Medical Home & Health Home Accreditation – What Are The Options?

While the concept of medical homes has been around since the 1960s (see A New Approach for People with Complex Service Needs: The Behaviorally-Focused Medical Home), health homes (or specialty medical homes) are a relatively new creation ushered in by the Patient Protection and Affordable Care Act (PPACA). (And if you’re confused about the difference between the two, check out these resources in the OPEN MINDS Industry Library –Medical Home V. Health Home – Confused?, How Are Medicaid Health Homes Reimbursed For Services?, and The OPEN MINDS Medical Home Update).

The uptake of medical homes and health homes has been rather dramatic. According to our recent OPEN MINDS research, there are at least 20 state Medicaid plans that have medical home initiatives. Nineteen states also have Medicaid health home initiatives and another four states plan to implement health homes in the next few years. But the construct is not limited to Medicaid – medical homes are increasingly common in commercial health plans and accountable care organizations (ACOs) (see A Health Home Update – Health Homes Go Private and Health Homes For Children).

Even newer than the proliferation of medical homes and health homes is the accreditation of these program models. There are five organizations – The Accreditation Association for Ambulatory Health Care (AAAHC), CARF International, the Joint Commission, the National Committee for Quality Assurance (NCQA), and URAC – that offer some type of accreditation. And, on the payer side, requirements for accreditation are on the increase. For example, of the 20 state Medicaid plans that have medical home initiatives, eight of these states require patient-centered medical home (PCMH) accreditation.