4 Tips for Patient-Centered Medical Home Recognition

Patient-centered medical homes are sprouting up nationwide. More than 1,400 medical homes — in which a primary care physician usually quarterbacks care for patients with the help of a team of clinicians — have attained recognition from the National Committee for Quality Assurance, which recognizes medical homes that provide expanded access to patients and enhance care management while using data to manage patient populations, among other NCQA criteria.

However, to receive recognition, providers may need to establish a host of new in-house measures to help prove they meet official medical home standards, which could take months or even years to complete.

Michael Meucci, principal consultant on patient-centered medical homes at Arcadia Solutions, which recently partnered with the California Primary Care Association to accelerate PCMH recognition in that state, shares tips for medical homes seeking a prompt, smooth path to recognition.

1. Create a clear plan for PCMH recognition and transformation. There are really two parts to obtaining medical home certification, Mr. Meucci says. The first is recognition.

"You have to put in place the proper policies and make sure the right analytics tools are available to physicians," he says.

The second part of certification involves transformation of a practice. This involves the actual delivery and coordination of care, using processes put in place to operate the practice as a medical home.

Providers looking to form medical homes need scalable platforms for their practices, Mr. Meucci says. There needs to be a clear plan for both how to obtain medical home recognition and for how to transform the practice into a functioning PCMH. For example, participating physicians will need a plan for tracking patient populations and setting up coordinated care teams. They will need to figure out how to expand office hours and how to establish registries and health information exchanges. The plan should have measureable goals and objectives, he adds. It may involve management tools that walk practices and physicians through the medical home process in a step-by-step fashion.

2. Have a uniform way to measure performance against the PCMH model. It's also important for practices to have standardized plans for how to become a medical home. In a provider network with multiple practices seeking PCMH recognition, there needs to be a uniform plan of action.

"When working with multiple practices it is important to have a standardized practice plans" Mr. Meucci suggests. " this allows both practices and management to quickly assess their performance against peers and allows for targeted intervention where there maybe stragglers"

Providers may want to create a checklist to mark items as complete, or they may choose a software program that automatically updates their PCMH plan and tracks how well they are implementing against those goals.

"By providing structure and concrete milestones around the PCMH transformation and recognition process, you enable a typically long term and high touch process to be easily scaled across a wide practice audience and report on performance in real time," Mr. Meucci says.

Mr. Meucci says leveraging clinical analytics tools is another way to enable providers to know if they are meeting PCMH standards, in particular the patient reporting requirements.  Further, a robust analytics suite is critical in the long term sustainability of an effective medical home.

"You need data and analytics to be a successful and sustainable patient-centered medical home," he says.

3. Use all the medical home resources at your fingertips. There is no need to reinvent the wheel when pursuing the transformation into a PCMH.  There are many available online resources on medical homes, Mr. Meucci says. He encourages providers to use those at-the-fingertip resources when developing a medical home plan and compiling the recognition application.

"If you're a provider and you're going at this alone, there are places where you can get both paid and free resources," he says. "It's a big time saver to use resources that are already available."

For instance, the Arcadia has a paid PCMH accelerator tool, while a number of healthcare consultancies and coaching services have developed PCMH tutorials and guides. There's also a website dedicated to explaining the Federally Qualified Health Center Medical Home Demonstration.

"If you're not reinventing the wheel, you have more time to focus on care delivery to actually delivering on the promise of the PCMH model to provide better clinical outcomes and reduce total cost of care," Mr. Meucci says.

4. Consider clinical analytics needed after NCQA recognition. One important thing for medical homes to keep in mind is considering how to implement clinical analytics that focus on delivering quality care and improving outcomes, which will sustain a medical home's mission.

In short, medical homes need to have a plan for what happens after recognition. This will vary depending on where the medical home is geographically located or the patient population. For instance, a health center with a large diabetic patient population  will demand a different medical home model than a children's center. Both will need separate clinical analytic plans to measure performance and improve care for each unique patient population.

"Every medical home needs to start with an assessment to establish the practice baseline," Mr. Meucci says. "From there, it's possible to develop a customized project plan."

More Articles Related to Medical Homes:

Medical Homes Making Strides: Q&A With Independence Blue Cross Medical Director Dr. Donald Liss
NCQA Recognizes 60 Medical Homes for Reporting Patient Feedback
20 States With the Most Medical Homes

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