Pa#ent-‐Centered Medical Home (PCMH) Wednesday, June 25, 2014
Disclaimer: Nothing that we are sharing is intended as legally binding or prescrip7ve advice. This presenta7on is a synthesis of publically available informa7on and best prac7ces.
• Provide updated informa0on on current landscape and recent changes
• Build on January 2014 Insights webinar -‐“PCMH Overview”
• Summary of NCQA 2014 Standards
• Present advantages of vendor pre-‐valida0on, mul0-‐site applica0ons, alignment of measures
PCMH -‐ Update
Medical Home Recogni0on • NCQA
– Pa0ent-‐Centered Medical Home 2011 and Proposed 2014 Standards • AAAHC
– 2011 Medical Home Standards • Joint Commission Primary Care Medical Home
– 2011 and 2014 Standards and Elements of Performance • URAC
– Pa0ent-‐Centered Medical Home Prac0ce (PCMH) Cer0fica0on Standard V1.1
• Others – Private Insurers, Employers, State En00es
• MGMA January 30, 2014 – Comparison of the Na0onal PCMH Accredita0on and Recogni0on Programs Report
Financial Incen0ves
NCQA Vendor Prevalida0on
• Evalua0on can result in approved automa0c credit scores transferable to eligible prac0ces submiWng for Recogni0on
• Reduced documenta0on support, saving 0me and allevia0ng some administra0ve burden mee0ng PCMH survey requirements
• Contact NCQA for current list of prevalida0ons
Mul0 Site & Mul0 Specialty
• Op0on for 3+ prac0ce sites/specialty organiza0ons sharing EHR with standard policies and procedures
• Sites not required to submit together or be same specialty – Can organiza0on sign one agreement to cover all sites/
special0es? – Currently (for min 3 months), do all prac0ce sites/special0es
share, and use EHR the same way, to document pa0ent care?
– Do all operate under the same policies and procedures? • Complete same Survey Tools as individual applicants but
avoid repea0ng responses and documenta0on
NCQA 2014 Standards
• Retains strengths of earlier NCQA standards, including alignment with Meaningful Use Stage 2
• What’s new: – Integra0on of behavioral health – Care management focus on high-‐need popula0ons – Enhanced emphasis on team-‐based care
– Alignment of improvement efforts with the triple aim – Sustained transforma0on
NCQA Dates: New PCMH Version and Re0rement of PCMH 2011
• March 24, 2014 -‐ New Version survey tools made available
• June 30, 2014 -‐ last date to purchase PMCH 2011 survey tools • December 31, 2014 -‐ suggested last date to submit PCMH
2011 corporate survey tools for mul0-‐site submission
• Submit either PCMH 2011 or New Version between March 24, 2014-‐ March 31, 2015
• Pa0ent-‐Centered Medical Home (PCMH) 2011 standards with NCQA’s Pa0ent-‐Centered Medical Home (PCMH) 2014 standards iden0fies same or similar items and calls out differences when they exist
NCQA 2014 Standards & Stage 2 MU
#1 Pa0ent Centered Access – Element A: Pa0ent-‐Centered Appointment Access – Element B: 24/7 Access to Clinical Advice – Element C: Electronic Access
#2 Team Based Care – Element A: Con0nuity – Element B: Medical Home Responsibili0es – Element C: Culturally and Linguis0cally Appropriate Services
– Element D: The Prac0ce Team
NCQA 2014 Standards & Stage 2 MU
#3 Popula0on Health Management – Element A: Pa0ent Informa0on
– Element B: Clinical Data – Element C: Comprehensive Health Assessment – Element D: Use Data for Popula0on Management
– Element E: Implement Evidence-‐Based Decision Support
NCQA 2014 Standards & Stage 2 MU
#4 Care Management & Support – Element A: Iden0fy Pa0ents for Care Management
– Element B: Care Planning and Self-‐Care Support – Element C: Medica0on Management – Element D: Use Electronic Prescribing
– Element E: Support Self-‐ Care and Shared Decision Making
NCQA 2014 Standards & Stage 2 MU
#5 Care Coordina0on & Care Transi0ons – Element A: Test Tracking and Follow-‐Up – Element B: Referral Tracking and Follow-‐Up – Element C: Coordinate Care Transi0ons
# 6 Performance Measurement & Quality Improvement – Element A: Measure Clinical Quality Performance – Element B: Measure Resource Use and Care Coordina0on – Element C: Measure Pa0ent/Family Experience – Element D: Implement Con0nuous Quality Improvement – Element F: Report Performance – Element G: Use Cer0fied EHR Technology
NCQA Training Introduc0on to PCMH: Founda0onal Concepts of the Medical Home August 19 -‐20, 2014 | Washington, DC
New! Advanced PCMH 2014 August 21 | Washington, DC
Intro to PCMH: Founda0onal Concepts of the Medical Home-‐ NEW Updated 2014 September 30-‐ October 1 | CharloNe, NC
Advanced PCMH 2014: Mastering the Medical Home Transforma0on October 2 | CharloNe, NC
Introduc0on to Pa0ent-‐Centered Specialty Prac0ces October 22 | Washington, DC
Introduc0on to PCMH: Founda0onal Concepts of Medical Home -‐ NEW Updated 2014 November 18 – November 19 | San Francisco, CA
Advanced Topics in PCMH -‐ NEW Updated 2014 Product November 20 | San Francisco, CA
What’s Next?
July 9, 2014 –
Data Conversion and Database Merges
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