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https://www.readbyqxmd.com/read/28720627/costs-of-transforming-established-primary-care-practices-to-patient-centered-medical-homes-pcmhs
#1
Neil S Fleming, Briget da Graca, Gerald O Ogola, Steven D Culler, Jessica Austin, Patrice McConnell, Russell McCorkle, Phil Aponte, Michael Massey, Cliff Fullerton
BACKGROUND: The patient-centered medical home (PCMH) shows promise for improving care and reducing costs. We sought to reduce the uncertainty regarding the time and cost of PCMH transformation by quantifying the direct costs of transforming 57 practices in a medical group to National Committee for Quality Assurance (NCQA)-recognized Level III PCMHs. METHODS: We conducted structured interviews with corporate leaders, and with physicians, practice administrators, and office managers from a representative sample of practices regarding time spent on PCMH transformation and NCQA application, and related purchases...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28553751/patient-centered-care-in-small-primary-care-practices-in-new-york-city-recognition-versus-reality
#2
Margaret M Paul, Stephanie L Albert, Tod Mijanovich, Sarah C Shih, Carolyn A Berry
BACKGROUND: The Primary Care Information Project (PCIP) is a program administered by the New York City Department of Health and Mental Hygiene to help primary care providers adopt a fully functional electronic health record (EHR) and focus on population health. PCIP also offers practices assistance with the National Committee for Quality Assurance (NCQA) patient-centered medical home (PCMH) recognition application. The objectives of this study were to assess the presence of key dimensions of PCMH among PCIP practices with 5 or fewer providers and to determine whether and to what extent NCQA recognition was related to the presence of these dimensions...
May 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28550610/association-between-patient-centered-medical-home-capabilities-and-outcomes-for-medicare-beneficiaries-seeking-care-from-federally-qualified-health-centers
#3
Justin W Timbie, Peter S Hussey, Claude M Setodji, Amii Kress, Rosalie Malsberger, Tara A Lavelle, Mark W Friedberg, Suzanne G Wensky, Katherine D Giuriceo, Katherine L Kahn
BACKGROUND: Patient-centered medical home (PCMH) models of primary care have the potential to expand access, improve population health, and lower costs. Federally qualified health centers (FQHCs) were early adopters of PCMH models. OBJECTIVE: We measured PCMH capabilities in a diverse nationwide sample of FQHCs and assessed the relationship between PCMH capabilities and Medicare beneficiary outcomes. DESIGN: Cross-sectional, propensity score-weighted, multivariable regression analysis...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28245657/perceptions-of-the-medical-home-by-parents-of-children-with-chronic-illnesses
#4
Emily B Vander Schaaf, Elisabeth P Dellon, Rachael A Carr, Neal A deJong, Asheley C Skinner, Michael J Steiner
OBJECTIVES: The patient-centered medical home (PCMH) strives to improve the quality of care in the primary care setting. Recently, certification programs for patient-centered coordinated care have expanded to subspecialty care. Children with chronic conditions are particularly in need of patient-centered and coordinated care. Our objective was to compare parent perceptions of PCMH elements at primary care and specialty practices for children receiving specialty care. STUDY DESIGN: Cross-sectional survey study...
February 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28099065/exploring-variation-in-transformation-of-primary-care-practices-to-patient-centered-medical-homes-a-mixed-methods-approach
#5
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/28030459/implementation-and-sequencing-of-practice-transformation-in-urban-practices-with-underserved-patients
#6
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/27875602/practice-facilitation-for-pcmh-implementation-in-residency-practices
#7
Emilie Buscaj, Tristen Hall, Linda Montgomery, Douglas H Fernald, Jaclyn King, Nicole Deaner, W Perry Dickinson
BACKGROUND AND OBJECTIVES: Primary care residency programs continue to adapt and change to become high-performing training sites for advanced primary care. Practice facilitation is a key method to assist practices in implementing organizational changes. This evaluation described the unique nature and essential roles and qualities of practice facilitation for residency program patient-centered medical home (PCMH) transformation. METHODS: Evaluation of the Colorado Residency PCMH Project from 2009 through 2014 included template and immersion-crystallization approaches to qualitative analysis of field notes, key informant interviews, and meeting documentation to identify themes related to external facilitation for practice transformation in 11 Colorado primary care residency practices...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27681310/pediatric-informed-facilitation-of-patient-centered-medical-home-transformation
#8
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...
June 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/27006433/medical-home-implementation-gaps-for-seniors
#9
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 1, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/26769878/effects-of-patient-centered-medical-home-transformation-on-child-patient-experience
#10
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
https://www.readbyqxmd.com/read/25964407/the-dissenter-s-viewpoint-there-has-to-be-a-better-way-to-measure-a-medical-home
#11
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
https://www.readbyqxmd.com/read/25906698/associations-between-practice-reported-medical-homeness-and-health-care-utilization-among-publicly-insured-children
#12
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
https://www.readbyqxmd.com/read/25845132/increased-patient-communication-using-a-process-supplementing-an-electronic-medical-record
#13
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
https://www.readbyqxmd.com/read/25787893/addressing-psychosocial-adversity-within-the-patient-centered-medical-home-expert-created-measurable-standards
#14
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
https://www.readbyqxmd.com/read/25741875/there-s-more-than-one-way-to-build-a-medical-home
#15
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
https://www.readbyqxmd.com/read/25077375/total-cost-of-care-lower-among-medicare-fee-for-service-beneficiaries-receiving-care-from-patient-centered-medical-homes
#16
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
https://www.readbyqxmd.com/read/24928567/differences-in-patient-ratings-of-medical-home-domains-among-adults-with-diabetes-comparisons-across-primary-care-sites
#17
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
https://www.readbyqxmd.com/read/24849691/patient-centered-medical-homes-recognition-and-reimbursement-part-3
#18
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
https://www.readbyqxmd.com/read/24808108/national-committee-for-quality-assurance-ncqa-patient-centered-medical-home-pcmh-recognition-is-suboptimal-even-among-innovative-primary-care-practices
#19
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
https://www.readbyqxmd.com/read/24716678/transforming-specialty-practice-the-patient-centered-medical-neighborhood
#20
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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