The following blog post was written by Heather Banks, a Healthcare Transformation Coordinator at RMS.
The marketplace recognizes the potential for return on investment in the medical home through realization of improved quality of care and reduced healthcare expenses. Data has shown that Patient-Centered Medial Homes (PCMH) improves health outcomes, enhances patient experience of care, and reduces expensive unnecessary hospital and Emergency Department care.1
Major insurers are driving the primary care transformation payments for patient-centered services nationwide in order to increase access to care, control costs, improve patient satisfaction, and improve the health of United States citizens. Payments to providers will be based on the value of services provided, which means getting away from old formulas that were heavily weighted to episodic care. It is evident that being a PCMH will position practices very well for any future incentives.
Practices which pursue and achieve PCMH Recognition also help primary care practices achieve the Triple Aim goals, which are:
- To improve the experience of care
- To improve the health of populations
- To reduce per capita costs of health care
A medical home can achieve these goals by adopting new technologies, care delivery methods, and relationships with patients and their families.Practices that achieve PCMH recognition from NCQA position themselves for long-term success by focusing on:
- Optimizing patient flow and the team approach to care
- Incorporating information technology appropriately
- Implementation of evidence-based care guidelines and continual measurement to improve quality of care
- Measuring patient experience and satisfaction
Attaining PCMH recognition from NCQA is a source of pride for medical practices, but the real value lies in what the designation means to patients. Those receiving care from a recognized PCMH get:
- Comprehensive, well-coordinated care
- Ease in making appointments and short waiting times to see a physician
- Personal relationships with their healthcare team
- Electronically stored medical information for instant access by care givers
- Close monitoring of their chronic conditions; follow-up is frequent and self-management is taught and supported
- Convenient access to their test results, prescription refills, and appointment requests
- A smooth and immediate referrals process for specialists
A PCMH practice drives and impacts the delivery of well orchestrated, quality driven, and coordinated patient care in 3 stages:
PCMH practices are the centralized focus of patient care. Primary Care and Specialty Care management are integral to providing quality driven, patient centered care. Communication and team work are essential to ensure that patient care in the practice is operating efficiently. When striving for patient centered care, the development of a well integrated set of standards for monitoring compliance is most important.
As of April 2015, more than 9,000 practices have been recognized as PCMH. If you would like to join the ranks of these NCQA Recognized Patient Centered Medical Homes, RMS Healthcare can help you transform your practice, allowing you to take advantage of current and future financial incentives
RMS Healthcare, a division of Research and Marketing Strategies, Inc. (RMS) has over 50 years of collective and proven experience in providing consulting services to meet the specific needs of our clients. Regardless of your healthcare research or practice transformation needs, RMS Healthcare can help. If you are interested in learning more, please contact Susan Maxsween, Senior Director, Healthcare Operations and Compliance SusanM@rmsresults.com or at 1-866-567-5422.
1https://www.pcpcc.org/2014/01/15/pcmh-data-certifies-proof-concept
