Since the Quality Forum was established in 2007, the Patient-Centered Medical Home (PCMH) model of care has been a primary focus of the organization. Today, the Quality Forum team supports physicians across the state that are pursuing recognition as medical homes. According to the Patient-Centered Care Collaborative, providers must provide care that is “patient-centered, comprehensive, team-based, coordinated, accessible and focused on quality and safety.” Practice Consultant Jody Marsh has worked closely with different groups since 2012 as they transform primary and specialty care delivery for their patients. She recently shared her thoughts and experiences related to the PCMH model and the road to practice transformation.
Q. What do you see as the key benefits of PCMH recognition for a practice or group?
A. I think one of the main benefits is that becoming a PCMH creates and strengthens personal relationships between providers and their patients. The process itself builds a foundation within the practice for physicians and their staff to provide coordinated, comprehensive and personalized care plans for their patients. In addition, it also prepares the practice to better adapt to a value-based payment system.
Q. What type of services does the Quality Forum offer to help providers with this transformation?
A. Our team provides on- and off-site consulting/coaching for providers and their staff with regard to PCMH standards set by the National Committee on Quality Assurance (NCQA) as well as practice and workflow redesign, project management and education/outreach. It begins with a practice assessment to evaluate current processes and capabilities. Once the assessment is complete, we work with the office manager to implement necessary policies and procedures. Then, we assist with training the staff to incorporate medical home procedures into their daily operations and ensure that the documentation meets evidence-based standards for preventive, acute and chronic care management. Proper documentation is important because it is sent to NCQA for approval of recognition.
Q. What role does health information technology (IT) play in the PCMH model of care?
A. We have found that a practice’s health IT infrastructure plays a major role in the PCMH transformation process. Some electronic health record (EHR) systems are limited in reporting capabilities, and the practice may not be able to provide every detail on a report requested by NCQA to prove compliance. Because of the Quality Forum’s experience in helping providers implement and meaningfully use EHRs and administering Louisiana’s health information exchange – LaHIE – we can optimize a practice’s EHR utilization and HIE integration.
Q. What do you see as the biggest challenges that practices/groups face when pursuing PCMH recognition?
A. One of the major barriers is that our current health care environment still utilizes a fee-for-service payment model. Physicians and group practices are seeing as many patients as they can in a day, but they aren’t being properly reimbursed for taking the extra time to provide meaningful quality care and to document that care. As we move closer to a value-based payment system, I am hopeful that more and more small practices will turn to practice transformation. Other factors that may pose challenges include staff and patient engagement. The key to successfully working within these two areas lies in empowering the health care team and patients so they better understand the rationale for the coordinated services, the evidence-based care and increased access to the clinical staff.