A Step-by-Step Guide to Establishing a Patient Centered Medical Home Part 6

Posted on February 28, 2013 by Patrick Christopher

Part six of the seven-part series

Practice Performance Measurement

Addresses the organization and promotion of safe and high quality care

The purpose of this section is to provide tools and strategies to help you evaluate the performance of your practice; this includes both the URAC Medical Home Accreditation physician performance and the patient/family perspective regarding the quality of their care. Collecting data on performance, sharing these data with clinicians, staff and families and being transparent with consumers will help drive improvement and prepare your practice for successful completion of the NCQA recognition application process. Use the following ‘Practice Performance Guide’ tool and checklist to assess how well your practice tracks performance.

This tool may help prepare you to meet the PCMH elements 8A, 8B, & 8C for NCQA accreditation.

Step 1:

Check the following planned, proactive and comprehensive management strategies that your practice currently uses for each patient.

Complete a practice performance assessment

The following tools are available to measure the performance of your overall practice. tools

Medical Home Index
Assessment measuring Medical Home activities in the practice- short version

Measuring Medical Homes: Tools to Evaluate the Pediatric Patient- and Family-Centered Medical Home

EQIPP: Medical Home for Pediatric Primary Care
This course helps a practice improve its medical home, and includes a practice survey to assess organizational capacity

Obtain feedback from families; share this data with all staff

There are a variety of ways to learn from families about their experience of care. Methods range from simple face-to-face inquiries or focus groups, to more formal survey approaches. Patients and families will need help becoming comfortable providing critical feedback. Making a commitment to use their feedback builds trust.

Consider using the following resources to obtain feedback:

CAHPS (Clinician/Group Pediatric Care Survey)
Survey for providers to assess patient-centeredness

Medical Home Family Index and Survey (short version)
Survey for families to assess their satisfaction with the provide

Family Focus Group
Fact Sheet on the benefits of Family Focus Groups

Family ‘Exit’ Survey
Survey for families on their post-visit experience with the practice

Family Advisory Group
Fact Sheet on how to create Family Advisory Groups in the practice

Measuring Medical Homes: Tools to Evaluate the Pediatric Patient- and Family-Centered Medical Home

Report practice performance and family feedback data back to all clinical staff
Presentation of practice performance data and family feedback to all partners fosters improvement. It benefits the practice to share these data building blocks with partners and discuss implications for improvement. Together you can select changes and use the Model for Improvement to test and implement improvements.

Prepare for completion of the NCQA PPC®-PCMH™ Recognition application
Achieving Level 1, 2 or even 3 using the NCQA positions your practice for potential enhanced payments and/or inclusion in medical home pilot demonstrations projects.

Step 2:

Assess the performance strategies from Step 1 to determine whether they are currently in place and note areas necessary for development.

To read the previous articles in this series, please click on the links below.

If you build it they will come.

A step-by-step guide to establishing a Patient Centered Medical Home

Part 1 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-1/

Part 2 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-2/

Part 3 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-3/

Part 4 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-4/

Part 5 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-5/

Please check back with us for the final article in this series.

Do you have questions or comments about Medical Homes? We invite you to contact our NCQA consultants at BHM Healthcare Solutions today.

BHM Healthcare Solutions website: http://www.bhmpc.com

Call us 1-888-831-1171

Email us newideas@bhmpc.com

We would like to offer you a free gift of a presentation on denial management. Please click on the gift box below to download.

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Patient Centered Medical Homes: What it Takes for PCMH Accreditation Part 12

Posted on February 27, 2013 by Danyell Jones

Patient centered medical homes have become a very hot healthcare topic recently, and while there are multiple recognition, or PCMH accreditation, programs to choose from there are commonalities in the guidelines of what must be met by any medical home seeking accreditation. So whether your organization is pursuing URAC PCHCH accreditation, TJC Accreditation, NCQA Accreditation, or the recently launched CARF Accreditation for medical homes, keep these general standards in mind:

12. Apply Reasonable Documentation/Data Collection Requirements

In order for a Medical Home to become accredited, it may be necessary for documentation of practices within the organization to be reviewed. Common documentation may include Policies and Procedures, or meeting notes from internal committees such as Quality Management Committee. Some of this documentation is the basis upon which it is established that the Medical Home is able to provide all types of services required in the Medical Home model (such as acute and chronic care.) Other documentation is used to verify that the Medical Home has reasonable processes and data collection in place to ensure that performance improvement thresholds are being met.

Whatever the documentation required by the Accrediting organization, it is required that documentation requirements be transparent, consistent, and reviewed at regular intervals for relevancy.

In light of this, many accrediting bodies are now partnering with health information technology (HIT) vendors to ensure that the data elements required for review are built into the vendors system. A common example of this occurrence is Electronic Health Record (EHR) vendors who design their software and platforms with accreditation standards in mind. In the future it may be possible for accrediting bodies to gather all of the data required to meet documentation and data collection requirements directly through their health IT portals.

To read the previous articles in this series, please click the following links:

Part 1 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-1/

Part 2 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-2/

Part 3 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-pcmh-accreditation-part-3/

Part 4 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-4/

Part 5 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-5/

Part 6 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-6/

Part 7 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-7/

Part 8 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-8/

Part 9 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-9/

Part 10 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-10/

Part 11 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-11/

Please check back with us for Part 13 and the conclusion to our What it Takes for PCMH Accreditation series.

A Step-by-Step Guide to Establishing a Patient Centered Medical Home Part 5

Posted on February 26, 2013 by Patrick Christopher

Part five of the seven-part series

Resources & Linkages

Addresses successfully linking patient and families with community resources to help meet their needs PCHCH Accreditation

In a medical home it is important to have good, quick resources for your patients and their families catalogued and at your fingertips.

This tool may help prepare you to meet the PCMH elements 1A & 4A for NCQA Accreditation.

Step 1:

Check the following information to indicate which ones your practice provides to your patients and families.

Family to family supports
Health insurance/other assistance
State funded family relief (e.g. food, housing, electricity, transportation, equipment)
Educational rights and resources
Employment rights and resources
Condition specific patient education materials/classes
Patient self-management tools/guidance
Language appropriate services and resources
External care management assistance
Home care/respite help

Step 2:

Review the Community Resources to learn additional resources you may want to share with your patients and families. The Community building blocks Resources tool guides you to access available “go to” resources and help get them into the hands of patients/families. These resources can also inform practice materials for children, youth, and their families such as: parent brochures, new patient packets, or family resource binders.

Step 3:

Score how well your practice refers patients/families to resources and note areas necessary for development:

For the previous articles in this series, please click on the following links:

If you build it they will come.

A step-by-step guide to establishing a Patient Centered Medical Home

Part 1 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-1/

Part 2 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-2/

Part 3 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-3/

Part 4 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-4/

Please check back with us for Part 6 in our series.

Do you have questions or comments about Medical Homes? We invite you to contact our NCQA consultants at BHM Healthcare Solutions today.

BHM Healthcare Solutions website: http://www.bhmpc.com

Call us 1-888-831-1171

Email us newideas@bhmpc.com

A Step-by-Step Guide to Establishing a Patient Centered Medical Home Part 4

Posted on February 25, 2013 by Patrick Christopher

Part four of the seven-part series

Care Delivery Management

Promotes clinical care that is consistent with patient and family preference and scientific evidence

Many children and youth require more than the usual well child, preventive and acute illness interventions. The purpose of this section is to help you assess needs and develop clinical care consistent with patient and family preferences and available scientific evidence.

The tools in this section can help you achieve this, and also may help prepare you to meet the PCMH elements 1A, 1B, 2D, 2E, 3D, 4B, 6A, & 7A for NCQA accreditation.

Step 1:

Check the following planned, proactive and comprehensive management strategies that your practice currently uses for each patient. PCHCH Accreditation

Identification, enrollment in a registry, and monitoring of children/youth with particular health conditions or concern or all children/youth with special health care needs (CYSHCN)*
Assessment of care coordination needs
Tracking of tests and referrals with monitoring of progress
Planned office visits of appropriate length – matching resources to the needs of children, youth, and families
Co-management agreements establishing shared roles with specialists (these agreements can be faxed back and forth)
Planned outreach and communication with schools and other community partners
Other needed education, advocacy and linkages to community supports and resources
The use of a medical summary: The medical summary (care plan) includes all pertinent current and historic, medical and social aspects of a child and family’s needs. It also includes key interventions, each partner in care, and contact information.
The use of an action plan: The action plan lists imminent next steps while detailing who is responsible for each referral, test, evaluation or other follow up.
The use of an emergency plan, if needed: Emergency plans provide explicit instructions for prepared actions to be taken by the family, other caregivers or teachers, and all health care professionals.

Step 2:

Assess the use of patient specific protocols in your practice.

According to the NCQA Medical Home Recognition Tool you will need to identify, monitor, and track each test, referral and key outcomes for URAC PCHCH Accreditation children/youth with “three conditions of concern” for your practice. These conditions can be common chronic illnesses (e.g. asthma, attention deficit hyperactivity disorder (ADHD), or obesity), or specific areas of concern having evidence based care protocols (eg gastroenteritis or Safe and Healthy Beginnings).

The National Center for Medical Home Implementation recommends choosing at least three conditions and/or protocols to demonstrate quality in your practice. Provided below are six examples to help you. Each condition example is provided with a link to a protocol or best available practice, clinical measures, and suggested registry fields to help you monitor and track care for patients affected by these conditions of concern.

To develop your practice in this area you should:

a) Choose three conditions from the six provided (or others consistent with practice priority)

b) For each of those three chosen:

Review its evidenced based protocol (or best available practices)
Select the 2-3 measures to use in your practice to demonstrate quality of care delivery
Develop a patient registry (sample registry fields provided in the following examples that can be used in a spreadsheet template)

Six sample conditions:

Attention Deficit Hyperactivity Disorder (ADHD)
Asthma
Childhood Obesity
Children and Youth with Special Health Care Needs
Gastroenteritis
Safe and Healthy Beginnings/Hyperbilirubinemia

Step 3:

Based on the checklist and the criteria established in steps 1 and 2, assess whether your practice has in place strategies for assessing and healthcare 7 developing clinical care management and note areas for development:

For the previous articles in this series, If you build it they will come.

A step-by-step guide to establishing a Patient Centered Medical Home, please click on the following links.

Part 1 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-1/

Part 2 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-2/

Part 3 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-3/

Please check back with us to read Part 5 of our Establishing a Medical Home Series.

Do you have questions or comments about Medical Homes? We invite you to contact our NCQA consultants at BHM Healthcare Solutions today.

BHM Healthcare Solutions website: http://www.bhmpc.com

Call us 1-888-831-1171

Email us: newideas@bhmpc.com

As a token of our appreciation, we invite you to click on the gift box below to download a presentation on Denial Management.

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Patient Centered Medical Homes: What it Takes for PCMH Accreditation Part 11

Posted on February 25, 2013 by Danyell Jones

Patient centered medical homes have become a very hot healthcare topic recently, and while there are multiple recognition, or PCMH

PCHCH Accreditation

accreditation, programs to choose from there are commonalities in the guidelines of what must be met by any medical home seeking accreditation. So whether your organization is pursuing URAC PCHCH accreditation, TJC accreditation, NCQA Accreditation, or the recently launched CARF accreditation for medical homes, keep these general standards in mind:

11. Ensure Transparency in Program Structure and Scoring

The Accrediting/Recognition body should ensure that transparency is built into their program scoring and structure, so that those seeking accreditation are clear on what standards need to be met for successful accreditation. This includes identifying how the standards relate to one another so that an organization can prioritize which items to work on first.

Most accreditations provide a type of “roadmap” which outlines standards, and makes the accreditation process more user friendly for PCHCH/PCMH homes applying for recognition. The roadmap will show how the applying organization can approach requirements and move along a continuum toward successful Medical Home implementation.

Along the same lines, it is required that accrediting organizations make sure that the scoring of practices and standards is transparent, and that organizations applying for PCMH accreditation, or PCHCH accreditation know which standards need to be met. These scoring standards are supported by evidence and aim at being as objective and consistent as possible, while still allowing for variation in Medical Home structuring. Feedback is provided to applicants who go through the application process, and scores are a reflection of strengths and weaknesses of the Medical Home assisting in highlighting where continuous quality activities may be applied.

To read the previous articles in this series, please click on the following links:

Part 1 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-1/

Part 2 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-2/

Part 3 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-pcmh-accreditation-part-3/

Part 4 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-4/

Part 5 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-5/

Part 6 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-6/

Part 7 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-7/

Part 8 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-8/

Part 9 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-9/

Part 10 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-10/

Please check back with us for Part 12

As a token of our appreciation for reading our exciting series on What it Takes for PCMH accreditation, please click the gift box to download a free presentation on denial management.

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A Step-By-Step Guide to Establishing a Patient Centered Medical Home Part 3

Posted on February 22, 2013 by Patrick Christopher

Part three of the seven-part series.

Clinical Care Information

Addresses standards for practice organization and use of clinical information

Providing a high quality medical home means that your practice has well-organized medical records with all pertinent clinical information for children, youth and families. Use the following Clinical Care Checklist to assess how well your practice organizes this clinical care information.

This tool may help prepare you to meet the PCMH elements 2D, 4B, 6A, and 7A for NCQA Accreditation.

Step 1:

Consider the following standards for the organization of clinical care information; next assess whether your practice has them in place for each patient.

1. An up-to-date problem list with ICD9 codes current

2. Narrative current progress notes based upon a structured or standard template (paper or electronic)

3. A listing of a patient’s over-the-counter medications, supplements and alternative therapies

4. A listing of all prescribed medications (chronic and short term)

5. Growth charts plotting height, weight, head circumference, and body mass index (BMI)

6. Document use of age appropriate standardized screening tools and developmental testing (eg Newborn Screening, Parent’s Evaluation of building blocks >Developmental Status; Ages and Stages; Child Development Inventory)

7. Developmental Surveillance and Screening Policy Implementation Project (D-PIP)

8. Use of a structured template for tracking age appropriate risk factors (at least 3 factors – e.g. seat belt, secondary smoke, bike helmet, mental health needs, etc.)

9. Prevention milestones which are periodically addressed and documented

10.Process for tracking tests, referrals and their resolution

Step 2:

Assess how well your practice addresses these clinical care information standards and note areas for development and necessary action steps:

To read the previous articles in this series, please click on the following links:

Part 1 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-1/

Part 2 http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-2/

Please check back with us to read Part 4

If you build it they will come.

A step-by-step guide to establishing a Patient Centered Medical Home

Do you have questions or comments about Medical Homes? We invite you to contact our NCQA Consultants at BHM Healthcare Solutions today.

BHM Healthcare Solutions website: http://www.bhmpc.com

Call us 1-888-831-1171

Email us newideas@bhmpc.com

We would like to thank you for reading Part 3 of our Step by Step Guide to Establishing a Medical Home. Please click on the gift box to download a free presentation on Denial Management.

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Patient Centered Medical Homes: What it Takes for PCMH Accreditation Part 10

Posted on February 21, 2013 by Danyell Jones

Patient centered medical homes have become a very hot healthcare topic recently, and while there are multiple recognition, or PCMH/PCHCH PCHCH Accreditation accreditation, programs to choose from there are commonalities in the guidelines of what must be met by any medical home seeking accreditation. So whether your organization is pursuing URAC PCHCH accreditation, TJC accreditation, NCQA Accreditation, or the recently launched CARF accreditation for medical homes, keep these general standards in mind:

10. PCHCH and PCMH Recognition and Accreditaiton Programs must clearly identify requirements for training programs

With the transition to a Medical Home environment, change will come for many practitioners. It is important that during this change, and during accreditation, appropriate training programs are clearly identified and implemented.

As the medical home concept is fairly new, some of the training developed to address knowledge gaps regarding the concept will be new. It is pivotal that the accrediting and recognition bodies are flexible in their acknowledgement of what constitutes appropriate training, while maintaining quality standards on what training is required. For instance, residency programs within the Medical Home environment will need to receive additional clarification and/or explanations in some cases in order to ensure that they appropriately meet training standards for the Medical Home standards.

Training for medical homes should include some of the following core modules: Training on required accreditation standards, HIPAA training, electronic medical record EHR/EMR training, person centered planning training, clinical specialties training. For a full list of required trainings, please contact your accrediting organization:

URAC

NCQA

TJC

CARF

Additionally, a variety of recommended trainings addressing multiple issues are available through the National Center for Medical Home Implementation.

To read the previous articles in this series, please click on the links below:

Part 1 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-1/

Part 2 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-2/

Part 3 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-pcmh-accreditation-part-3/

Part 4 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-4/

Part 5 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-5/

Part 6 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-6/

Part 7 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-7/

Part 8 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-8/

Part 9 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-9/

Please check back with us for Part 11

We would like to offer a free presentation on Electronic Medical Records as a token of our appreciation. Please click on the gift box below.

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A Step-By-Step Guide to Establishing a Patient Centered Medical Home Part 2

Posted on February 21, 2013 by Patrick Christopher

Part two of the seven-part series

Care Partnership Support

Family access and communication

Step 1:

Consider the following aspects of care and communication for how well your practice performs. Craft a practice policy and include this building blocks information in a brochure (see sample) or website which communicates the following:

1. Roles and Responsibilities

Who each clinician at the practice is; any other professional staff and their roles (eg social worker, lactation consultant, child development specialist)? Does your communication express roles the practice encourages patients and families to take? Is there clarity about each clinician and staff person at the practice?

2. Appointments

Think through your options for families; are they helped to make timely appointments? Can they expect a same-day visit? When are better times of day to come in? How can families inform front office staff of their particular needs?

3. Having a Personal Clinician

Can children, youth and families expect a personal clinician? How do they access their personal clinician/team during office hours? What should they do when their personal clinician is away?

4. About Emergencies and Urgent Situations

What are the steps to take for after hour emergencies? For non-emergent issues?

5. Secure Family Friendly Communications

Does the practice communicate variable ways to interact with clinicians and office staff? These may include: PCHCH Accreditation

Phone contact and clear call back expectations
E-mail and stated response time expectations
Interactive Web communications and feedback time standards/expectations
Fax back communications with timely responses
Phone or video conference/appointments

6. Other Special Services

Describe any other special services provided by the office (e.g. practice orientation, care coordination, lactation consultant, in house mental health supports, etc.)

Step 2:

Assess how you promote patient access and quality communication within your medical home.

Communication Checklist

1. Check the communications standards that your practice currently employs. checklist

2. Assignment of patients/families to a personal physician and/or consistent clinical care team

3. Coordination of visits with multiple clinicians or multiple tests on one day

4. Triage process to determine the timing and urgency of visits

5. Schedule patients on the same day that they call

6. Schedule same day appointments using practice triage

7. Schedule same day appointments based upon patient request

8. Offer physician, nurse or other clinical telephone advice during office hours

9. Provide urgent phone advice within a specified time (call back)

10.Physician phone support is available 24/7

11.Provide secure email consultation with specified hours/response time

12.Offer a website with all practice information and policies (Is it interactive?)

13.Provide language support services for patients with limited English

14.Identify health insurance resources for uninsured patients

Step 3:

Quantitatively document the following:

1. Visits with assigned personal clinician for each patient Patient Centered Health Care Home Accreditation
Example: % of patients seen in last month who saw their personal clinician

2. Appointments scheduled to meet the standards in the communication checklist

Examples: Coordinated visits or % patients seen in last month on same day called

3. Response times to meet standards for telephone, email requests (per above)

Examples: Time tracking for last week’s emails and average response time

4. Language services offered for patients with limited English proficiency

Example: % patients assessed for language barrier receiving translation service in last month

Step 4:

Overall, score how well your practice addresses the Communication standards listed in the checklist from Step 2) and note areas for development and necessary action steps.

To read Part 1, please click here: http://www.bhmpc.com/2013/02/a-step-by-step-guide-to-establishing-a-patient-centered-medical-home-part-1/

Please check back with us for Part 3

If you build it they will come.

A step-by-step guide to establishing a Patient Centered Medical Home

Do you have questions or comments about Medical Homes? We invite you to contact the healthcare management consultants at BHM Healthcare Solutions today.

BHM Healthcare Solutions website: http://www.bhmpc.com

Call us 1-888-831-1171

Email us newideas@bhmpc.com

As a token of our appreciation, we would like to offer you a free white paper on Mental Health Parity. Please click on the gift box below.

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Patient Centered Medical Homes: What it Takes for PCMH Accreditation Part 9

Posted on February 20, 2013 by Danyell Jones

Patient centered medical homes have become a very hot healthcare topic recently, and while there are multiple recognition, or PCMH or PCHCH accreditation, programs to choose from there are commonalities in the guidelines of what must be met by any medical home seeking accreditation. So whether your organization is pursuing URAC PCHCH accreditation, TJC accreditation, NCQA Accreditation, or the recently launched CARF accreditation for medical homes, keep these general standards in mind:

9. Care Coordination within the Medical Neighborhood

According to the Joint Principles of the Patient-Centered Medical Home, a Medical Home “is characterized by every patient/family having a personal physician who provides first contact care, understands the health care needs of the patient/family, facilitates planned co-management across the lifespan, and has the resources and capacity to meet the patient/family needs.” This is an important distinction from other programs, as it creates a necessity in the Medical Home environment for organizations to utilize and collaborate with community and external healthcare resources for the total care of the patient.

Medical Homes will be the leaders in personal care coordination for the patients that they serve, and the care being coordinated will not be limited to the care offered within the medical home setting, but will include all care from external practitioners as well as community resources. This care coordination is especially important as individuals transition to different care settings, or when care involves specialists and subspecialists. Examples of this include care coordination for those who are transitioning form pediatric/adolescent care to adult care, and those transitioning across facilities such as from home to a hospital or nursing home setting. Across this continuum of care the Medical Home is expected to lead the charge in healthcare integration and care coordination, and to also ensure that appropriate connections are made between healthcare services and vital community support services.

In this way the Medical Home is envisioned as a hub within a larger “medical neighborhood” which encompasses all providers and resources in a web that maintains connection between all sources of patient guidance and care.

Some important care coordination measures have been put into place across all practices and settings, and may include the following:

URAC Medical Home Accreditation

Patient reported outcomes: Did a patient receive appropriate follow up care? Were the patients needs met? Was care effectively coordinated?
Capturing data and documentation: Did the patients’ preferences align with prescribed interventions and treatments in a standardized way? Were these preferences linked and documented so that it can be ensured that the goal is met?
Continuity within the plan of care: There must be an initial care plan developed, a transmission of the plan between patients and all providers/resources, and a receipt and acknowledgement of acceptance of such a plan
Accessibility of care: Was the care generally accessible to the population that it was intending to serve and can this be documented in a meaningful way? Are there any gaps in care and what steps were taken to resolve these gaps to ensure appropriate whole care for the patient.
Measurements of adverse events: a measurement of adverse events which could be signs of poor care coordination should be established. For instance, hospitalization of patients may be utilized as a care coordination indicator when the patients illness/presentation indicates that they could receive appropriate treatment at a lower level of care (such as in an outpatient setting).

To read the previous articles in this series, please click on the links below.

Part 1 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-1/

Part 2 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-2/

Part 3 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-pcmh-accreditation-part-3/

Part 4 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-4/

Part 5 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-5/

Part 6 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-6/

Part 7 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-7/

Part 8 http://www.bhmpc.com/2013/02/patient-centered-medical-homes-what-it-takes-for-pcmh-accreditation-part-8/

Please check back with us to read Part 10 in our PCMH series.

A Step-By-Step Guide to Establishing a Patient Centered Medical Home Part 1

Posted on February 19, 2013 by Patrick Christopher

Part one of a seven-part series If You Build it They Will Come – A Step by Step Guide to Establishing a Patient Centered Medical home

Summary: How do you build a Medical Home? – Part 1

The Agency for Healthcare Research and Quality, the health services research arm of the U.S. Department of Health and Human Services (HHS), states that the goal of the Patient Centered Medical Home (PCMH) is to “improve health care in America by transforming how primary care is organized and delivered.” To that end, many health practices are now establishing Patient Centered Medical Homes.

The Health Resources and Services Administration (HRSA) states that “today’s medical home is a cultivated partnership between the patient, family, and primary provider in cooperation with specialists and support from the community. The patient/family is the focal point of this model, and the medical home is built around this center.”

Ultimately, the medical home is the model for twenty-first century primary care, with the goal of addressing and integrating high quality health promotion, acute care, and chronic condition management in a planned, coordinated, and family-centered manner.

So where do you begin? This guide, presented in seven installments, offers a step-by-step overview that can help you successfully establishing a Patient Centered Medical Home.

How to Build Your Medical Home

Each of the six Medical Home ‘Building Blocks’ includes content and tools to help you improve care while meeting NCQA Accreditation standards for Patient-Centered Medical Home (PCMH). Tools and related information can be used as they are provided or adapted to meet the needs of your practice.

The Six Essential Building Blocks

1. Care Partnership Support

Empowers children, youth and families to manage their health and healthcare

2. Clinical Care Information

Assures delivery of effective, efficient clinical care & patient self-management support

3. Care Delivery Management

Promotes clinical care that is consistent with patient and family preference and scientific evidence

4. Resources & Linkages

Mobilizes community resources to meet patient and family needs

5. Practice Performance Measurement

Addresses the organization and promotion of safe and high quality care

6. Payment & Finance

Matches quality care and NCQA recognition with payment / solid return on investment

Check back with us to read Part 2 of:

If you build it they will come.

A step-by-step guide to establishing a Patient Centered Medical Home

Do you have questions or comments about Medical Homes? We invite you to contact the NCQA consultants at BHM Healthcare Solutions today. BHM is a healthcare management consulting firm.

BHM Healthcare Solutions website: http://www.bhmpc.com

Email us at: newideas@bhmpc.com

Call us at 1-888-831-1171