patient-centered medical/health home initiative update
TRANSCRIPT
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Patient-Centered Medical/Health
Home Initiative Update
Office of Quality and Data Bureau of Primary Health Care
Health Resources Services Administration June 16, 2014
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Agenda
1. PCMH Achievements 2. Health Center PCMH Experience 3. Upcoming Timelines 4. Helpful Resources 5. Next Steps
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Overview
• DHHS Goal – FY 15 goal is 55% of health centers with PCMH
recognition • HRSA Activities
– FY 2011 Supplemental Funding – 904 health centers – FY 2012 Supplemental Funding – 810 health centers
• Ongoing support for PCMH recognition/certification – AAAHC, NCQA, TJC – MN or OR state-based recognition programs – CMS FQHC APCP Demonstration – Health Center Quality Awards
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Accomplishments
1% 4% 13%
33%
44%
0%
10%
20%
30%
40%
50%
60%
70%
80%
FY 2010 FY 2011 FY 2012 FY 2013 Current
Health Center PCMH Recognition 2010-present
2015 Goal=55%
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PCMH Recognition
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Health Center Experience
• Importance of engaged leadership
• Equipping and utilizing the team
• Competing Priorities − Increasing trend of surveys denied and unsubmitted
• PCMH as a framework to guide all work, not “just another project”
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Health Center Strengths
• 1D - Continuity of Provider
• 1F - Culturally and Linguistically Appropriate Services
• 3A - Implement Evidence-Based Guidelines
• 3E - Use Electronic Prescribing
• 6C and 6D - Implement and Demonstrate Continuous Quality Improvement
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Areas for Improvement
• 1A – Access During Office Hours • 1C – Electronic Access • 1E – Medical Home Responsibilities • 3B – Identify High-Risk Patients • 3D – Medication Management • 4B – Provide Referrals to Community Resources • 5A – Test Tracking and Follow-Up • 6B – Patient Experience Data • 6E – Report Performance • 6F – Report Data Externally
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Tips for Success
• Plan ahead • Transformation takes time • Leverage all available support
– Primary Care Associations − Over 100 PCMH coaches, many are NCQA content experts
– Health Center Controlled Networks – Regional Extension Centers – EHR User groups – Local and state initiatives (QIOs, payers etc.) – National Association of Community Health Centers’ PCMH-Institute
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Upcoming Timelines
• 2015 Goal = 55% PCMH recognition
• NCQA and TJC 2014 PCMH standards updates
• CMS FQHC APCP Demonstration
• PCMH and Quality Improvement Awards
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NCQA PCMH 2011 Renewals and Add-Ons
• Renewal Surveys – Streamlined process to allow organizations to maintain recognition
for another 3-year period. – PCMH Recognition expiration dates of 2014/2015 are encouraged
to renew under 2011 standards
• Add-On Surveys – Allow organizations to increase level of recognition – Sites denied recognition may also submit an add-on survey – Does not extend the recognition period. – Will be accepted until March 2018 to increase recognition level
(level 2 to level 3)
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NCQA PCMH Dates to Remember
• June 30, 2014 – Last day to purchase 2011 initial and renewal survey tools from NCQA.
• March 31, 2015 – Last day to submit 2011 initial and renewal survey tools to NCQA for review
• March 31, 2018 – Last day to submit 2011 add-on survey tool to NCQA for review
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2014 NCQA PCMH Standards
• Released March 2014 – More emphasis on team-based care – Care Management focus with high need populations – Alignment of quality improvement activities with the
“triple aim” – cost, quality, patient experience – Further integrates behavioral health into the primary care
setting – Sustained practice transformation
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The Joint Commission
• PCMH certification available as add-on to TJC accreditation
• 2014 Revised PCMH Standards available July 1, 2014 – Aligned with CMS Meaningful Use Stage 2 requirements – Process and infrastructure improvements necessary to
improve health care quality, efficiency, and patient safety.
– Team-based care including availability of physician when required
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CMS FQHC APCP Demonstration
• 467 participating health center sites – Goal to achieve NCQA PCMH Level 3 recognition
• 3-year demonstration project ending 10/31/14 – August 1, 2014 – Deadline to submit surveys to NCQA to meet goals
of demo – October 31, 2014 – Deadline for NCQA Level 3 recognition;
demonstration ends
• Technical assistance resources – State PCA Coaches – CMS Collaboration site
o https://collaboration.cms.gov
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Health Center Quality Awards
PCMH Recognition Award – Health centers recognized as PCMHs by July 1st are eligible – Annual award added to base adjustment for health centers that
maintain PCMH recognition
Quality Improvement Award – Based on 2013 UDS submissions – Four categories:
• Top Reporters – reports on whole universe using EHR • Top Improvers – compared to self • High Performers – compared to peers using quartile rankings • Clinical Excellence – highest performers compared to national
standards in key clinical areas
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Next Steps
• Improving systems and infrastructure to support growing PCMH program
• Enhancing TA to support ongoing practice transformation • Upcoming webinars:
– 2014 PCMH Standards Update – PCA/HCCN office hours – Clinician Leaders’ Forum – PCMH and Quality Incentive Awards
• Health Center Quality Awards – July 2014 - Opportunity to review and update PCMH recognition
data – Late summer 2014 – anticipated awards
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Resources
• HRSA/BPHC PCMH Initiative – http://bphc.hrsa.gov/policiesregulations/policies/pal201101.html
• HRSA/BPHC Accreditation Initiative – http://bphc.hrsa.gov/policiesregulations/accreditation.html
• Primary Care Associations – http://bphc.hrsa.gov/technicalassistance/partnerlinks/associations.ht
ml
• Health Center Controlled Networks – http://www.hrsa.gov/healthit/toolbox/HealthITAdoptiontoolbox/Oppor
tunitiesCollaboration/controlnetworks.html
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More Resources
• National Committee for Quality Assurance (NCQA) – http://www.ncqa.org
• The Joint Commission (TJC) – http://www.jointcommission.org
• American Association for Ambulatory Health Care (AAAHC) – http://www.aaahc.org
• AHRQ PCMH Resource Center – http://pcmh.ahrq.gov/
• Safety Net Medical Home Initiative – http://www.safetynetmedicalhome.org/
• National Association of PCMH-I – [email protected]
• Risk Management/Patient Safety Resources – http://www.ecri.org/clinical_RM_program
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Contact Information
For inquires related to NCQA PCMH recognition: [email protected] For inquiries related to TJC/AAAHC accreditation: [email protected]
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Thank you!
Questions?
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