Nurse Practitioners in the PCMH

The Centers for Medicare & Medicaid Services (CMS) has defined "providers" as physicians, nurse practitioners and physician assistants.1 To be consistent with this definition, The Joint Commission recently approved several revisions to its certification requirements for a Primary Care Medical Home (PCMH).2Ambulatory care organizations that provide care under the PCMH model and already are accredited by The Joint Commission can earn this certification.

The Joint Commission's PCMH requirement revisions affirm NPs and PAs as qualified to serve in the role of primary care clinician. A doctor of medicine or doctor of osteopathy must participate on the interdisciplinary team. The Joint Commission will continue to certify PCMHs led by NPs, PAs or physicians. The revised requirements do not impose any restrictions on the scope of practice of professionals serving as primary care clinicians, nor do they preempt applicable state law.

Collaborative, Team-Based Care
Since being introduced nearly 50 years ago, the medical home model has been supported by multiple federal laws and initiatives as a way to improve health outcomes and contain healthcare costs. The PCMH model emphasizes collaborative, team-based care that meets the needs of the patient. To achieve this aim, The Joint Commission's ambulatory care PCMH requirements place responsibility for each patient's care on the organization rather than on a particular clinician. It's up to the organization to determine how the primary care clinician - be it a physician, NP or PA - and the interdisciplinary team work in partnership with the patient and family to support the provision and continuity of care.