Patient-Centered Medical Home – A Model

Posted on April 11, 2012 by Kathleen Rand

A Medical Home Model

The medical home model, or simply “medical home,” is built on the idea that patients should develop meaningful relationships with their family care physician. In a medical home, primary care is used to achieve better health outcomes, improved patient experience, more efficient use of resources and ideally, lower overall costs to the healthcare system.

The basic concept of a patient-centered medical home is simple – patients have continuous access to a primary care physician who provides comprehensive and coordinated care for the majority of their health needs. Ideally, a medical home would be responsible for acute care, chronic care, preventive services and end-of-life care. The medical home staff coordinates patient care with specialists, lab and X-ray facilities, hospitals, home care agencies and other healthcare professionals on the patient care team.

Now, with federal healthcare reform, medical homes are fundamentally changing the way care is delivered. There are programs that accredit organizations as a medical home such as URAC PCHCH Accreditation. And as healthcare reform continues to roll out, the prevalence of URAC PCHCH auditors will increase.

The following characteristics are important components of the medical home model.

Patient-centered

The primary care medical home model provides primary healthcare that is relationship-based with an orientation toward the whole person. Medical homes should attempt to provide care in a culturally and linguistically appropriate manner. The patient-centered medical home model recognizes that patients and their families are meant to be members of the team and that they are fully informed when making and carrying out care plans for the patient. Medical homes also support patients in learning to manage and organize their own care at a level at which the patient is comfortable.

Comprehensive care

In order for a medical home to provide comprehensive care, a team of care providers is essential. For example, physicians, advanced practice nurses, physician assistants, nurses, pharmacists, social workers, nutritionists, and care coordinators could all be a part of the “home”.

Some larger medical homes may bring together a diverse team of care providers in-house while smaller practices or those with fewer resources, such as those in rural areas, may build virtual teams by linking themselves and their patients to providers and services in their communities.

Coordinated care

The medical home is accountable for coordinating care across all elements of the broader healthcare system, including specialty care, hospitals, home health care and community services and supports. Care coordination is principally critical during transitions between various sites of care, such as when patients are being discharged from the hospital. Medical home practices also are aadept at communicating openly among patients and families, the medical home, and members of the broader care team.

What To Do, What To Do…

Posted on June 19, 2011 by Kathleen Rand

Hello, again. In this second installment of effective proposal writing, we will examine some essential elements to include in every proposal. We will also discuss a few tips on what not to do.
Proposals are simple in their objective: to secure new business from a client. Whether it is new or add-on services you are selling, whether it is a financial or operational analysis or an overhaul of technology to improve profit margins, the goal of any proposal is to define what matters to your clients and persuade them to act on your sustainable and achievable solution.
The following is a list of items to keep in mind when building a proposal:
• Start with the key points your clients need to know. They will be more likely to continue reading if you begin with options that are relevant to them and their concerns. When your clients know that you understand their situation, the probability of your resolution being considered rises considerably in your favor.
• Illustrate your main points with graphics. Bar graphs, pie charts, flow charts are quite effective at breaking up the page and holding the interest of your client while simultaneously delivering pertinent facts about your company. Most people skim initially rather than read (you’re probably skimming right now, hence the bullet points and short paragraphs) – anything to keep the information flowing and your client hooked.
• Get to the point quickly and keep sentences short and simple. Try to be as clear and as uncomplicated as possible – your clients want to know how you can solve their problem, not that you can use three syllable words in a sentence.
• However, you should always be professional in tone and language: simple does not mean familiar, just straightforward and objective. Descriptions of your process should be described basically and in terms of why they matter to your client.
Some practices to avoid:
• Do not disregard the client’s needs by overusing jargon and acronyms and by focusing on technical details rather than functions and outcomes.
• Stay away from clichés and grandiose claims that are not supported by evidence.
• The overuse of complicated words and sentence structures can have the opposite of the intended effect: a client will stop reading your proposal.
• Do not use words like ‘might’ and ‘could’ – instead words like ‘will’ and ‘can’ are strong, qualifying verbs that let your client know you are responsible and honest.
Well, once again, I thank you for your time. I look forward to next time when we will evaluate the structure of a proposal and the importance of word choice. Until then, be well and be happy…

It’s Okay To Be Different

Posted on June 13, 2011 by Kathleen Rand

Highlighting Organizational Value

As promised, I am going to present the first part of the series about proposal writing: creating a persuasive value statement. What is a value statement, anyway? It is an assertion that differentiates your company from others, that separates your services, your product from the rest.
Very often, a written proposal is the only means of communication you have with the highest levels of your client’s organization. Time is short, and money is tight; proposals not only have to be straightforward and succinct but, more importantly, relevant and specific.

The value statement is essential in that it tells clients how your solution will offer the greatest rate of return for their organization as well as focus on the benefits your services will provide to them. It should be consistently repeated and built upon throughout your proposals and be substantiated with precise examples, evidence and statistics.
Some points to keep in mind when crafting a value proposition:
Focus on a specific measure of value: be clear on what you can do; don’t promise everything to everybody.
Provide substance/proof that backs up statements such as ‘uniquely qualified’ or ‘industry leading’ – otherwise these phrases become empty, invalid and, quite potentially, disqualifying.
Concentrate on responding to your clients’ needs rather than attacking a competitor. Being aware of the competition’s capabilities is a benefit; exploiting their weaknesses could be perceived as a lack of professionalism.
Present a realistic and accurate description of your organization’s scope of work while simultaneously emphasizing how your outcome will offer the greatest amount of gain to your clients.
Avoid placing too much attention on presenting “the cheapest” option to clients – let your services speak for themselves and your cost-effective resolutions will not be overlooked but will stand out instead.
Choosing the right differentiators to include in your value statement (and that will be further clarified within your proposals) is paramount.

Put simply: determine what is important to your client and build your strategy around it. Only include the differentiators that will best meet your client’s goals and support them with evidence like past performance reports, case studies, customer testimonials, project summaries, and a company history.

Thank you for taking the time to review the relevance of building a persuasive value proposition with me. Next time we will examine essential components of winning proposals and some unnecessary elements to stay away from. We look forward to hearing your questions and comments, and best of luck!

Do You Know What I Mean?

Posted on June 2, 2011 by Kathleen Rand

“The difficulty … is not to write but to write what you mean…” Robert Louis Stevenson
Hi, my name is Kathleen Rand, a Senior Proposal Writer with BHM Healthcare Solutions. I am new to the BHM team but not to writing. After I graduated from college, it was common for people to ask me: ‘What are you going to do with an English degree?’ Well, what I did was write…a lot. For over fifteen years and for various organizations, I wrote just about everything from marketing materials to technical manuals, from educational curriculums and student catalogs to policies and procedures, from training documentation to government grant submissions.
It turns out communicating effectively – writing what you mean – is a marketable skill. Even in today’s digital age of texting and smart phones, a well-written presentation or proposal, one that is clear, concise and accurate, cannot be underestimated. It can translate into the close of a deal, the addition of a new client, the reward of state or government monies.
I plan to present a three part series discussing the impact of writing in the business world, more specifically the significance of solid business proposals. I will share tips on how to create a persuasive value statement that will truly differentiate your organization. Further, I will examine the elements essential to successful proposals, and those that aren’t. Finally, I will evaluate the writing process in whole: from defining the basic steps necessary to organize a proposal to assessing the importance of word choice and sentence structure.
I am excited to jump into the BHM blogosphere and look forward to the journey with you.

Increased Adoption of “Never Event” Payment Policies

Posted on February 24, 2010 by Mark Rosenberg

Never events are medical events that are serious, largely preventable, and of concern to both the public and health care providers. The National Quality Forum has identified a list of 28 events such as surgery on the wrong patient, and hospital acquired injuries which are currently identified as never events, but proponents would like to add more events to this list.
The payment policies for never events as set forth by Minnesota, and followed by more and more states recently states that providers will not be reimbursed for procedures and treatments needed as the result of a preventable serious medical event. These events as reported by the CDC account for 2.4 million extra hospital days per year and $9.3 billion dollars in excess charges.
Payers which are adopting these policies include Aetna, CMS, and Blue Cross and Blue Shield, Medicaid (in some states such as VA, and PA). Payers insist that the purpose of these policies is not to save money, but to raise awareness and accountability within hospitals, and help medical establishments prevent serious errors. Increasingly medical “Never Events” are being worked into hospital contracts as they come up for renewal, but not everyone is on board with the adoption of these policies.
Some providers are worried about events which may occur even after they have put significant safe guards in place such as suicide and falls. Others are concerned about payment determination wondering how it will be determined which services are related to “Never Events” and which are not. Patient advocates are also up in arms since if the insurer fails to pay and the hospital disputes the charges the patient may still be responsible. Whatever the outcome of these disputes, “Never Events” policies are catching on and Managed Care Organizations as well as providers should become familiar with these events and the related payment policies going into the future. BHM can help in designing quality improvement programs to decrease the risk of Never Events.