The National Committee for Quality Assurance (NCQA) developed the patient centered medical home (PCMH) model for improving standards in primary care. Objectives of NCQA's vision for a medical home mirror those envisioned for HIV quality care (HIVQC): a patient centered, comprehensive, coordinated system of care with quality, safety and enhanced access. UFCARES recently received level 3 NCQA recognition. This process required an extensive evaluation of current practice policies/procedures. The corner stones of a robust medical home are communication, health education, care plan development/coordination requiring active patient participation. Our center had the capability to perform all these functions but required concerted effort and pooling all resources to put into practice.This process will result in a) emphasis on improving HIVQC and improved health outcomes, b) potential for greater reimbursements and cost savings by health plans. During this session we plan to work with other Ryan White Grantees to achieve the same.
Learning Objectives:
- Learn the process for achieving NCQA recognition as a PCMH and understand the conceptual framework for the PCMH model adapted within a Ryan White out-patient clinic as well as expected transformation necessary for becoming a PCMH. Understand the different NCQA standards and the elements associated with each standard some of which are must pass. Each standard will be discussed in detail and participants will be asked to join in the discussion and interpret these standards as they see them. Further discussion on how UFCARES interpreted and presented the practice standards to meet those defined by NCQA.
- Assess readiness to achieve PCMH within a particular practice. Focus on establishing a team dedicated to development of an action plan and identification of resources needed to create a realistic project timeline. We will encourage participant discussion on how to identify and define their current practice in light of the NCQA requirements. Specific screen shots of different items will be shared to help participants understand and apply the same standards in their own practice which will help develop more efficient patient centered care.
- Review UFCARES experience in applying for PCMH recognition, challenges encountered, and helpful suggestions for a successful application utilizing SOPs, electronic medical record screen shots, and other guidelines developed during this process. Include recommendations to evaluate data and system capabilities necessary to achieve performance standards. For those working within the context of a large organization, legal and contractual issues (as in our case) may also present a significant challenge and will also be discussed.
