4 Tips to a Successful PCMH Transformation and Recognition

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Transforming primary care practices into patient-centered medical homes and achieving PCMH recognition from the National Committee for Quality Assurance is anything but easy. Many months or even years of work can go into the transition process, and the NCQA application can take more than 300 hours to complete.

The following are four tips on transitioning practices to operate as PCMHs and achieving NCQA recognition, provided by organizations that have made the transformation.

1. Start with a solid foundation. Before deciding to implement the model and seek NCQA recognition, organizations should determine if the philosophy and function of its physician practices are already similar to that of a patient-centered medical home. "Process-wise and patient-centered wise, we were in line with the model," says Christine Grey, COO of Blackstone Valley Community Health Care in Pawtucket and Central Falls, R.I. "Our philosophy was closely aligned with patient-centered medical homes," she says, before the health center sought recognition from the NCQA. BVCH earned recognition in 2011.

Having a strong foundation rooted in patient-centered care is so important, in fact, it was one of the main reasons Methodist Health System in Dallas pursued PCMH recognition from the NCQA to begin with. "We felt our clinics and physicians were, for the most part, already operating as patient-centered medical homes," says Melissa Gerdes, MD, the CMO of outpatient services and accountable care organization strategy at Methodist and medical director of the system's ACO.

2. Find the right electronic health records system. When it comes to offering coordinated, patient-centered care, EHR systems are essential. This holds especially true when becoming a PCMH, since organizations have to provide feedback to care providers and staff as well as be able to complete comprehensive quality reporting. "The selection of robust EHR is crucial," says Ms. Grey.

Ray Lavoie, executive director of BVCHC, is in complete agreement. "I don't think I could stress anything more strongly than having robust HIT for patient-centered medical homes," he says.

3. Get leaders on board. As with any major change, the transformation into a PCMH will go a whole lot smoother with the help of influential and supportive leadership. "It takes the right leadership, motivation and physician involvement" to become a PCMH, says Simon Prince, MD, CEO of Beacon Health Partners in Manhasset, N.Y. "This is a big transition."

Jacqueline Delmont, MD, medical director of Beacon Health Partners, agrees. "The leadership has to believe in the philosophical concept [of patient-based care]," she says. Beacon Health Partners is a Medicare Shared Savings ACO and is in the process of turning 60 of its independent physician offices in to PCMHs.

Dr. Gerdes implemented a leadership team to lead the medical home transformation process at Methodist. "I…recommend having a centralized steering team, which should include physicians, nurses, information technology specialists and a communications coordinator to manage information flow," she says.

4. Don't bite off more than you can chew. Even if practices are already performing like a medical home, making final adjustments and completing the NCQA recognition application can be time consuming and stressful. "It was a much bigger process than what I expected it to be," says John Gardner, Yuma (Colo.) District Hospital CEO, says of adopting the PCMH model at his organization. "One of our problems in the first year was doing everything at once." He recommends taking small steps toward the end goal of patient-centered care so as to not to get overwhelmed by the process.

"I think you need to define the scope of the project," says Dr. Gerdes. "Identify which physicians and clinics will be applying for recognition." Methodist achieved NCQA recognition for 11 of its clinics in 2012 and is seeking recognition for five more of its clinics this year.

Following these four tips can make the path to transforming physician practices into PCMHs and achieving recognition a little smoother for hospitals, health systems and medical groups.

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