PATIENT CENTEREDMEDICAL HOME

(PCMH)Allison Palmer, CHES, PCMH CCE

SHIP Quality Improvement Specialist

OBJECTIVES• PCMH background and overview

• PCMH Transformation

• PCMH Recognition

• ChangeBarriers

Benefits

Succeed

PCPCC 2015. All rights reserved.Source: www.ahrq.gov

Defining the Medical HomeThe medical home is an approach to primary care that is:

Committed to Quality and SafetyMaximizes use of health IT,

decision support and other tools

AccessibleCare is delivered with short

waiting times, 24/7 access and extended in-person hours

CoordinatedCare is organized across

the ‘medical neighborhood’

ComprehensiveWhole-person care provided by a team

Person-Centered Supports patients and families in managing

decisions and care plans

4

HISTORY OF PCMH1967

Concept first developed and introduced by

American Academy of Pediatrics

(AAP)

1992 AAP publishes

a policy statement

defining the medical home

2002 AAP expands

their definition of the medical

home

2007Joint Principles

of PCMH are published2008

2008Launch

medical home accreditation

programs

2011ACA is signed by President

Obama

TodayAdvancing

PCMH recognition

programs and value based payments

Region 6 Cohort 2

Bear Lake Community Health Center, Montpelier

Bingham: First Choice, Blackfoot

Bingham: Cedar Creek, Blackfoot

Bingham: Idaho Physicians Clinic, Blackfoot

Health West: Downey

Health West: ISU Family Medicine

Health West: Lava Hot Springs

Physicians Immediate Care, Chubbuck

Physicians Immediate Care, Pocatello

State of the PCMH Practices selected for Model Test Years 1 and 2 Implementation

Region 6 Cohort 1

Health West - Aberdeen Clinic

Health West - American Falls Clinic

Health West - Pocatello Clinic

Not-tsoo Gah-nee Indian Health Center

Pocatello Children's Clinic

Portneuf Primary Care and Behavioral Health Clinic

RECOGNITION

WHAT IS TRANSFORMATION

TRANSFORMATION

• “A thorough or dramatic change in form or appearance or character”

PCMH TRANSFORMATION

• A thorough or dramatic change in form or appearance or character Structure

Workflows

Policies & Procedures

• Continuous journey

CHANGING TO A NEW PARADIGMToday Future

Treating Sickness / Episodic Managing PopulationsFragmented Care Collaborative CareSpecialty Driven Primary Care Driven

Isolated Patient Files Integrated Electronic RecordsUtilization Management Evidence-Based Medicine

Fee for Service Shared Risk/RewardPayment for Volume Payment for Value

Adversarial Payer-Provider Relations

Cooperative Payer-Provider Relations

“Everyone For Themselves” Joint Contracting

HOW DO WE REACT TO CHANGE?

CHANGE• Difficult

• Time

• Dedication

• Communication

• Resilience EHR barriers

Organizational changes

WHY CHANGE?

•External pressures

•Performance gaps

•Keep up with technology/advancements

•Productivity

•Opportunity

CHANGE IS GOOD!!!

•Growth

•Outside of comfort zone

•Flexible, adaptable, thrive

•Triple Aim/Quadruple Aim

•Benefits: Practices

Clinicians

Patients

BENEFITS TO PRACTICES• Align with where health care is headed

• Integrate services across your entire organization

• Support revenue growth

• Improve your practice

• Keep staff happy

• Market your practice

BENEFITS TO CLINICIANS• Earn higher reimbursement

• Succeed in Medicare Access & CHIP Reauthorization Act (MACRA) Merit Based Incentive Payment

System

Advanced Payment Models

• Earn Maintenance of Certification (MOC) credits

• Focus on patient care

BENEFITS TO PATIENTS• Better communication

• Better management of chronic conditions

• Have a better experience

• Stay healthy!

QUESTIONS

RESOURCES• http://smallbusiness.chron.com/change-important-organization-728.html• https://in.kaizen.com/blog/post/2015/06/02/9-reasons-organizations-need-to-change.html• http://www.ncqa.org/programs/recognition/practices/patient-centered-medical-home-pcmh/why-pcmh/pcmh-

benefits/benefits-to-clinicians-practices-patients• https://www.bing.com/images/search?view=detailV2&ccid=%2bZHcYFYX&id=1567221A4D88FAF51CD447E3FD853DFFA80D9

D38&thid=OIP.-ZHcYFYXEB2cNh7dN7o1_gEsDu&q=question&simid=607986449796173427&selectedIndex=87&ajaxhist=0https://www.bing.com/images/search?view=detailV2&ccid=NlVDxtoF&id=AF5F329B95881C812AA4A2D455A88D32858F0D9B&thid=OIP.NlVDxtoFDVHVNuYNKhvx1gEsCi&q=change&simid=608004200907146293&selectedIndex=28&ajaxhist=0

• https://www.bing.com/images/search?view=detailV2&ccid=f%2bTYrsjD&id=AA4AB476B2BBF0743E87C0AD6F8E9FF0F5E8C577&thid=OIP.f-TYrsjDXIkM7VztPXv7ngEsCo&q=tornado&simid=608055216494084101&selectedIndex=25&ajaxhist=0

• https://www.bing.com/images/search?view=detailV2&ccid=t0DmvLYX&id=B7B85BD88B394CF153BF4E97C85A8B32D2E53FC1&thid=OIP.t0DmvLYXrWU77TE7c2g6CgEsDQ&q=angry&simid=608021050015678913&selectedIndex=4&ajaxhist=0

• https://www.bing.com/images/search?view=detailV2&ccid=PX%2fChJK4&id=DA8522FFD567EBBFF30EAE2F1F776084E1827C46&thid=OIP.PX_ChJK42uqA8lXRFXmKEQEJEs&q=Confused+Animal&simid=608003853027773963&selectedIndex=0&ajaxhist=0

• https://www.bing.com/images/search?view=detailV2&ccid=TdmTf69y&id=DFF56A8F0E59DDB9882A8537659ED41F539D19F1&thid=OIP.TdmTf69yNYOUZsw8v0pBFwEsDH&q=dont+care&simid=608025125950588547&selectedIndex=14&ajaxhist=0

• http://www.pcpci.org/• http://www.aaahc.org/• https://www.jointcommission.org/• https://www.urac.org• /https://medicalhomeinfo.aap.org/overview/Pages/Whatisthemedicalhome.aspx• https://www.pcpcc.org/content/history-0• https://www.bing.com/images/search?view=detailV2&ccid=et%2b2WOEx&id=CDB3EFCCC32A532DD77F17475D3504634D92

CC74&thid=OIP.et-2WOExXzD0qYZG0bI1JAEsDH&q=Teamwork&simid=608019460894163590&selectedIndex=66&ajaxhist=0• https://www.bing.com/images/search?view=detailV2&ccid=AcPKRgP4&id=F157CC465FAB10D2FF38211A07DED747FB448E60

&thid=OIP.AcPKRgP4t9RmC6hloODuxAEsDw&q=Teamwork&simid=608006515875647347&selectedIndex=4&ajaxhist=0• https://www.bing.com/images/search?view=detailV2&ccid=mUibOMiM&id=BD4D5F4AC266A5DFDD343BEDE5F76EA6261B83

A6&thid=OIP.mUibOMiMZnHIIpg2eylUMwEsDF&q=Teamwork&simid=607993510733546461&selectedIndex=9&ajaxhist=0

http://smallbusiness.chron.com/change-important-organization-728.htmlhttps://in.kaizen.com/blog/post/2015/06/02/9-reasons-organizations-need-to-change.htmlhttp://www.ncqa.org/programs/recognition/practices/patient-centered-medical-home-pcmh/why-pcmh/pcmh-benefits/benefits-to-clinicians-practices-patientshttps://www.bing.com/images/search?view=detailV2&ccid=%2bZHcYFYX&id=1567221A4D88FAF51CD447E3FD853DFFA80D9D38&thid=OIP.-ZHcYFYXEB2cNh7dN7o1_gEsDu&q=question&simid=607986449796173427&selectedIndex=87&ajaxhist=0https://www.bing.com/images/search?view=detailV2&ccid=NlVDxtoF&id=AF5F329B95881C812AA4A2D455A88D32858F0D9B&thid=OIP.NlVDxtoFDVHVNuYNKhvx1gEsCi&q=change&simid=608004200907146293&selectedIndex=28&ajaxhist=0https://www.bing.com/images/search?view=detailV2&ccid=f%2bTYrsjD&id=AA4AB476B2BBF0743E87C0AD6F8E9FF0F5E8C577&thid=OIP.f-TYrsjDXIkM7VztPXv7ngEsCo&q=tornado&simid=608055216494084101&selectedIndex=25&ajaxhist=0https://www.bing.com/images/search?view=detailV2&ccid=t0DmvLYX&id=B7B85BD88B394CF153BF4E97C85A8B32D2E53FC1&thid=OIP.t0DmvLYXrWU77TE7c2g6CgEsDQ&q=angry&simid=608021050015678913&selectedIndex=4&ajaxhist=0https://www.bing.com/images/search?view=detailV2&ccid=PX/ChJK4&id=DA8522FFD567EBBFF30EAE2F1F776084E1827C46&thid=OIP.PX_ChJK42uqA8lXRFXmKEQEJEs&q=Confused+Animal&simid=608003853027773963&selectedIndex=0&ajaxhist=0https://www.bing.com/images/search?view=detailV2&ccid=TdmTf69y&id=DFF56A8F0E59DDB9882A8537659ED41F539D19F1&thid=OIP.TdmTf69yNYOUZsw8v0pBFwEsDH&q=dont+care&simid=608025125950588547&selectedIndex=14&ajaxhist=0http://www.pcpci.org/http://www.aaahc.org/https://www.jointcommission.org/https://www.urac.org/https://www.urac.org/https://medicalhomeinfo.aap.org/overview/Pages/Whatisthemedicalhome.aspxhttps://www.pcpcc.org/content/history-0https://www.bing.com/images/search?view=detailV2&ccid=et%2b2WOEx&id=CDB3EFCCC32A532DD77F17475D3504634D92CC74&thid=OIP.et-2WOExXzD0qYZG0bI1JAEsDH&q=Teamwork&simid=608019460894163590&selectedIndex=66&ajaxhist=0https://www.bing.com/images/search?view=detailV2&ccid=AcPKRgP4&id=F157CC465FAB10D2FF38211A07DED747FB448E60&thid=OIP.AcPKRgP4t9RmC6hloODuxAEsDw&q=Teamwork&simid=608006515875647347&selectedIndex=4&ajaxhist=0https://www.bing.com/images/search?view=detailV2&ccid=mUibOMiM&id=BD4D5F4AC266A5DFDD343BEDE5F76EA6261B83A6&thid=OIP.mUibOMiMZnHIIpg2eylUMwEsDF&q=Teamwork&simid=607993510733546461&selectedIndex=9&ajaxhist=0

SHIP CREWRHONDA D’AMICO, SHIP PROGRAM MANAGERLAURIE BRENCHLEY, SHIP ADMINISTRATIVE ASSISTANTALLISON PALMER, SHIP QA/QI SPECIALIST

Patient Centered Medical Home �(PCMH)ObjectivesSlide Number 3Defining the Medical HomeHistory of PCMHState of the PCMH RecognitionWhat is TransformationChanging to a new ParadigmHow do we react to change?Slide Number 11ChangeWhy Change?Benefits to PracticesBenefits to CliniciansBenefits to PatientsSlide Number 17QuestionsResources����SHIP Crew��Rhonda D’Amico, SHIP Program Manager�Laurie Brenchley, SHIP Administrative Assistant�Allison Palmer, SHIP QA/QI Specialist��