.

When it comes to the PCMH, it is important to differentiate a marketable versus a functional program. At this point, achieving a certain level of PCMH accreditation, certification, or recognition implies that one’s practice is embarking on the journey toward patient-centered health. This is something that can immediately be marketed to patients and payers who hopefully will support the practice as it progresses through its transformation. On the other hand, practices whose transformation efforts stall after receiving PCMH accreditation, certification, or recognition are likely to be unpleasantly surprised when patients and payers begin to trivialize this status over time. At the end of the day, PCMH’s will need to clear a hurdle much higher than those set by the AAAHC, NCQA, or TJC in order to be functional (i.e. deliver on their promise to provide high quality, cost efficient care to populations of patients in a personalized manner). In the long run, PCMH’s will have to be both functional and marketable to continue to reap any ongoing incremental financial incentives from payers or employers (i.e. care coordination fees).

Primary care practices flirting with or committed to the PCMH model should seek accreditation, certification, and / or recognition in the near-term. This process brings the practice together around a common goal and builds momentum, skills, and competencies for a much needed transformation. When accreditation, certification, or recognition is received a practice has every right to celebrate its achievement. That said, the practice’s members should view the achievement of this milestone as the completion of the first leg of a long and arduous race (something akin to the first leg of the Tour de France) and redouble their efforts to exemplify the Joint Principles of the PCMH in the long-term. -Dr. John Redding

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