Patient-Centered Medical Home: The Call to Action Adele Allison National Director of Government Affairs
<ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><...
What is a PCMH? <ul><li>Integrates patients as active participants in care </li></ul><ul><li>Physician-led medical team th...
PCMH Evolution Timeline AAP establishes “Medical Home” Concept “ Medical Home” evolves to provide primary care as a commun...
<ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><...
U.S. Trends – Health Care <ul><li>1934-1939  – Great Depression – 25% unemployment rate – Roosevelt enacts SSA as part of ...
U.S. Trends – Health Care <ul><li>1965  – Medicare/Medicaid created by Pres. Johnson (Title XIX to SSA) </li></ul><ul><ul>...
Funding Medicare
Unemployment & States 1% Increase in National Unemployment Rate ═ Decrease in State Revenue 3-4% + 1M Increase in ‘Caid an...
U.S. Medicaid - Present Health Insurance –  58M 29M Children, 15M Adults, 14M Elderly & Disabled Asst. to ‘Care Beneficiar...
Health Care Spending & GDP
Health Care Spending & GDP Source:  OEDC Health Data – Total Expenditures as % of GDP
PCP Shortage <ul><li>NACHC estimates 60M Americans (1 in 5) lack adequate access to primary </li></ul><ul><li>56% of OV in...
PCP Shortage
Role of Prevention & Chronic Disease Management <ul><li>Ah, America … </li></ul><ul><ul><li>Obesity -> Type 2 Diabetes -> ...
Role of Prevention & Chronic Disease Management <ul><li>“ An ounce of prevention is worth a pound of cure,”  Ben Franklin ...
<ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><...
PCMH Pre-PPACA <ul><li>PCMH Initiatives </li></ul><ul><ul><li>27 multi-stakeholder projects in 20 states </li></ul></ul><u...
PCMH Pre-PPACA <ul><li>Agency for Healthcare Research and Quality (AHRQ) </li></ul><ul><ul><li>Primary Care with orientati...
PCMH – Addressing the Heart of the PCP Shortage <ul><li>Payment models devalue time spent with patients </li></ul><ul><li>...
Joint Principles of PCMH <ul><li>Developed by AAP, AAFP, ACP, and AOA </li></ul><ul><li>Principles: </li></ul><ul><ul><li>...
Joint Principles of PCMH <ul><li>Enhance access  through such systems as open scheduling, expanded hours, and new communic...
PPACA – Accountable Care Organizations <ul><li>ACOs contract to provide services for a defined population of Medicare pati...
PPACA – Legal & Policy Supporting PCMH PPACA or Reconciliation  Act Section Opportunity Description Effective Date PPACA §...
PPACA – Legal & Policy Supporting PCMH PPACA or Reconciliation  Act Section Opportunity Description Effective Date PPACA §...
PPACA – Legal & Policy Supporting PCMH PPACA or Reconciliation  Act Section Opportunity Description Effective Date PPACA §...
<ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><...
NCA-PPC-PCMH 2011 <ul><li>Program contains 6 standards consisting of 27 elements and 149 factors. </li></ul><ul><li>Standa...
NCQA PCMH 2011 Scoring Points NCQA PCMH 2011 Standard and Element Number  of Factors Must  Pass? 20 PCMH Standard 1:  Enha...
10 Commandments of PCMH Health IT Support <ul><li>Collect standardized, accurate, essential data ->  MEDCIN, Multum, Inter...
<ul><li>Collect, store, measure and report on individual and population process, outcomes and quality ->  Registry, Busine...
<ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><...
<ul><li>HRSA Patient-Centered Medical Health Home Initiative (PCMHH Initiative) </li></ul><ul><li>Provides cost coverage f...
<ul><li>HRSA provides 3 types of: </li></ul><ul><ul><li>Technical assistance </li></ul></ul><ul><ul><li>Training </li></ul...
<ul><li>Health Centers must complete a Notice of Intent to receive HRSA support </li></ul><ul><li>NOI available at  http:/...
<ul><li>SuccessEHS offers PCMH Specialized Project Management </li></ul><ul><ul><li>Gap Analysis </li></ul></ul><ul><ul><l...
<ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><...
<ul><li>Increased Quality of Care  </li></ul><ul><li>National Recognition </li></ul><ul><li>Increased Market Competitivene...
To learn more about the Patient-Centered Medical Home, visit:  http://www.successehs.com/category/patient-centered-medical...
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Patient-Centered Medical Home: The Call to Action

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The Patient-Centered Medical Home (PCMH) is becoming widely acknowledged as the key to health care reform. Learn about the history and impetus behind this care delivery model, the ways in which it can strengthen the physician-patient relationship b moving from episodic care to coordinated care and the potential for increased reimbursements as an NCQA-certified PCMH.

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Patient-Centered Medical Home: The Call to Action

  1. 1. Patient-Centered Medical Home: The Call to Action Adele Allison National Director of Government Affairs
  2. 2. <ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><ul><li>NCQA – Role and Process </li></ul><ul><li>HRSA Opportunity </li></ul><ul><li>Call to Action </li></ul><ul><li>Questions </li></ul>Patient-Centered Medical Home (PCMH)
  3. 3. What is a PCMH? <ul><li>Integrates patients as active participants in care </li></ul><ul><li>Physician-led medical team that coordinates </li></ul><ul><ul><ul><li>Preventive </li></ul></ul></ul><ul><ul><ul><li>Acute </li></ul></ul></ul><ul><ul><ul><li>Chronic Disease </li></ul></ul></ul><ul><li>Uses evidence-based guidelines and technology </li></ul><ul><li>Offers patients comfort, convenience, and optimal care </li></ul><ul><li>Manages the patient throughout their lifetime </li></ul>
  4. 4. PCMH Evolution Timeline AAP establishes “Medical Home” Concept “ Medical Home” evolves to provide primary care as a community HI places the “Medical Home” into its Child Health Plan Surg. Gen’l holds 1 st major conference for Children with Special Health Care Needs (CSHCN) AAP holds first “Medical Home” Conference AAP publishes policy statement defining “Medical Home” 7 U.S. Family Med. Org. publish “Future of Family Medicine” stating every American should have a “ personal medical home” ACP develops its “Advanced Medical Home” model AAFP, AAP, ACP, and AOA release the “Joint Principles of the PCMH” 20 Bills promoting the “Medical Home” introduced in 10 states PPACA is signed into law incorporating the “Medical Home” into CMS’ establishing Accountable Care Org. (ACOs) 1967 1978-79 1987 1989 1992 2002 2005 2007 2009 2010
  5. 5. <ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><ul><li>NCQA – Role and Process </li></ul><ul><li>HRSA Opportunity </li></ul><ul><li>Call to Action </li></ul><ul><li>Questions </li></ul>Patient-Centered Medical Home (PCMH)
  6. 6. U.S. Trends – Health Care <ul><li>1934-1939 – Great Depression – 25% unemployment rate – Roosevelt enacts SSA as part of the “New Deal” </li></ul><ul><li>1939 – AHA creates Blue Cross – embracing concept of “prepaid health” </li></ul><ul><li>1945 – Blue Cross serves 59% of the health insurance market </li></ul><ul><li>1946 – Prepaid MD service plans affiliate and form Blue Shield </li></ul><ul><li>1954 – IRS solidifies idea of “prepaid” insurance with tax deduction </li></ul>
  7. 7. U.S. Trends – Health Care <ul><li>1965 – Medicare/Medicaid created by Pres. Johnson (Title XIX to SSA) </li></ul><ul><ul><li>Health Care Spending as a % of GDP is 5.7% </li></ul></ul><ul><ul><li>Life Expectancy for males is 66 and for females is 71.7 </li></ul></ul><ul><ul><li>Almost 75% of Americans have private insurance </li></ul></ul><ul><ul><li>In 1966, Medicare serves 19.1M -> 47M today </li></ul></ul><ul><ul><li>In 1966, Medicaid serves 10M -> 49M today </li></ul></ul>
  8. 8. Funding Medicare
  9. 9. Unemployment & States 1% Increase in National Unemployment Rate ═ Decrease in State Revenue 3-4% + 1M Increase in ‘Caid and CHIP Enrollment 1.1M Increase in Uninsured
  10. 10. U.S. Medicaid - Present Health Insurance – 58M 29M Children, 15M Adults, 14M Elderly & Disabled Asst. to ‘Care Beneficiaries – 8.8M 8.8M Aged and Disabled (21% of Medicare) Long-Term Care – 3.8M 1M Nursing Home, 2.8M Community-based Residents Support for Healthcare and Safety Net 16% of nat’l spending; 41% of LTC services State Capacity for Health Coverage Federal share 50%-76%; 44% of all Federal funds to states Source: Kaiser Permanente Commission on Medicaid 2010
  11. 11. Health Care Spending & GDP
  12. 12. Health Care Spending & GDP Source: OEDC Health Data – Total Expenditures as % of GDP
  13. 13. PCP Shortage <ul><li>NACHC estimates 60M Americans (1 in 5) lack adequate access to primary </li></ul><ul><li>56% of OV in the U.S. are Primary Care but: </li></ul><ul><ul><li>Only 37% of physicians practice Primary Care medicine </li></ul></ul><ul><ul><li>Only 8% of Med School graduates go into Primary Care </li></ul></ul><ul><li>PPACA will cover 16M more Americans by 2014 </li></ul><ul><ul><li>“ Our first available appointment is in 3 months” </li></ul></ul><ul><ul><li>Today there is only time for episodic treatment </li></ul></ul><ul><li>Impact of PPACA (Projection) 1 </li></ul>1 Source: Association of American Medical Colleges, June, 2010 Year (All Specialties) Supply (All Specialties) Demand (All Specialties) Shortage (Primary Care) Shortage (Non-PCP) Shortage 2008 699,100 706,500 7,400 7,400 0 2010 709,700 723,400 13,700 9,000 4,700 2015 735,600 798,500 62,900 29,800 33,100 2020 759,800 851,300 91,500 45,400 46,100 2025 786,400 916,000 130,600 65,800 64,800
  14. 14. PCP Shortage
  15. 15. Role of Prevention & Chronic Disease Management <ul><li>Ah, America … </li></ul><ul><ul><li>Obesity -> Type 2 Diabetes -> $147B health care spending </li></ul></ul><ul><ul><li>Smoking -> Direct medical costs (lung cancer, et al) -> $96B health care costs </li></ul></ul><ul><ul><li>Alcohol -> Alcohol-related health problems -> $22.5B health care costs </li></ul></ul><ul><ul><li>Sedentary lifestyles -> Heart Disease -> $143B health care spending </li></ul></ul>
  16. 16. Role of Prevention & Chronic Disease Management <ul><li>“ An ounce of prevention is worth a pound of cure,” Ben Franklin 1735 </li></ul><ul><ul><li>Chronic Disease affects 138M Americans </li></ul></ul><ul><ul><li>Requires care coordination and patient engagement/education </li></ul></ul><ul><ul><li>SuccessEHS offers: </li></ul></ul><ul><ul><ul><li>Population Management </li></ul></ul></ul><ul><ul><ul><li>Patient Portal </li></ul></ul></ul><ul><ul><ul><li>Digital Dashboard </li></ul></ul></ul><ul><ul><ul><li>Ad Hoc Reporting </li></ul></ul></ul><ul><ul><ul><li>Communication tools (e.g. Flags, T/calls, Audit Trails, CDS, Alerts) </li></ul></ul></ul>
  17. 17. <ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><ul><li>NCQA – Role and Process </li></ul><ul><li>HRSA Opportunity </li></ul><ul><li>Call to Action </li></ul><ul><li>Questions </li></ul>Patient-Centered Medical Home (PCMH)
  18. 18. PCMH Pre-PPACA <ul><li>PCMH Initiatives </li></ul><ul><ul><li>27 multi-stakeholder projects in 20 states </li></ul></ul><ul><ul><li>21 states with single, commercial payer project </li></ul></ul><ul><ul><li>38 states with Medicaid/CHIP projects </li></ul></ul><ul><ul><li>Only 5 states without PCMH </li></ul></ul>
  19. 19. PCMH Pre-PPACA <ul><li>Agency for Healthcare Research and Quality (AHRQ) </li></ul><ul><ul><li>Primary Care with orientation toward whole person and relationship-based collaboration </li></ul></ul><ul><ul><li>Caregiver (“Home”) is accountable for majority of physical and mental health through a “team” </li></ul></ul><ul><ul><li>Home coordinates care needs across the health continuum </li></ul></ul><ul><ul><li>Patient accessibility is increased </li></ul></ul><ul><ul><li>Systems-based approach to Quality and Safety (CDS) </li></ul></ul>
  20. 20. PCMH – Addressing the Heart of the PCP Shortage <ul><li>Payment models devalue time spent with patients </li></ul><ul><li>PCPs earn 33-50% of income earned by specialists </li></ul><ul><li>PCPs experienced a 10% reduction in income between 1995 and 2003 </li></ul><ul><li>PPACA – Ultimately 32M more patients </li></ul><ul><li>PCP burn-out </li></ul><ul><li>PCMH provides each patient with a personal MD, and a physician-directed “team” using technology </li></ul><ul><li>Transforms episodic care with coordinated/long-term healing </li></ul>
  21. 21. Joint Principles of PCMH <ul><li>Developed by AAP, AAFP, ACP, and AOA </li></ul><ul><li>Principles: </li></ul><ul><ul><li>Personal MD for each patient for 1 st contact and ongoing care </li></ul></ul><ul><ul><li>MD-directed medical team for collective care management </li></ul></ul><ul><ul><li>Whole person oriented coordinating tertiary care needs for all life stages: acute, chronic, preventive, and end-of-life </li></ul></ul><ul><ul><li>Coordination/integration of care across the full continuum and the patient’s community using registries, IT, HIE, etc. </li></ul></ul><ul><ul><li>Quality and safety by providing patient advocates, evidence-based medicine with CDS, continuous quality improvement, patient active engagement in care, and use of HIT for measurement-education-communication </li></ul></ul>
  22. 22. Joint Principles of PCMH <ul><li>Enhance access through such systems as open scheduling, expanded hours, and new communication tools. </li></ul><ul><li>Appropriate payment for value added based on: </li></ul><ul><ul><li>Reflection of work outside the face-to-face visit </li></ul></ul><ul><ul><li>Both within the practice and coordination between consultants, ancillary providers, and community resources </li></ul></ul><ul><ul><li>Adoption and use of Health IT for quality improvement </li></ul></ul><ul><ul><li>Support of enhanced communication access (e.g. email, phone consult) </li></ul></ul><ul><ul><li>Value of MD work with remote monitoring using technology </li></ul></ul><ul><ul><li>No reduction in payments for face-to-face visits </li></ul></ul><ul><ul><li>Recognition of case mix differences being treated </li></ul></ul><ul><ul><li>Shared savings from reduced hospital stays associated with care management </li></ul></ul><ul><ul><li>Additional payments for measurable, continuous quality improvements </li></ul></ul>
  23. 23. PPACA – Accountable Care Organizations <ul><li>ACOs contract to provide services for a defined population of Medicare patients </li></ul><ul><li>ACOs share savings if quality objectives are achieved and performance measures met </li></ul><ul><li>Model is effective January 1, 2012 </li></ul><ul><li>ACO models include: </li></ul><ul><ul><li>Integrated Delivery Systems (e.g. Kaiser, Group Health Coop.) </li></ul></ul><ul><ul><li>Multi-specialty Group Practices (e.g. Mayo Clinic) </li></ul></ul><ul><ul><li>Physician-Hospital Organizations (PHOs) </li></ul></ul><ul><ul><li>Independent Physician Associations (IPAs) </li></ul></ul><ul><ul><li>Virtual Physician Organizations </li></ul></ul><ul><li>Must be Physician-led with PCMH at the hub </li></ul>
  24. 24. PPACA – Legal & Policy Supporting PCMH PPACA or Reconciliation Act Section Opportunity Description Effective Date PPACA § 5501 Increased Reimbursement PCPs receive 10% increase in reimbursement for Medicaid and Medicare primary care services. FY 2011-2016 Reconciliation § 1202 Increased Reimbursement Medicaid payment rates to PCPs for primary care services shall be no less than 100% of the Medicare payment rates. 2013 and 2014 Reconciliation § 1202 Increased Reimbursement 100% of federal funding for incremental state costs to meet the above noted Medicaid requirement. 2013 and 2014 PPACA § 4104-6 Prevention Support Improved access for preventive services, including Medicaid and Medicare clinical preventive services recommended with a grade A / B by the USPSTF and adult immunizations recommended by ACIP. CY 2011 PPACA § 4108 Prevention Support Incentives for prevention of chronic disease for Medicaid patients As early as CY 2011 PPACA § 2001 Coverage / Service Expansion $11B in new funding over 5 years for health center program expansion ($9.5B for operational capacity and $1.5B for facility improvement, expansion, and construction). FY 2011 PPACA § 5207 Workforce Development <ul><li>Expands education/training under Titles VII and VIII of the Public Health Service Act with: </li></ul><ul><li>$1.5B in new funding for the National Health Service Corps for 15,000 PCPs in HPSAs. </li></ul><ul><li>National Health Service Corps members may count up to 50% of their time spent teaching towards service obligation. </li></ul>FY 2010 - 2016 PPACA § 5508 Workforce Development Authorizes health centers to develop residency programs and pays for CHCs operating teaching programs. FY 2010 - 2012
  25. 25. PPACA – Legal & Policy Supporting PCMH PPACA or Reconciliation Act Section Opportunity Description Effective Date PPACA § 2706 Payment Delivery PPACA establishes Accountable Care Organization (ACO) contracting with CMS effective January 1, 2012. Included is a 5-year Medicaid pediatric demonstration with shared savings incentives. CY 2012 PPACA § 3022 Payment Delivery Establishment of ACOs for Medicare shared savings incentives with CMS. CY 2012 PPACA § 2703 Health Home Medicaid State Plan Option with enhanced FMAP for enrollees with 2 chronic conditions (or 1 condition with a risk for a second) can designate qualified provider as their health home for care management, coordination, health promotion, transitional care, and community / social support services. Beginning CY 2011 PPACA § 3502 Health Home Grants to create community health teams to support PCMH development for patients with chronic conditions. CY 2013 PPACA § 3503 Care Delivery Grants available to pharmacists for medication therapy management (MTM) May 1, 2010 PPACA § 10333 Care Delivery <ul><li>Grants available for creation of Community Based Collaborative Care Networks (hospital + FQHC) for comprehensive care coordination for low-income populations. Grants may be used for: </li></ul><ul><li>Enrollment assistance and provider assignment </li></ul><ul><li>Case management and care management </li></ul><ul><li>Health outreach through neighborhood health workers </li></ul><ul><li>Transportation </li></ul><ul><li>Expansion for tele-health, after hours services or urgent care </li></ul><ul><li>Direct patient care services </li></ul>FY 2011 - 2015
  26. 26. PPACA – Legal & Policy Supporting PCMH PPACA or Reconciliation Act Section Opportunity Description Effective Date PPACA § 1139B Reporting Adult quality health measures for Medicaid-eligible adults through a Medicaid Quality Measurement Program. CY 2013 PPACA § 3015, 10305 Reporting Grants for data collection and other public reporting requirements FY 2010 - 2014
  27. 27. <ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><ul><li>NCQA – Role and Process </li></ul><ul><li>HRSA Opportunity </li></ul><ul><li>Call to Action </li></ul><ul><li>Questions </li></ul>Patient-Centered Medical Home (PCMH)
  28. 28. NCA-PPC-PCMH 2011 <ul><li>Program contains 6 standards consisting of 27 elements and 149 factors. </li></ul><ul><li>Standards contain “Must Pass” and non-must pass elements </li></ul><ul><li>Elements are associated to points, resulting recognition Level </li></ul><ul><li>3 Levels – Level 1 (lowest) to Level 3 (highest) </li></ul>Level 3 85-100 points + all 6 must pass elements Level 2 50-84 points + all 6 must pass elements Level 1 35-59 points + all 6 must pass elements No Recognition 34 points or less and/or less than 6 must pass elements
  29. 29. NCQA PCMH 2011 Scoring Points NCQA PCMH 2011 Standard and Element Number of Factors Must Pass? 20 PCMH Standard 1: Enhance Access and Continuity 34 4 Element A: Access during office hours 4 Yes 4 Element B: Access after hours 5 No 2 Element C: Electronic Access 6 No 2 Element D: Continuity 3 No 2 Element E: Medical Home Responsibilities 4 No 2 Element F: Culturally & Linguistically Appropriate Services (CLAS) 4 No 4 Element G: Practice Organization 8 No 17 PCMH Standard 2: Identify and Manage Patient Populations 35 3 Element A: Patient Information 12 No 4 Element B: Clinical Data 9 No 4 Element C: Comprehensive Health Assessment 10 No 5 Element D: Using Data for Population Management 4 Yes 17 PCMH Standard 3: Plan and Manage Care 23 4 Element A: Implement evidence-based guidelines 3 No 3 Element B: Identify High-Risk Patients 2 No 4 Element C: Manage Care 7 Yes 3 Element D: Management Medications 5 No 3 Element E: Electronic Prescribing 6 No 9 PCMH Standard 4: Provide Self-Care and Community Support 10 6 Element A: Self-Care Process 6 Yes 3 Element B: Referrals to Community Resources 4 No 18 PCMH Standard 5: Track and Coordinate Care 25 6 Element A: Test Tracking and Follow-up 10 No 6 Element B: Referral Tracking and Follow-up 7 Yes 6 Element C: Coordinate with Facilities / Care Transitions 8 No 20 PCMH Standard 6: Measure and Improve Performance 22 4 Element A: Measures of performance 4 No 4 Element B: Patient / Family feedback 4 No 4 Element C: Implements Continuous Quality Improvement 4 Yes 3 Element D: Demonstrates Continuous Quality Improvement 4 No 3 Element E: Performance Reporting 3 No 2 Element F: Report Data Externally 3 No 100 149 6
  30. 30. 10 Commandments of PCMH Health IT Support <ul><li>Collect standardized, accurate, essential data -> MEDCIN, Multum, Interfaces </li></ul><ul><li>Incorporate data from outside systems -> Interfaces / HIE </li></ul><ul><li>Support care coordination -> Referral Tracking / HIE </li></ul><ul><li>Facilitate medication reconciliation -> Surescripts, Extended eRx </li></ul><ul><li>Capture/Respond to population health needs -> Clinical Event Manager </li></ul><ul><li>Link to community resources -> Evidence-based CDS </li></ul>
  31. 31. <ul><li>Collect, store, measure and report on individual and population process, outcomes and quality -> Registry, Business Objects, CEM, Dashboard </li></ul><ul><li>Engage care team in decision support at the point of care -> CDS, CEM </li></ul><ul><li>Facilitate provider engagement to reduce risk stratification -> Referral Management, HIE, CPOE with audit trails and alerts </li></ul><ul><li>Support patient self-management and enhance patient access/communication -> Patient Portal, Surveys, Summaries, ExitCare </li></ul>10 Commandments of PCMH Health IT Support
  32. 32. <ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><ul><li>NCQA – Role and Process </li></ul><ul><li>HRSA Opportunity </li></ul><ul><li>Call to Action </li></ul><ul><li>Questions </li></ul>Patient-Centered Medical Home (PCMH)
  33. 33. <ul><li>HRSA Patient-Centered Medical Health Home Initiative (PCMHH Initiative) </li></ul><ul><li>Provides cost coverage for recognition process fees ($580-$4,080+ depending on number of clinicians) </li></ul><ul><li>Coordinating strategy with primary care associations, national cooperative agreements and Health Center Controlled Networks (HCCNs) </li></ul><ul><li>Eligibility based upon section 330 funding </li></ul>HRSA & PCMH
  34. 34. <ul><li>HRSA provides 3 types of: </li></ul><ul><ul><li>Technical assistance </li></ul></ul><ul><ul><li>Training </li></ul></ul><ul><ul><li>Mock Surveys </li></ul></ul><ul><ul><li>Consultant advice </li></ul></ul>HRSA & PCMH
  35. 35. <ul><li>Health Centers must complete a Notice of Intent to receive HRSA support </li></ul><ul><li>NOI available at http://bphc.hrsa.gov/policiesregulations/policies/pdfs/pal201101noi.pdf </li></ul><ul><li>Completed NOI should be emailed to [email_address] </li></ul><ul><li>Once approved, NCAQ will provide PCMH standards and guidelines, instructions and details regarding application </li></ul><ul><li>Additional Links: </li></ul><ul><ul><li>Helpline: 877.974.2742 or [email_address] </li></ul></ul><ul><ul><li>NCQA Project Liaison: 888.375.7585 or [email_address] </li></ul></ul>HRSA & PCMH
  36. 36. <ul><li>SuccessEHS offers PCMH Specialized Project Management </li></ul><ul><ul><li>Gap Analysis </li></ul></ul><ul><ul><li>Workflow redesign </li></ul></ul><ul><ul><li>Coordination with development of Policies & Procedures </li></ul></ul><ul><ul><li>Reporting Assistance </li></ul></ul>HRSA & PCMH
  37. 37. <ul><li>Historical Perspective </li></ul><ul><li>U.S. Trends and PCP Shortage </li></ul><ul><li>PPACA and PCMH </li></ul><ul><li>NCQA – Role and Process </li></ul><ul><li>HRSA Opportunity </li></ul><ul><li>Call to Action </li></ul><ul><li>Questions </li></ul>Patient-Centered Medical Home (PCMH)
  38. 38. <ul><li>Increased Quality of Care </li></ul><ul><li>National Recognition </li></ul><ul><li>Increased Market Competitiveness </li></ul><ul><li>Potential Increased Reimbursement </li></ul><ul><li>Aligns with PPACA Legislation </li></ul><ul><li>Added Structure for CHC Expansion </li></ul><ul><li>Parallels and Compliments Meaningful Use </li></ul><ul><li>Aligns with new and existing pilots/demonstration projects </li></ul><ul><li>Positions for ACOs under PPACA </li></ul>PCMH – Why do it?
  39. 39. To learn more about the Patient-Centered Medical Home, visit: http://www.successehs.com/category/patient-centered-medical-home.htm

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