has been wonderful having the assistance of the Quality Forum staff in the PCMH
transformation process. This is something we were committed to accomplishing
for our patients, and we first attempted the recognition process one year ago.
We found it very difficult and finally decided to simply put it off until we
were able to connect with the PCMH services available through the Quality
Forum. It’s been a gradual process, but our patients have indicated they like
what we’re doing. They appreciate the improved quality of care they’re
receiving, and that’s our most important goal: to give them the best care
Kramer, Officer Manager, St. James
Primary Care, Gramercy, La.
Medical Home: An Overview
The Patient-Centered Medical Home (PCMH)
model of care has existed in the U.S. for more than 40 years, having been first
introduced by the American Academy of Pediatrics (AAP) in 1967 as a central
location for the archival of children’s medical records.
Over the past four decades, however, the
PMCH model has evolved into a model of care in which patients have a direct
relationship with a health care provider who coordinates a cooperative team of
health care professionals, takes collective responsibility for the care
provided to the patient and arranges for appropriate care with other qualified
providers as needed. This innovative care model is founded in the principles of
health information technology (IT) and health information exchanges (HIEs) and
other means designed to ensure that patients receive the best care possible
when and where they need it.
Today, the PCMH model of care is
considered one of the most promising strategies for the improvement of health
care quality, decreased health care costs and enhanced patient-provider
relationships in the U.S. Jointly endorsed by the AAP, American Academy of
Family Physicians (AFP), American College of Physicians (ACP) and the American
Osteopathic Association, the model continues to grow in popularity and
currently includes recognized practices in nearly every state, including
Since 2008, the Louisiana Health Care
Quality Forum has championed the patient-centered medical home (PCMH) model of
care because of its potential to enhance the quality of care and access to care
for Louisiana residents. The model focuses on four critical principles: access
to a personal health care provider who leads the care team within a medical
practice; a whole-person orientation to providing patient care; integrated and
coordinated care; and dual focuses on quality and safety.
PCMH Right For Your Practice?
Because of its individualized approach,
a patient-centered medical home is designed to help your practice offer many
benefits to your patients, including:
· Enhanced access to health care
· Improved health outcomes
· Improved patient experiences
· Increased health care provider satisfaction
· Reduced unnecessary medical costs
In addition, because the PCMH model of
care is designed to reduce the unnecessary and expensive use of hospitals and
emergency rooms, the model meets the goals of the Institute for Healthcare
Improvement’s Triple Aim.
PCMH may also help your practice achieve
a greater level of efficiency because it utilizes a team-based approach to
patient care, which allows you to increase the amount of time you can spend
with your patients while reducing your overall caseload.
Your practice may benefit, too, from the
growing support of major health plans across the nation for the PCMH model.
These health plans are increasingly developing and offering reimbursement
incentives to medical practices that achieve PCMH recognition.
Will Your Patients Benefit From PCMH Care?
Your patients will find that they have
more one-on-one time with you, which provides them with the opportunity to ask
more questions and share more concerns about their health and which gives you
the opportunity to more fully respond to their questions and concerns.
In addition, the team-based approach of
PCMH gives your patients access to a team of providers such as nurse health
educators, optometrists, podiatrists, pharmacists, nutritionists, dentists and
mental health specialists. This approach allows you to empower your patients
with a wide range of resources that can help them make more informed decisions
about their health.
Your Practice Eligible To Participate In A PCMH?
Currently, PCMH-eligible practices
· Family Practitioners
· General Practitioners
· Nurse Practitioner-led practices
· Nurse Practitioners and Physician Assistants
o Eligible to
be listed as part of a recognized practice if managing their own panel of
and Health IT: What’s The Connection?
Recognition standards for PCMH practices
include an emphasis on health information technology (IT) such as electronic
record keeping, electronic disease registries, electronic prescribing and
electronic communication with patients.
These health IT standards are designed
to support high quality patient care by helping practices capture accurate patient
information while providing the practice with timely data on outcome measures.
This data can be used to review trends such as visit frequency, medications and
dosages, treatment changes and patient progress among population groups.
Practices that are already utilizing
health IT in patient care are well-positioned to move forward with PCMH program
Can The Quality Forum Assist My Practice In Becoming A PCMH?
The Quality Forum was approved as a
‘Sponsoring Organization’ in July 2012 by the National Committee for Quality
Assurance (NCQA). This designation enables the organization to extend special
assistance to medical practices seeking NCQA recognition as PCMHs, and allows
it to accelerate feedback to and from the NCQA regarding practice recognition
questions. The Quality Forum assists practices with NCQA applications for
The Quality Forum also assists practices
in achieving PCMH recognition from The Joint Commission, an independent,
not-for-profit organization that certifies more than 20,000 health care organizations
and programs in the U.S., as well as other accrediting bodies.
In addition, the Quality Forum can
assist practices seeking accreditation from the NCQA Patient-Centered Specialty
Program (PCSP), the NCQA Back Pain Recognition Program, the NCQA Heart/Stroke
Recognition Program and the Diabetes Recognition Programs.
To aid providers in the PCMH
transformation process, the Quality Forum offers several other key specialized
· PCMH assessment
· Practice and workflow redesign
· Project management
· Education and outreach
· Quality assurance and quality improvement plan
· Templates for policies and procedures
· Health coach services (on-site and virtual)
In addition, because health IT is a key
tenet of the PCMH model, the Quality Forum has also integrated PCMH support
with the services of the Louisiana Health Information Technology Resource
Center, which aids health care providers in the transition from paper-based
medical records to electronic health records (EHRs).