pcmh - getting ready for transformation

8/6/2019 PCMH - Getting Ready for Transformation

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Patient Centered Medical Home:Getting Ready for Transformation

Vicki Young, PhDJanet Viars, RN, MPH


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Goals and Objectives

Understand the Application Process

Understand the Recognition ProcessRecognize How Achieving Stage 1 MeaningfulUse Facilitates PCMH RecognitionBecome familiar with the PCDC Assessment

Tool


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The Application Process

PCMH Application


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The Application Process

Practice Specific

An incorporated group of 3 or more clinicians inan office who use the same systems and staff Only clinicians that may be selected as a PersonalClinician are eligible for Recognition

All eligible clinicians practicing together at apractice site must be included in the PCMHapplication


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Application Requirements

Account Information

Demographic information about the practiceNCQA Legal DocumentsPCMH Recognition Program AgreementHIPAA Business Associate Agreement

Practice Site InformationName and address of each site in theorganizationSite contact information


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Application RequirementsMulti-Site Group Self-AssessmentQuestionnaire

Determines the practices eligibility for Multi-SiteSurvey process

Clinician InformationNumber and name of each eligible clinician andlink to the site where they provide care

ApplicationThe practice provides the license number for theSurvey Tool and information about each

site where the survey will be completed


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Application Requirements

Important Conditions

The practice identifies 3 important conditionsInclude chronic or recurring conditions such asasthma, diabetes, CHF, mental health issuesConsiderations in selection include:

x

Prevalence of diagnosisx Importance of care management and self-managementx Availability of evidence-based guidelines


8/19

Practice Readiness Evaluation

Self-Evaluation may be conducted before

submission of survey tool.Estimates the scoreNot viewable by NCQA


9/19

The Recognition Process

PCMH


10/19

PCMH Recognition

Survey submitted on-line

Documentation attached in Document Library and linked to pertinent element60 days for turn-around on approval fromNCQA

Recognized for a 3-year period


11/19

Meaningful Use: The Foundation of aMedical Home


12/19

Stage 1 Meaningful Use and PCMH

Review of Meaningful Use

Reporting for 90 day period during first year andfull year for subsequent yearsMust Meet Objectives and Clinical Quality Measures

To meet objectives must report on 15 coreobjectives and 5 out of 10 from menu setMust report on 6 Clinical Quality Measures

x 3 Core Measuresx 3 Additional Measures


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PCMH-M/U RelationshipsPCMH M/U

All of the many thingsthat people need to doin order to assurehigh quality patient-

centric care in asustainable mannerand at a cost that isaffordable to society.

All of the many thingsthat computers needto do to store,organize, and manage

information in a way that supports peoplein the enterprise of healthcare.

Jeff Hummell, MD, Qualis Health


14/19

PCMH and Meaningful Use MeasuresPCMH Meaningful Use

Enhance Access andContinuity

Identify and ManagePatient PopulationsPlan and Manage CareProvide Self-Care

Support andCommunity Resources

Track and CoordinateCare

Measure and ImprovePerformance

Improve quality,efficiency and reduce

health disparitiesEngage patient &families

Improve CareCoordination

Improve population &public health

Ensure privacy andsecurity


15/19

PCMH/MU Clinical Quality Measures/UDS

:Triple Dip!!!PCMH M/U UDS

(2011 measures)

3 ImportantConditionsExamples:

Unhealthy Behaviors -Smoking or Obesity

Hypertension orCHF

Core SetHypertensionTobacco

assessment andintervention Adult weight

screening

Proposedand/or Revised Adult weight

screening and F/UTobacco

assessment andintervention


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PCMH/MU Clinical Quality Measures/UD STriple Dip!!!

PCMH M/U UDS(2011 measures)

3 Important

ConditionsExamples: AsthmaUnhealthy

behavior obesity (children)

Alt. Core Set

Children weightassessment andcounseling

Flu vaccine forages > 50

Childhoodimmunizationstatus

Proposed or

RevisedChildren weight

assessment andcounseling Asthma


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Next StepsJune 10, 2011 - Medical Directors Preconference atthe Clinical Network Retreat

June 11, 2011 Breakout Session at ClinicalNetwork Retreat Webinar Series Deep Dive into Standards

June 29 Standards 1 and 2August 2 Standards 3 and 4August 24 Standards 5 and 6September 28 - Pulling it all together

Fall 2011 Begin first collaborative toward PCMHRecognition


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PCDC Assessment Tool


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PCDC Assessment Tool

PCDC Assessment Tool for NCQA 2011Standards