The original Joint Principles of the patient-centered medical home were written and endorsed in February 2007 but did not include language on the incorporation of behavioral healthcare into the model. A recent article from the American Academy of Family Physicians, published in the Annals of Family Medicine, changes that.
The following is a summary of the new set of joint principles that recognize that behavioral healthcare is a central part of a PCMH. The new principles are meant to supplement, not replace, the original joint principles document.
1. Personal physicians are committed to the well-being of individual patients.
2. Physician-directed medical practice. Typically, a physician's practice will be the physical location of a PCMH, and the practice will rely on a team of providers to integrate the physical, mental, emotional and social aspects of a patient's health.
3. Whole person orientation. "Given that over one-half of primary care patients have a mental or behavioral diagnosis or symptoms that are significantly disabling, given that every medical problem has a psychosocial dimension, given that most personal care plans require substantial health behavior change — a PCMH would be incomplete without behavioral healthcare fully incorporated into its fabric," the document states.
4. Care is coordinated across all elements. Healthcare has traditionally been fragmented across many lines, and behavioral health has often been outside of the main communication streams. The updated joint principles call for care to be coordinated through shared registries, medical records, decision-making, revenue streams and responsibility for care plans.
5. Quality and safety. Care planning should include behavioral health providers, and electronic health records should include behavioral health provider's notes and mental health screening tools.
6. Enhanced access. This should included patient, family and physician access to behavioral healthcare resources. "Physical integration of a behavioral health professional into the PCMH is a particularly attractive strategy for improving both access and coordination," according to the document.
7. Payment recognizes the added value of behavioral health. Funding should be pooled to include behavioral health provisions.
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