AAAHC First to Offer Onsite Survey for Medical Home Accreditation

SKOKIE, Ill.  — One of the nation’s ambulatory healthcare accrediting organizations announced today that it has put standards in place and is now reviewing physician practices that define themselves as medical homes, an emerging trend in healthcare delivery. The announcement was made by the Accreditation Association for Ambulatory Health Care (AAAHC/Accreditation Association), which accredits more than 4,000 ambulatory healthcare organizations. 

The medical home concept calls for each patient to have one central, primary care physician who oversees and integrates all medical care. An adult’s medical home might be with a family practitioner or internist, while a child’s might be with a pediatrician. 

“The medical home is more than a concept.  It is also a ‘place’ where the medical home physicians deliver care as well as coordinate the care provided by others. Having that facility, the equipment, the medical procedures and coordination processes reviewed and accredited will add a layer of safety and assurance for the consumer,” said John Burke, PhD, AAAHC executive director and CEO. 

The potential of the medical home to improve patient care and hold down healthcare costs is gaining increasing support from government, providers, insurers and the public. A number of demonstration projects, including an eight-state program sponsored by Medicare, and others sponsored by commercial insurers, are assessing the benefits of the medical home.

“An important distinction with our standards is that they are designed to assess medical home providers from the perspective of the patient for whom the medical home is the primary point of care,” said Sam J.W. Romeo, MD, MBA, chair of the AAAHC Medical Home Task Force. “The Accreditation Association’s unique, onsite survey process gives us an opportunity to observe the quality of patient care, review medical records and assess patient perceptions and satisfaction.”

The recently released AAAHC 2009 Accreditation Handbook for Ambulatory Health Care includes a chapter specifically devoted to medical home standards, including assessment of the following characteristics: 

• Relationship, including communication, understanding and collaboration between the patient and the physician and physician-directed healthcare team. Where appropriate the relationship between the medical home and the patient’s family or other caretakers also is assessed.
• Continuity of care, including the requirement that a significant number (more than 50 percent) of a patient’s medical home visits are with the same physician/physician team. The standards also require documentation of all consultations, referrals and appointments in the clinical record; and proactively planned transitions of care (e.g. from pediatric to adult or adult to geriatric or from inpatient to outpatient to nursing home to hospice). 
• Comprehensiveness of care, including preventive and wellness care, acute injury and illness care, chronic illness management and end-of-life care. Standards for the provision of appropriate patient education, self-management and community resources also are addressed.
• Accessibility, including written policies that support patient access and routine assessment of patients’ perceptions and satisfaction regarding access to the medical home. Medical care must be available 24/7, 365 days a year. 
• Quality, including patient care that is physician directed, the use and periodic assessment of evidence based guidelines and performance measures in delivering clinical services, and ongoing quality improvement activities.

In addition, electronic data management must be continually assessed as a tool for facilitating the Accreditation Association medical home standards.

In preparation for implementing the medical home accreditation standards, AAAHC surveyors have conducted pilot program surveys in a number of AAAHC-accredited ambulatory healthcare organizations, including U.S. Coast Guard and Air Force programs, community health clinics, group practices and Indian health services. 

Source: Accreditation Association for Ambulatory Health Care