Having your practice recognized by the National Committee for Quality Assurance (NCQA) as a Patient-Centered Medical Home (PCMH)—while challenging—can provide countless rewards.
This new approach allows patients to receive timely medical care coordinated through their primary care physician. The main objective is for practices to preserve their patient panel by minimizing unnecessary visits to urgent care centers and emergency rooms. PCMH’s proactive patient outreach allows primary care physicians to fill gaps in care for preventive services, immunizations and chronic care management with the ultimate goal of excelling in population health management.
PCMH transformation involves the use of evidence-based guidelines and standardization that support whole-person patient care management, including behavioral health, to achieve patient-centered care.
We follow IHI’s Triple Aim dimensions in order to ensure that we are providing quality patient-centered care, while also focusing on population health management and lowering the cost of health care. Patient-centered care requires that the entire care team’s focus be on the individual’s cultural needs, values, and preferences when providing comprehensive medical services resulting in increased satisfaction.
Pursuing PCMH certification creates an opportunity for providers to reconsider their use of IT with the goal of maximizing its use in patient management.
Better IT integration and improved care team utilization can enable practices to provide more comprehensive visits, in which the care team fulfills the patient’s medical and psychosocial needs resulting in the delivery of superior care.
The NYS DOH is heavily implementing DSRIP, in order to restructure the health care delivery system, by investing in the Medicaid program. They plan on reducing hospital use significantly. Therefore, Medicaid and Medicaid managed-care insurance plans offer higher reimbursement rates to PCMH recognized practices.
Many private payers also reward clinicians for providing outstanding care in a patient-centered setting.
The practice will operate more efficiently resulting in decreased costs and increased staff productivity.
RR Health Strategies (RRHS) offers PCMH consulting services that can help your practice achieve NCQA recognition – and the benefits it provides. Partnering with your practice care team, our consultants develop a detailed gap analysis and work plan that strategically align each implementation task with specific elements vital to obtaining NCQA recognition. PCMH submission represents 15% of the Merit-Based Incentive Payment System (MIPS).
An RR Health Strategies representative will reach out to you shortly.