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https://www.readbyqxmd.com/read/28199265/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#1
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28186016/collaborators-and-communication-channels-in-eight-patient-centered-medical-homes
#2
Dian A Chase, David A Dorr, Deborah J Cohen, Joan S Ash
BACKGROUND: The patient-centered medical home (PCMH) concept requires collaboration among clinicians both within the medical home clinic, and outside the clinic. As we redesign health information technology (HIT) to support transformation to the PCMH, we need to better understand these collaboration patterns. This study provides quantitative data describing these collaborations in order to facilitate the design of systems to allow for more efficient collaboration. APPROACH: Eighty-four clinicians in eight clinics identified their two most recent significant collaborators - one each within the clinic and in the medical neighborhood...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28169976/the-impact-of-alternative-payment-in-chronically-ill-and-older-patients-in-the-patient-centered-medical-home
#3
Claudia A Salzberg, Asaf Bitton, Stuart R Lipsitz, Cal Franz, Shimon Shaykevich, Lisa P Newmark, Japneet Kwatra, David W Bates
BACKGROUND: Patient-centered medical home (PCMH) has gained prominence as a promising model to encourage improved primary care delivery. There is a paucity of studies that evaluate the impact of payment models in the PCMH. OBJECTIVES: We sought to examine whether coupling coordinated, team-based care transformation plan with a novel reimbursement model affects outcomes related to expenditures and utilization. RESEARCH DESIGN: Interrupted time-series model with a difference-in-differences approach to assess differences between intervention and control groups, across time periods attributable to PCMH transformation and/or payment change...
February 6, 2017: Medical Care
https://www.readbyqxmd.com/read/28166580/outcomes-of-embedded-care-management-in-a-family-medicine-residency-patient-centered-medical-home
#4
Robert J Newman, Richard Bikowski, Kristy Nakayama, Tina Cunningham, Pam Acker, Dana Bradshaw
BACKGROUND AND OBJECTIVES: Much attention is devoted nationally to preventing hospital readmissions and emergency department (ED) use, given the high cost of this care. There is a growing body of evidence from the Patient Centered Primary Care Collaborative that a patient-centered medical home (PCMH) model successfully lowers these costs. Our study evaluates a specific intervention in a family medicine residency PCMH to decrease readmissions and ED utilization using an embedded care manager...
January 2017: Family Medicine
https://www.readbyqxmd.com/read/28148227/effective-team-based-primary-care-observations-from-innovative-practices
#5
Edward H Wagner, Margaret Flinter, Clarissa Hsu, DeAnn Cromp, Brian T Austin, Rebecca Etz, Benjamin F Crabtree, MaryJoan D Ladden
BACKGROUND: Team-based care is now recognized as an essential feature of high quality primary care, but there is limited empiric evidence to guide practice transformation. The purpose of this paper is to describe advances in the configuration and deployment of practice teams based on in-depth study of 30 primary care practices viewed as innovators in team-based care. METHODS: As part of LEAP, a national program of the Robert Wood Johnson Foundation, primary care experts nominated 227 innovative primary care practices...
February 2, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28099065/exploring-variation-in-transformation-of-primary-care-practices-to-patient-centered-medical-homes-a-mixed-methods-approach
#6
Robert D Lieberthal, Tom Karagiannis, Evan Bilheimer, Manisha Verma, Colleen Payton, Mona Sarfaty, George Valko
The objective was to quantify the activities required for patient-centered medical home (PCMH) transformation in a sample of small to medium-sized National Committee for Quality Assurance (NCQA) recognized practices, and explore barriers and facilitators to transformation. Eleven small to medium-sized PCMH practices in Southeastern Pennsylvania completed a survey, which was adapted from the 2011 NCQA standards. Semistructured follow-up interviews were conducted, descriptive statistics were computed for the quantitative analysis, and a process of thematic coding was deployed for the qualitative analysis...
January 18, 2017: Population Health Management
https://www.readbyqxmd.com/read/28079645/the-role-of-patient-navigators-in-building-a-medical-home-for-multiply-diagnosed-hiv-positive-homeless-populations
#7
Mariana Sarango, Alexander de Groot, Melissa Hirschi, Chukwuemeka Anthony Umeh, Serena Rajabiun
CONTEXT: People living with human immunodeficiency virus (HIV) (PLWH) who are most at risk for falling out of HIV primary care and detectable viral loads include homeless and unstably housed individuals and those codiagnosed with behavioral health disorders. The patient-centered medical home (PCMH) is a model that promotes provision of comprehensive, patient-centered, accessible, coordinated, and quality care for patients. This initiative provided patient navigation to HIV-positive homeless and unstably housed individuals codiagnosed with a mental health or substance use disorder as a means to create an adapted PCMH to meet the specific needs of this population...
January 11, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28076260/medical-home-implementation-in-small-primary-care-practices-provider-perspectives
#8
Gilbert Gimm, Jay Want, Dan Hough, Treniese Polk, Margaret Rodan, Len M Nichols
BACKGROUND: CareFirst BlueCross BlueShield of Maryland implemented a voluntary patient-centered medical home (PCMH) program in 2011 that did not require formal certification to participate. This study assessed attitudes and awareness of PCMH programs among participating providers in Maryland and Northern Virginia. METHODS: This qualitative study used information from 13 focus groups. In addition, 39 telephone interviews were conducted. An experienced facilitator moderated the focus groups...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28075696/dual-eligibles-experience-of-care-with-north-carolina-s-patient-centered-medical-home
#9
Sarah Grantham, Debora Goetz Goldberg, Donna Lind Infeld
Although individuals enrolled in both Medicare and Medicaid (dual eligibles) are among those with the nation's greatest need, at $300 billion per year, their care is also expensive and beset by quality problems. Previous research found problems associated with inadequate coordination of benefits and services; however, these studies have largely used quantitative approaches and focused on providers-few studies have explored the perspective of dual eligible patients. In an effort to improve care and reduce costs, North Carolina (NC) developed a Patient-Centered Medical Home (PCMH) model centered on a continuous relationship with a primary care provider who is responsible for coordination of services and addressing patients' health care needs by providing direct services or arranging care with other qualified professionals...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28072896/the-medical-home-machine
#10
Joey Berlin
Practices that achieve patient-centered medical home (PCMH) status could realize reduced costs and incentive payments from insurance payers if they see the value in contracting with a PCMH.
January 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28068138/payment-reform-in-the-patient-centered-medical-home-enabling-and-sustaining-integrated-behavioral-health-care
#11
Benjamin F Miller, Kaile M Ross, Melinda M Davis, Stephen P Melek, Roger Kathol, Patrick Gordon
The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28068137/meeting-evolving-workforce-needs-preparing-psychologists-for-leadership-in-the-patient-centered-medical-home
#12
Abbie O Beacham, Kristi S Van Sickle, Parinda Khatri, Mana K Ali, Daniel Reimer, Eugene W Farber, Nadine J Kaslow
Behavioral health integration in the patient-centered medical home (PCMH) offers opportunities for psychologists to play leadership roles. Widespread practice transition to PCMH models of care are expected to substantially impact the psychology workforce. Conservative estimates suggest that approximately 90% of the 93,000 clinically trained psychologists would be required to meet projected need in these settings. This has implications for how health service psychologists are trained. In addition to relevant clinical competencies, they must be versed in system/program development, administration, evaluation, quality improvement, and interprofessional collaboration...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28068136/psychology-in-patient-centered-medical-homes-reducing-health-disparities-and-promoting-health-equity
#13
Eugene W Farber, Mana K Ali, Kristi S Van Sickle, Nadine J Kaslow
With persisting health disparities contributing to a disproportionate impact on the health and well-being of socially disenfranchised and medically underserved populations, the emerging patient-centered medical home (PCMH) model offers promise in bridging the health disparities divide. Because behavioral health care is an important component of the PCMH, psychologists have significant opportunity to contribute to the development and implementation of PCMH services in settings that primarily serve medically underserved communities...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28068135/the-pediatric-patient-centered-medical-home-innovative-models-for-improving-behavioral-health
#14
Joan Rosenbaum Asarnow, David J Kolko, Jeanne Miranda, Anne E Kazak
This article examines the concept of the Patient-Centered Medical Home (PCMH) as it applies to children and adolescents, emphasizing care for behavioral health conditions, the role of psychology and psychological science, and next steps for developing evidence-informed models for the Pediatric-PCMH. The PCMH concept for pediatric populations offers unique opportunities for psychological science to inform and enhance the transformation of the United States health care system and improve health in our nation...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28068134/psychologists-in-patient-centered-medical-homes-pcmhs-roles-evidence-opportunities-and-challenges
#15
Anne E Kazak, Justin M Nash, Kimberly Hiroto, Nadine J Kaslow
The patient-centered medical home (PCMH) is an increasingly common model of health care delivery with many exciting opportunities for psychologists. The PCMH reflects a philosophy and model of care that is highly consistent with psychological science and practice. It strives to provide patient-centered, comprehensive, team-based, coordinated, accessible, and quality and safety-oriented health care delivery to individuals and families. Moreoever, in keeping with changes in the health care system more broadly, the PCMH model prioritizes the integration of behavioral and physical health care, and this emphasis lays the foundation for active and full engagement of psychologists in this context...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28062818/visit-entropy-associated-with-hospital-readmission-rates
#16
Gregory M Garrison, Rachel Keuseman, Buck Bania, Paul Robelia, Jennifer Pecina
PURPOSE: The chronic disease model suggests continuity of care and team-based care can improve outcomes for multimorbidity patients and reduce hospitalizations. Continuity of care following admission has had mixed effects on readmission rates; however, its effect before admission has not been well studied. Increased outpatient care organization and continuity before admission is hypothesized to reduce the odds of readmission. METHODS: In a cohort of 14,662 primary care patients from a Patient-Centered Medical Home (PCMH) practice, continuity of care in the 12 months before admission was assessed using 3 established metrics; usual provider continuity (UPC), dispersion continuity of care (COC), and sequence continuity (SECON)...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28033146/health-service-management-interns-serve-as-practice-facilitators-for-patient-centered-medical-home-recognition-east-carolina-university-appalachian-state-university-initiative
#17
Bonita Sasnett, R W Watkins, Marianne Ferlazzo
East Carolina University College of Allied Health Science's Department of Health Services Management program is partnering with Community Care of North Carolina and Access East to transform medical practices and educate students on the Patient-Centered Medical Home (PCMH) model of health care delivery. Why now? The Affordable Care Act (2010) and other health care reform changes brought to the forefront the need to focus on improving the quality of care while lowering the overall cost of care. This article describes the first year of implementation of a PCMH initiative where students in a health services management internship program act as facilitators to assist practices in the PCMH recognition process...
January 2017: Health Care Manager
https://www.readbyqxmd.com/read/28030459/implementation-and-sequencing-of-practice-transformation-in-urban-practices-with-underserved-patients
#18
Denise D Quigley, Zachary S Predmore, Alex Y Chen, Ron D Hays
BACKGROUND: Patient-centered medical home (PCMH) has gained momentum as a model for primary-care health services reform. METHODS: We conducted interviews at 14 primary care practices undergoing PCMH transformation in a large urban federally qualified health center in California and used grounded theory to identify common themes and patterns. RESULTS: We found clinics pursued a common sequence of changes in PCMH transformation: Clinics began with National Committee for Quality Assurance (NCQA) level 3 recognition, adding care coordination staff, reorganizing data flow among teams, and integrating with a centralized quality improvement and accountability infrastructure...
January 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28007226/role-expansion-on-interprofessional-primary-care-teams-barriers-of-role-self-efficacy-among-clinical-associates
#19
Karleen F Giannitrapani, Lynn Soban, Alison B Hamilton, Hector Rodriguez, Alexis Huynh, Susan Stockdale, Elizabeth M Yano, Lisa V Rubenstein
BACKGROUND: Interprofessional team-based models of primary care that expand the role of clinical associates (CAs) are increasingly adopted in primary care practices. In this study we query team members of a newly implemented patient centered medical home (PCMH) to identify facilitators and barriers of occupational role self-efficacy, a belief of possessing the capacity to execute their new team based role effectively. METHODS: 79 key informants, members of primary care teams at six Veterans Health Administration (VA) clinics, were interviewed to assess their experiences with implementing expanded roles for CAs...
December 2016: Healthcare
https://www.readbyqxmd.com/read/27909251/-in-principle-we-have-agreement-but-in-practice-it-is-a-bit-more-difficult-obtaining-organizational-buy-in-to-patient-centered-medical-home-transformation
#20
Janelle Applequist, Michelle Miller-Day, Peter F Cronholm, Robert A Gabbay, Deborah S Bowen
The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state...
November 30, 2016: Qualitative Health Research
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