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During this Insights webinar we discussed the topic of Patient Centered Medical Home (PCMH). This discussion will take you through the current landscape under the 2011 standards and also provide an overall look as a nation provides insight into states that are comprised of more Public PCMH status, as opposed to Private PCMH status.
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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