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Patient Centered Medical Home Consulting

AHS offers assistance with a variety of NCQA programs

 

Contact Us at: info@acehealthsolutions.com or (919) 228-8744

The “Medical Home” has been an innovative concept that has kept the “patient at the center of care” while  streamlining clinical processes, optimizing workflow and ultimately improving overall quality of care. The recognition program given by NCQA (National Committee for Quality Assurance) and  the Joint Commision  forces practices to adopt practices and procedures that improve quality and efficiency of care. Case studies of how we have helped organizations achieve Patient Centered Medical Home (PCMH) are at the end of the page.

PCMH  is built on guiding principles such as:

Although there is not a penalty for not achieving PCMH (like that from the Medicare Meaningful Use Program),  becoming a recognized practice  from either one of these organizations has proven to improve patient care quality and safety, enhance marketing for the practice and increase reimbursement from certain payers. Another great benefit of PCMH is that it forces a more.

 Specific benefits of recognition include:

1)      Increased  payment from certain payers (ie. NC BCBS Physicians Quality Program where reimbursements for               primary care practices can be high as a 30% increase per member rate)

2)      NCQA certificate to hang in practice waiting room and logos for website/front door

3)      Higher quality, improved safety and more cost-effective, efficient care for patients

4)      More  optimal use of the organization’s health information technology

The process to come a PCMH (Patient Centered Medical Home) recognized practice can can be quite time consuming, costly and confusing. Our consultants will transform this process to one that is rather pleasant, cost-effective and readily achievable. 

We currently provide assistance with achieving recognition for the NCQA 2014  Standards and will be assisting with JCAHO recognition soon. Furthermore, we are in the process of creating a PCMH compliant EMR.

Specifically, our consultants can help with:

1)      Determining whether PCMH certification matches your practice goals and is a positive ROI

2)      Determining your eligibility for PCMH and registering your practice

3)      Ensuring compliance with recognition requirements with assistance in workflow re-design, protocol/policy development, using the EMR  to collect the appropriate data for reporting

4)      Implementation of new workflows, policies and facilitating organizational change

5)      Helping with filling out the NCQA survey tool and attesting answers

6)      Facilitating interaction with payers in order to receive increased reimbursement due to recognition

7)      Aligning PCMH criteria with other initiatives (as much as possible) that your practice may be involved with

other programs such as:   Meaningful Use, Physician Quality Reporting System(PQRS) or NCQA

Diabetes    Recognition Program (DRP), in order to maximize efficiency and use of resources.

We offer a complimentary, no obligation 30 minute assessment   where we determine the estimated cost and level of effort it may take your organization to achieve the Recognition. In this session, our Consultants will try to map our services with your needs and goals. We will suggest tools, resources and the best approach to cost-effectively help you achieve Recognition, as appropriate.

Case Studies on how ACE Health Solutions helped practices with PCMH implementation

(For measure 4/A/2, MUST PASS) Clinic XYZ had an EMR that was unable to produce reports with a denominator having the patients with important conditions and high risk conditions (PCMH 3 A &B). The patient education meaningful use report only produced a denominator with all eligible patients. AHS devised a smart excel template that could work with ICD-9 frequency reports, already a function of the Client’s EMR system, to pick up the number of patients under 3 A & B and also determine from the numerator only those eligible for patient education handouts.

(For measure 3/C/1-7, MUST PASS) Organization ABC, like all others, hasn’t had a need to record that for all patients seen for diabetes, hypertension, tobacco cessation and moderate persistent asthma (3 important conditions and high risk condition) self-management, medication reconciliation or developing an individual care plan in order to be compliant with a payer or government mandate. Now, this element requires this to be part of the note for at least 48 patients as recorded in the Records Review Workbook or else ABC can’t obtain medical home recognition. AHS devised verbiage for the existing templates used by different providers for the patients with the above conditions.  Also, we suggested a workflow pattern such that the providers would remember to use these modified templates regularly so that the 48 patients needed were easily obtained. All of this was done with very little to virtually no disturbance to the providers’ workflows and documentation styles.

 

To learn more, call us today  at (919) 228-8744 or email us at info@acehealthsolutions.com