TJC certifies primary care medical homes

Aim is to smooth transitions

Hospitals that have physician offices connected to and affiliated with them now have another option for getting certified for a Primary Care Medical Home. Along with programs run by the National Committee for Quality Assurance (NCQA), The Joint Commission started offering such certification in late February.

Based on the Agency for Healthcare Research and Quality model, the certification focuses on patient-centered care, care coordination, superb access to care, and a systems-based approach to quality and safety, says Mark Pelletier, RN, MS, interim chief operating officer and director of accreditation and certification services at TJC. “We built our standards on those definitions, and they require that an organization supply timely, evidence-based treatment. This will result in higher patient satisfaction, improved outcomes, and also reduced costs.”

There are some additional standards included in the TJC program that others do not have, and Pelletier emphasizes that they require a site visit, not a desk review of policies and procedures. For hospitals getting such certification, it will add at least an extra day to the general survey process. “I think our scope of accountability is broader than what’s out there, and we add requirements for oral health and end-of-life care.” The TJC model also includes standards related to health care literacy for patients, as well as proof of competency of the primary care clinician and care team. “It has to be an interdisciplinary team working in the primary care medical home,” he explains.

While the physician offices will handle the bulk of the preparation for the primary care medical home survey, there will be some impact on hospital-based quality managers. “You won’t be leading the charge, but you will probably be called on to assist with preparation.”

Keeping patients in the community

Despite the fact it might cause you some extra work, Pelletier thinks this is something that all appropriate hospitals should consider. “This is what is expected from the government after healthcare reform. We have to improve outcomes and make healthcare more efficient. This will help with that. And the good thing is that when you do that, you will have fewer readmissions, which will be an increasing financial burden for hospitals that don’t address them.”

Take typical congestive heart failure patients, who are the most likely type of patient to come back to the hospital because they can’t get in to see a primary care physician in a timely manner. Having that medical home connected to the hospital will help to smooth that transition and make it easier for patients leaving the hospital to see their doctors quickly.

Keeping patients out of the hospital and in the community is the idea behind medical homes, and while it might seem strange to think of a hospital trying to keep customers away, that’s the right thing to do and increasingly, the thing that will help hospitals financially.

“I think this is the best thing for patients, and that should make it exciting. Look at the return on investment. If you invest in that primary care medical home model, you can accomplish savings to the organization as a whole.”

The standards for certification as a primary care medical home are available at


For more information, contact: Mark Pelletier, RN, MS, Chief Operating Officer, Joint Commission, Oakbrook Terrace, IL. Email: