The patient-centered medical home — a model of providing primary care in a physician office that involves care teams and health coaches — has spread far and wide in the last five years. Numbers to prove it: There are now more than 6,000 physician practices that have received recognition from the National Committee for Quality Assurance as a PCMH. When NCQA's PCMH program started in 2008, just 38 practices were PCMHs.
"The growth of PCMH recognition shows practices are serious about providing the best kind of care for their patients. Patients get the access, personal attention and care coordination from their primary doctor that they need and deserve," Margaret O'Kane, president of the NCQA, said in an earlier news release.
Because of the desire to provide patients with the most attentive care possible, many family practice physicians in California wanted their practices to become PCMHs, according to Mark Dressner, MD, president of the California Academy of Family Physicians. However, making the transformation from a traditional physician practice into a medical home is not an easy transition, and many of CAFP's 8,500 members turned to the academy for help.
"The main responsibility of CAFP is to help with [members'] practice management issues," Dr. Dressner says. "Members wanted to change, but didn't know how." So, the organization began looking at ways to help train practices to become patient-centered medical homes and become recognized as such by the NCQA.
The partnership
Dr. Dressner and the CAFP turned to two other organizations to get the help its members were requesting: Earlier in 2013, the organization struck a partnership with Arcadia Solutions, a healthcare transformation solutions provider, and the California Primary Care Association to assist CAFP's members in their journey to patient-centered medical home status.
Arcadia Solutions and CPCA had a pre-established partnership, in which they developed a Health Home Accelerator Program, which provides tools to physicians during their PCMH transformation. CAFP was able to give its members access to the program through its new relationships with Arcadia and the CPCA.
The accelerator program "bridges the gap to provide the hands-on [training] and coaching to understand operating procedures and get set up to shift the model of care," explains Kathleen Palinski, principal at Arcadia Solutions.
The program includes an online portal, which connects practices with a library of PCMH documentation guides and provides direct access with the NCQA, allowing the practice to easily manage their application for PCMH recognition. Practices in the program also have access to clinical coaches, who, along with the technology, can help tailor a "transformation roadmap" that outlines the steps necessary to achieve recognition.
Focus on recognition
While beginning to provide patient-centered care in a medical home model is important on its own, the focus on NCQA recognition in tangent with PCMH goals is paramount, according to Dr. Dressner.
Physicians in a medical home model do so much outside the office to help patients, says Dr. Dressner. This includes responding to patient emails, making phone calls and talking to specialists about a particular case — work that generally isn't reimbursed in a traditional reimbursement model. "There has to be money tied to [completing these tasks] or we can't keep our practices going," he says.
Several payers have created incentive payment structures based on the achievement of NCQA PCMH recognition to help practices support the technology and resource investment needed to sustain a medical home model. Therefore, the focus on recognition is important during the overall journey to become a medical home.