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The affected person-centered medical house (PCMH) is just not solely a confirmed pathway to affected person satisfaction but in addition a authentic stepping stone to an accountable care group (ACO).
Fifty-two % of 2012 HIN survey respondents* have established medical house packages for his or her populations; fifty nine % of those at the moment are or quickly might be a part of an ACO.
To organize for this eventuality, medical houses are fortifying the mannequin with a framework of IT and infrastructure and indoctrinating docs in the medical house's twin priorities of care coordination and healthcare high quality.
These are a few of the hallmarks of the medical residence initiatives profiled in New Models in the Patient-Centered Medical House: Incentives, Infrastructure and IT to Support Accountable Care.
Starting with an summary of 2012 PCMH tendencies, this fifty seven-web page particular report presents snapshots of thriving medical house initiatives and their specific space of focus:
Florida Blue's statewide medical residence mannequin, and classes discovered from the 2011 rollout that transitioned the payor from a pay for efficiency emphasis to a medical house mannequin. Barbara Haasis, RN, CCRN, senior medical lead, high quality reward and recognition packages at Florida Blue, describes the transition, supplies particulars on the following areas:
-The standards for which doctor practices have been chosen to take part in the program;
-The shared financial savings strategy via which practices can be reimbursed;
-The position of a nurse educator in serving to the practices rework;
-Reporting follow outcomes to drive additional enchancment;
-Outcomes in complete value of care from physicians initially enrolled in the pay-for-efficiency program, now in the first quarter of the PCMH.
-A 4-pronged strategy by Horizon Blue Cross Blue Defend of New Jersey's shopper engagement workforce to extra intently contain shoppers and well being plan members in its medical house program, first launched in 2008. Jay Driggers, director of shopper expertise and engagement at Horizon BCBSNJ, shares how Horizon approaches engagement, together with:
-Seven key shopper engagement goals;
-The impact of stand-alone pilots on shopper engagement, from iPhone apps to telemonitoring;
-A greatest follow strategy to driving consciousness and schooling of the affected person-centered medical house to construct a connection between a affected person and a apply, together with the use of a affected person touchpoint map to improve a affected person's 'stickiness' to a follow;
-Outcomes from Horizon's affected person engagement strategy; and
-Utilizing PCMH affected person engagement methods to place for accountable care.
Views from the Hunterdon Healthcare medical residence initiative, in which its 24 household practices just lately achieved Degree III NCQA recognition. Moreover, Hunterdon is collaborating with Aetna in an accountable care group, has joined Horizon Blue Cross Blue Defend of New Jersey's affected person-centered medical house program and has been named to the CMS Complete Main Care initiative, a payor-supplier collaboration to check new main care reimbursement fashions.
In an prolonged interview, George Roksvaag, MD, chief medical officer of Hunterdon Healthcare, and Geralyn Prosswimmer, MD, FAAP, medical director of main care providers for Hunterdon Healthcare and medical director for Hunterdon Healthcare Companions, speak about the challenges of simultaneous participation in three main care initiatives.
Additionally they share particulars on the following:
-Organizational motivation for pursuing medical residence recognition;
-The challenges of doctor engagement;
-Reengineered staffing and workflows which might be reworking care coordination;
Affected person response to the PCMH;
-Variations they've noticed to date between the affected person-centered medical residence and the ACO mannequin.
-Hunterdon Healthcare was a respondent to HIN's 2012 Survey on the Patient-Centered Medical Residence Mannequin.
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