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Valerie S Harder, Webb E Long, Susan E Varni, Jenney Samuelson, Judith S Shaw
Patient-centered medical home (PCMH) transformation has been challenging for pediatric practices, in part because of the National Committee for Quality Assurance (NCQA) PCMH focus on conditions and processes specific to adult patients. Realizing the potential challenges faced by pediatric practices, Vermont supported pediatric-informed facilitators to help practices during PCMH transformation. This study characterizes the impact of pediatric-informed facilitators; provides benchmark data on NCQA scores, number of facilitation meetings, and the time between facilitation start and end; and compares pediatric- and adult-serving practices...
September 27, 2016: Clinical Pediatrics
Marilyn M Schapira, Brian L Sprague, Carrie N Klabunde, Anna N A Tosteson, Asaf Bitton, Jane S Chen, Elisabeth F Beaber, Tracy Onega, Charles D MacLean, Kimberly Harris, Kathleen Howe, Loretta Pearson, Sarah Feldman, Phyllis Brawarsky, Jennifer S Haas
BACKGROUND: Despite substantial resources devoted to cancer screening nationally, the availability of clinical practice-based systems to support screening guidelines is not known. OBJECTIVE: To characterize the prevalence and correlates of practice-based systems to support breast and cervical cancer screening, with a focus on the patient-centered medical home (PCMH). DESIGN: Web and mail survey of primary care providers conducted in 2014. The survey assessed provider (gender, training) and facility (size, specialty training, physician report of National Committee for Quality Assurance (NCQA) PCMH recognition, and practice affiliation) characteristics...
October 2016: Journal of General Internal Medicine
Timothy Hoff, Matthew DePuccio
OBJECTIVE: The study objective was to better understand specific implementation gaps for various aspects of patient-centered medical home (PCMH) care delivered to seniors. The study illuminates the physician and staff experience by focusing on how individuals make sense of and respond behaviorally to aspects of PCMH implementation. METHOD: Qualitative data from 51 in-depth, semi-structured interviews across six different National Committee for Quality Assurance (NCQA)-accredited primary care practices were collected and analyzed...
March 22, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Valerie S Harder, Julianne Krulewitz, Craig Jones, Richard C Wasserman, Judith S Shaw
INTRODUCTION: Patient experience, 1 of 3 aims for improving health care, is rarely included in studies of patient-centered medical home (PCMH) transformation. This study examines the association between patient experience and National Committee on Quality Assurance (NCQA) PCMH transformation. METHODS: This was a cross-sectional study of parent-reported child patient experience from PCMH and non-PCMH practices. It used randomly sampled experience surveys completed by 2599 patients at 29 pediatric and family medicine PCMH (n = 21) and non-PCMH (n = 8) practices in Vermont from 2011 to 2013...
January 2016: Journal of the American Board of Family Medicine: JABFM
Joseph T Hanlon, Todd P Semla, Kenneth E Schmader
The National Committee for Quality Assurance (NCQA) and the Pharmacy Quality Alliance (PQA) use the American Geriatrics Society (AGS) Beers Criteria to designate the quality measure Use of High-Risk Medications in the Elderly (HRM). The Centers for Medicare and Medicaid Services (CMS) use the HRM measure to monitor and evaluate the quality of care provided to Medicare beneficiaries. NCQA additionally uses the AGS Beers Criteria to designate the quality measure Potentially Harmful Drug-Disease Interactions in the Elderly...
December 2015: Journal of the American Geriatrics Society
Lynn Ho, Jean Antonucci
The patient-centered medical home (PCMH) is widely touted as the current pathway to high-quality primary care practice. Many payers and institutions are using the formal National Committee for Quality Assurance (NCQA) PCMH tool to evaluate practices. Practices commonly feel pressured financially to achieve NCQA recognition. As 2 small high-functioning innovative primary care practices, we describe the actual process of using this tool and assess its utility using a framework based on patient experience of care, costs, and population health...
May 2015: Annals of Family Medicine
Anna L Christensen, Joseph S Zickafoose, Brenda Natzke, Stacey McMorrow, Henry T Ireys
BACKGROUND: The patient-centered medical home (PCMH) is widely promoted as a model to improve the quality of primary care and lead to more efficient use of health care services. Few studies have examined the relationship between PCMH implementation at the practice level and health care utilization by children. Existing studies show mixed results. METHODS: Using practice-reported PCMH assessments and Medicaid claims from child-serving practices in 3 states participating in the Children's Health Insurance Program Reauthorization Act of 2009 Quality Demonstration Grant Program, this study estimates the association between medical homeness (tertiles) and receipt of well-child care and nonurgent, preventable, or avoidable emergency department (ED) use...
May 2015: Academic Pediatrics
Thomas D Garvey, Ann E Evensen
BACKGROUND: Importance: Patients with cervical cytology abnormalities may require surveillance for many years, which increases the risk of management error, especially in clinics with multiple managing clinicians. National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH) certification requires tracking of abnormal results and communicating effectively with patients. OBJECTIVES: The purpose of this study was to determine whether a computer-based tracking system that is not embedded in the electronic medical record improves (1) accurate and timely communication of results and (2) patient adherence to follow-up recommendations...
February 2015: WMJ: Official Publication of the State Medical Society of Wisconsin
Megan H Bair-Merritt, Mahua Mandal, Arvin Garg, Tina L Cheng
The Patient-Centered Medical Home (PCMH) may be improved by embedding identification and response for patients' experiences with psychosocial adversity, but how this might optimally occur in practice has not been well-specified. We sought input from an expert panel to define feasible elements that could adapt the PCMH to adequately respond to patients' experiences with psychosocial adversity. From December 2012 through September 2013, we used a Delphi process to systematically obtain expert opinions and reach consensus...
August 2015: Journal of Primary Prevention
Manasi A Tirodkar, Suzanne Morton, Thomas Whiting, Patrick Monahan, Elexis McBee, Robert Saunders, Sarah Hudson Scholle
OBJECTIVES: The patient-centered medical home (PCMH) is a critical aspect of delivery system reform. The purpose of this study was to examine variations in achievement of PCMH requirements across different types of practices. STUDY DESIGN: We used data on the points awarded, by standard and element, to 2369 practices recognized by September 2013 under the National Committee for Quality Assurance PCMH program, 2011 version. METHODS: We tested for differences across practice types in the percentage of practices achieving full credit for 27 element scores using likelihood ratio χ2 tests with an adjustment for multiple comparisons...
2014: American Journal of Managed Care
Grant R Martsolf, Ryan Kandrack, Eric C Schneider, Mark W Friedberg
BACKGROUND: Healthcare purchasers have created financial incentives for primary care practices to achieve medical home recognition. Little is known about how changes in practice structure vary across practices or relate to medical home recognition. OBJECTIVE: We aimed to characterize patterns of structural change among primary care practices participating in a statewide medical home pilot. DESIGN: We surveyed practices at baseline and year 3 of the pilot, measured associations between changes in structural capabilities and National Committee for Quality Assurance (NCQA) medical home recognition levels, and used latent class analysis to identify distinct classes of structural transformation...
June 2015: Journal of General Internal Medicine
Webb E Long, Arvin Garg
OBJECTIVE: To determine the association between a widely used individual-level assessment of the medical home derived from parental perception and practice-level assessment of the medical home. METHODS: Thirty parents at each of 6 Boston-area community health centers (CHCs) were administered the 19-question medical home measure of the 2011 National Survey of Children's Health (NSCH). Each CHC was scored in accordance with the National Committee for Quality Assurance (NCQA) 2011 Patient-Centered Medical Home Standards and Guidelines...
March 2015: Pediatrics
Marya J Cohen, Suzanne Morton, Sarah Hudson Scholle, Leif I Solberg, William A Kormos
Innovation in primary care has increased interest in patient self-management techniques; little is known about the methods practices use to support self-management. This study is a survey of small practices, fewer than 5 physicians, with NCQA (National Committee for Quality Assurance) recognition (response rate 59.1%). Main measures include the number and delegation of self-management support activities. Practices reported a high proportion of self-management support activities. Physicians perform most of these activities...
October 2014: Journal of Ambulatory Care Management
Brett Pinsky, James Harnett, Ryne Paulose-Ram, Jack Mardekian, Navendu Samant, Kavita V Nair
BACKGROUND: The National Committee for Quality Assurance supports high-quality care for patients through the Diabetes Recognition Program (DRP). The DRP recognizes physicians and practices that are providing high-quality diabetes care as determined by 10 key measures. OBJECTIVE: To examine the impact of treatment by DRP-certified physicians compared with non-DRP-certified physicians on patient outcomes. METHODS: This retrospective claims analysis was conducted from January 1, 2007, through November 30, 2007, using a large US database of approximately 14 million commercially insured members...
November 2011: American Health & Drug Benefits
Martijn van Hasselt, Nancy McCall, Vince Keyes, Suzanne G Wensky, Kevin W Smith
OBJECTIVE: To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. DATA SOURCES: Medicare Part A and B claims files from July 1, 2007 to June 30, 2010, 2009 Census, 2007 Health Resources and Services Administration and CMS Utilization file, Medicare's Enrollment Data Base, and the 2005 American Medical Association Physician Workforce file. STUDY DESIGN: This study used a longitudinal, nonexperimental design...
February 2015: Health Services Research
Amy M Bauer, Stephen M Thielke, Wayne Katon, Jürgen Unützer, Patricia Areán
OBJECTIVE: Healthcare reforms in the United States, including the Affordable Care and HITECH Acts, and the NCQA criteria for the Patient Centered Medical Home have promoted health information technology (HIT) and the integration of general medical and mental health services. These developments, which aim to improve chronic disease care, have largely occurred in parallel, with little attention to the need for coordination. In this article, the fundamental connections between HIT and improvements in chronic disease management are explored...
September 2014: Preventive Medicine
Allyson G Hall, Fern J Webb, Christopher B Scuderi, Claudia Tamayo-Friedel, Jeffrey S Harman
BACKGROUND: There is growing and sustained recognition that Patient-Centered Medical Homes (PCMHs) represent a viable approach to dealing with the fragmentation of care faced by many individuals, including those living with diabetes. The National Committee for Quality Assurance (NCQA) has spearheaded a program that recognizes medical practices that adopt key elements of the PCMH. Even though practices can achieve the same level of recognition, it is unclear whether all PCMHs deliver care in the same manner and how these differences can be associated with patient ratings of their experience with care...
October 2014: Journal of Primary Care & Community Health
Eric Stack, Karen Kier
As a result of current weaknesses and deficiencies in the United States health care system, the concept of patient-centered medical homes (PCMHs), a way of organizing primary care that emphasizes coordination and communication among patients and providers, has taken root. The formation of the National Committee for Quality Assurance-Patient- Centered Medical Homes (NCQA-PCMH) Recognition Program and its associated standards has assisted many clinicians seeking to evolve with these changing models of medical practice...
2014: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Karissa A Hahn, Martha M Gonzalez, Rebecca S Etz, Benjamin F Crabtree
The National Committee for Quality Assurance (NCQA) has promoted patient-centered medical home (PCMH) recognition among primary care practices since 2008 as a standard indicator of which practices have transformed into medical homes. A 40% PCMH adoption rate among a large national cohort of identified practices with innovative staffing (n = 131) calls into question whether the NCQA recognition process is truly transformative and patient-centered or simply another certificate to hang on the wall.
May 2014: Journal of the American Board of Family Medicine: JABFM
Xiaoyan Huang, Meredith B Rosenthal
The patient-centered medical home (PCMH) is a well accepted primary care delivery vehicle in the United States. The National Committee for Quality Assurance (NCQA) has recognized nearly 27,000 clinicians at more than 5000 sites throughout the country in its PCMH program. State and private payers..
April 10, 2014: New England Journal of Medicine
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