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Patient-Centered Medical Home (PCMH)

Examining the PCMH model

Brittany Abrams

on 26 October 2016

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Transcript of Patient-Centered Medical Home (PCMH)

What is PCMH?
Strengthens clinician-patient-family relationship
Episodic → Coordinated
Personalized, coordinated, effective, efficient
Increased accessibility, communication
Concierge medical service
Opportunity to enhance current operations
Emphasize Mission/Vision
Many of the requirements are currently being practiced
Standardizing operations

PCMH 1: Patient-Centered Access
PCMH 2: Team Based Care
PCMH 3: Population Health Management
PCMH 4: Care Management and Support
PCMH 5: Care Coordination and Transitions
PCMH 6: Performance Measurement and Quality Improvement
Must-Pass Elements
Element 1A: Patient-Centered Access
Element 2D: The Practice Team
Element 3D: Use Data for Population Management
Element 4B: Care Planning and Self-Care Support
Element 5B: Referral Tracking and Follow-Up
Element 6D: Implement Continuous Quality Improvement

Must submit and have ONE recognized site within twelve months of corporate survey decision
Recognition for all sites begins when first site is recognized
Recognition expires after three (3) years
Individual sits can apply any time within 3 years
Expiration date based on first recognized site

- Procedures
- Contract (POSA)
Corporate/Multi-site Application
$1360 for the Survey Tool
$4900 for 16-19 sites
$275 for each clinician at each site
For more than 12 clinicians, the cost is $3300
$27.50 for each additional clinician
~$58,635 Total

Application Fees
System requirement
- Patient Registry
- Satisfaction Surveys
Reporting and Data Collection
Quality Improvement
Care Management teams based on NCQA Standard
Empanelment and Non-Utilizers

Payor incentives
Patient Satisfaction
Enhance current operations
Enhanced access and continuity
Decrease Outpatient Emergency Department visits

Full transcript