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��