A patient-centered medical home (PCMH) is not simply a place but a model of primary care delivery. The medical home encompasses five attributes:
PCMHs offer coordinated, comprehensive primary healthcare that is accessible, continuous, compassionate and culturally appropriate.
Patients seen by a PCMH will notice that their care is delivered and coordinated by a team of professionals, all working together to keep them well, avoid errors and save time and money.
PCMH patients also get the information and support they need to manage their own care and stay healthy. And when patients need additional care, they often have access to extended hours, which helps keep them out of crowded and expensive emergency rooms.
Patients also gain access to effective treatments that consider their cultural traditions, personal preferences and values when they seek care from a PCMH.
PCMH recognition or accreditation can lead to various quality reporting incentive program opportunities offered by public and private payers, often through a per-patient savings and payment structure. Care plan and outcomes goals are often focused on preventive care, chronic disease management, patient compliance and measurable domains such as decreased emergency department visits, hospital admissions and readmissions.
Practices are also exposed to shared best practices around care plan compliance, remote technologies and patient engagement strategies which can lead to greater patient satisfaction, retention and patient volume growth.
CMS and other payers such as Blue Cross Blue Shield, Aetna, Well Care, WellPoint, UnitedHealthcare, Humana and Cigna offer financial incentives for practices that are recognized as PCMHs.
Greenway Health encourages practices to research available opportunities by state. For example, the National Academy for State Health Policy has an interactive map that illustrates multi-payer medical home activity.
Four organizations offer practices PCMH certification and recognition:
Greenway Health partners with NCQA for patient-centered medical home recognition because it is the most widely used PCMH accreditation body.
While EHR adoption is not required to become a PCMH, having an EHR will help practices manage the high volume of documentation and reporting required to establish and sustain a patient-centered medical home. There is considerable overlap between PCMH and other incentive programs such as meaningful use, and providers who achieve meaningful use will have a head start on establishing themselves as PCMHs.
Yes, Greenway Health’s Prime Suite, Intergy and SuccessEHS solutions have been awarded auto credit points to assist practices in receiving PCMH recognition. Additionally, our clinical exchange and patient portal solutions can help practices coordinate care with providers and patients.