Content for this blog post was provided by Susan Maxsween, Director of RMS Healthcare – Practice Transformation, and her team – Karen Joncas, Healthcare Transformation Coordinator, and Al Tripodi, Healthcare Administrative Assistant.

RMS Healthcare has assisted clients in a variety of transformation activities custom designed to meet specific organizational goals. Clients may seek assistance in order to improve the quality, continuity and safety of patient care, maintain or improve market share,  increase the satisfaction of their patients and their staff and/or improve their bottom line through optimizing work flows or taking advantage of public or private payment incentives. Regardless of their specific needs, our consulting efforts are customized to meet specific and often multiple needs. We provide the expertise to help our clients attain the maximum NCQA PCMH recognition level, improve patient experience response times and satisfaction results and/or optimize practice efficiencies.

1) Before engaging RMS Healthcare to assist my practice, physician organization or hospital owned/managed physician practice in the NCQA PCMH™ Recognition process, what are my responsibilities and expectations?

RMS Healthcare understands that when a practice takes on the commitment to become a Patient Centered Medical Home (PCMH) that it is embarking on an exciting, enlightening and empowering journey. We also recognize that this journey can be complex and challenging and, in the end, very rewarding. Practices may have to re-engineer their operating structure, develop policies and procedures, assess current operations and be prepared to make changes in workflows in order to successfully achieve recognition as a PCMH. RMS Healthcare is a premiere healthcare consulting firm, with more than 50 years of healthcare experience that has assisted more than 75 practices across the country with becoming NCQA PCMH recognized since 2010. RMS Healthcare has never failed to get client practices the recognition they seek at the level desired. We will commit to being fully engaged from the moment the journey commences through the final submission of documentation and ongoing after your recognition is awarded, assisting you every step of the way.

We expect that our clients will share in a passion of commitment and desire to achieve recognition. Together, we will successfully meet all of the mutually agreed upon expectations, which are discussed during our initial kick-off phase and revisited throughout the practice transformation journey. This process involves engagement as outlined in our mutually agreed upon work plan, which will provide responsibilities and expectations of your practice as it aligns with achieving full compliance with each standard you are looking to achieve recognition for.

Our first expectation is that you designate a PCMH work team consisting of management individuals who are empowered to take action based upon workplan tasks. At the initial kick-off meeting, we will outline the timeline and responsibilities. It is our recommendation that you will host a similar kick-off meeting with your entire staff to ensure that they are aware of the practice transformation underway and can be actively engaged in the transformation process. As a client, you will be expected to engage in weekly conference calls lasting one to two hours in duration and follow through with completing tasks, which are assigned during each call. We expect that regular and open dialogue occur throughout the process to ensure you are on track with reviewing documentation and submitting it in a timely manner for review and submission to NCQA. (Documentation may be development/review of policies and procedures and development of workflows and job descriptions, etc.). All meetings will be agenda driven and deliverables will be assigned at the end of each meeting. Together, we will work strategically with rigor and proven experience in meeting the objectives of each of the quality standards and provide a “story” to NCQA based upon sound policies and procedures, reports and documentation.

2) Who from my practice, physician organization or hospital owned/managed physician practice should be included in the PCMH team for the NCQA PCMH™ Recognition process with RMS?

We understand that becoming a PCMH recognized practice requires a practice to be goal-driven with a commitment to quality improvement and delivering quality driven patient care. This goal cannot be attained by just one individual’s efforts; instead, it requires the efforts of a collective community of professionals and clinicians within a practice. We will look to have a core centralized team of empowered staff including the Director of Quality Improvement and Grants Management, as well as other key staff member(s) that will be identified as being instrumental and key operational stakeholders in this PCMH journey. This may include the practice manager, the clinical manager and a provider.

To read FAQs Part 2 click here.

To read FAQs Part 3 click here.

This blog post is part one of a four-part series regarding frequently asked questions (FAQs) about working with a consultant during the NCQA PCMH™ Recognition process. If you have any further questions about this process or would like to receive a proposal to partner with Research & Marketing Strategies (RMS) for your NCQA PCMH™ journey, contact Susan Maxsween, Director of Healthcare – Practice Transformation at SusanM@RMSresults.com or by calling (315) 635-9802.