Report of the AACP Task Force on Patient-Centered Medical Homes and Accountable Care Organizations
TASK FORCE CHARGES A task force was convened by the American Association of Colleges of Pharmacy (AACP) to provide rationale for academic pharmacy engagement with organizations/ institutions providing new models of team-based patient care designed to improve patient access, care quality, and affordable care. Descriptions of new care models, such as patient centered medical homes (PCMHs) and accountable care organizations (ACO), were included as well as descriptions of existing partnerships with academic pharmacy. Specifically, this task force was charged with: 1. Providing a rationale for colleges/schools of pharmacy to engage in PCMHs and ACOs that includes a list of recommended articles and sites that could help members become informed about such organizations, corresponding professional association, regulatory bodies and government agencies. 2. Describing model partnerships of colleges of pharmacy with PCMHs and ACOs. 3. Disseminating information gathered above in a form of a white paper as a "call to arms" for the pharmacy academy. BACKGROUND The Patient-Centered Medical Home (PCMH) The medical home model holds promise as a way to improve health care in the United States by transforming how primary care is organized and delivered. Building on the work of a large and growing community, the Agency for Healthcare Research and Quality (AHRQ) defines a medical home not simply as a place, but as a model of the organization of primary care that delivers the core functions of primary health care. The Medical Home encompasses six functions and attributes: 1. Comprehensive Care. The PCMH is accountable for meeting the large majority of patient physical and mental health care needs, including prevention and wellness, acute care, and chronic care. Providing comprehensive care requires a team of care providers. This team might include multiple providers, including physicians, advanced practice nurses, physician assistants, nurses, pharmacists, nutritionists, social workers, educators, and care coordinators. Although some medical home practices may physically bring together large and diverse teams of care providers to meet the needs of their patients, others, particularly smaller practices, will build virtual teams linking patients to providers and services within specific communities. 2. Patient-Centered. The PCMH provides primary health care that is relationship-based with an orientation toward the whole person. Partnering with patients and their families requires understanding and respecting each patient's unique needs, culture, values, and preferences. The medical home practice actively supports patient education and self care management based on their desired level. Recognizing that patients and families are core members of the care team, medical home practices ensure that they are fully informed partners in establishing and participating in their own care plans. 3. Coordinated Care. The PCMH coordinates care across all aspects of the health care system. Such coordination is particularly critical during transitions between sites of care, such as when patients are being discharged from the hospital. Medical home practices also excel at building clear and open communication among patients and families, the medical home, and other members of the care team. 4. Accessible Services. The PCMH delivers accessible services with shorter waiting times for urgent needs, enhanced in-person hours, around-the-clock telephone or electronic access to a member of the care team, and alternative methods of communication such as email and telephone care. The medical home practice is responsive to patients' preferences regarding access. (1) 5. Quality and Safety. The PCMH demonstrates a commitment to quality improvement by ongoing engagement in activities such as utilizing evidence-based medicine and clinical decision-support tools to guide shared decision making with patients and their families, engaging in performance measurement and improvement, measuring and responding to patient experiences and satisfaction, and practicing population-based health management. …