PCPCC Announces Plans to Recognize Patient-Centered Medical Homes

The nation's largest primary care collaborative plans to use a new voluntary designation program from the National Committee for Quality Assurance, or NCQA, to recognize physician practices as patient-centered medical homes, a development designed to promote comprehensive and coordinated care.

The Patient-Centered Primary Care Collaborative, or PCPCC, is a coalition representing some of the country's largest corporations, policy-makers, consumers and 330,000 primary care physicians. The coalition unveiled the voluntary designation program during a national health care summit here on Nov. 7.

"This (program) is a way of handing a blueprint for the patient-centered medical home to physician practices," said NCQA EVP Greg Pawlson, M.D., M.P.H., during the summit. "Physician practices can then decide how to implement the criteria."

The NCQA developed the criteria for the recognition program in conjunction with the AAFP, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association. Pawlson described the criteria as a "roadmap for practices to follow." Program criteria are based on a series of requirements, including patient registries, care management programs, electronic prescribing and follow-ups on tests, among other measures.

Pawlson stressed, however, that the recognition program, which is due to be introduced in January, will not work without adequate payment for physicians. Public and private payers, he said, "have to step forward to recognize the value of the patient-centered medical home and to pay practices appropriately."

AAFP President Jim King, M.D., of Selmer, Tenn., explained that physicians themselves cannot be recognized as medical homes; only a physician practice can earn the designation of "patient-centered medical home." That means a patient-centered medical home is a team effort, involving everyone in the practice, said King.

The summit brought together a cross section of nearly 250 business leaders, policy analysts, consumer organizations and physician groups, underscoring the growing recognition of primary care and the patient-centered medical home as the most effective means of improving quality and reducing costs.

Former House Speaker Newt Gingrich, founder of the Center for Health Transformation, predicted that the Nov. 7 summit would serve as one of the major catalysts in driving profound and "breathtaking" changes during the next several years, creating opportunities and challenges for primary care physicians.

"Can you (primary care physicians) create a medical home?" Gingrich asked during his keynote address at the summit. "Can you get patients to buy into the medical home (concept)?"

Gingrich also asked whether primary care physicians can "invent a financing mechanism that minimizes acute care."

He noted that physicians deal with life and death issues -- making them inherently cautious, because mistakes can cause illnesses and even death. But to change the nation's health care system, physicians and other health care professionals will have to embrace fundamental change that is driven by "continuous experimentation," a difficult task for some providers, said Gingrich.

Finding an optimal health care model is an evolving process that can only be achieved through experimentation and continuous improvement, he said. Although trial and error ultimately will determine what the optimal health care model looks like, certain actions must be taken to ensure fundamental and appropriate reform of the system. For example, said Gingrich, the physician payment system should compensate and reward physicians for providing comprehensive and continuous care.