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SGM No. 17-01
May 1, 2017
TO: Addressees

FROM: Acting Director

SUBJECT: Patient-Centered Medical Home Designation in Ambulatory Care

The purpose of this Special General Memorandum (SGM) is to establish the Indian Health Service (IHS) policy on Patient-Centered Medical Home (PCMH) designation for all IHS ambulatory care facilities.  Health stations may be excluded, however, it is recommended that health stations work toward implementation of patient-centered medical home principles to improve quality of care.

All IHS ambulatory care facilities, including hospital-based ambulatory care health centers, excluding health stations, will attain PCMH certification/designation by December 31, 2021.  Once PCMH certification/designation is attained, it is the policy of the IHS for PCMH certification/designation to be maintained.  Certified PCMH practices are those that have received accreditation from any of the following nationally recognized accreditation organizations or state-based PCMH certification/designation programs that are recognized by CMS:

  1. Medical Home designations recognized by the CMS Quality Payment Program MIPS pathway.
  2. Medical home designations recognized by the Medicaid program of the state in which the IHS facility provides service.
  3. Medical Home models that are recognized as Advanced Alternative Payment Models (APM) by CMS.

PCMH Model of Primary Care Delivery

The PCMH is a model of primary care delivery in which patients receive well-coordinated services and enhanced access to a care team.  Providers practicing in PCMHs use decision support tools, measure their performance, engage patients in their own care and conduct quality improvement activities to address patients' needs.  Many medical home evaluations have shown improvements in quality and patient experience of care.

Importance for Implementation of certified/designated PCMH

The IHS leadership has determined that implementation of the PCMH model of care will promote high quality patient care, enhance patient experience, and improve the work environment within the IHS system.  Implementation of recognized PCMH models of care will best position IHS in alignment with CMS in movement toward value-based payment and care delivery models.

Effective Date

This SGM becomes effective on the date signed by the Acting Director, IHS.

/Chris Buchanan/
RADM Chris Buchanan, R.E.H.S., M.P.H.
Assistant Surgeon General, USPHS
Acting Director
Indian Health Service

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