Patient Centered Medical Home

WHAT WE DO...

We offer a variety of services to our clients including

Practice Transformation
A PCMH Certified Content Expert will serve as your practice transformation coach. She will help your organization design, implement, and lead an outcomes-driven PCMH program tailored to the practices’specific needs. This coach will guide the practice team through the necessary workflow steps, review data and policies submitted by the practice team, make suggestions for workflow changes, and lead a weekly conference call to hold practices accountable. Not only will this help practices achieve recognition for PCMH from NCQA, but it will also enable practices to establish the fundamental infrastructure neccesary to promote qualility in all programs. With a focus on transformation (when needed), Quality HealthCare Consulting will lead the transition from a fragmented delivery system into a cohesive model that will drive accountable care and prepare the organization for future success.
PCMH Recognition

A NCQA PCMH Certified Content Expert will guide practices through the process of obtaining PCMH recognition in order to standardize workflows that will drive accountable care and prepare the organization for future success.

NCQA’s PCMH Standards help practices/organizations establish the fundamental infrastructure necessary to: advance quality outcomes, reduce costs, and improve patient satisfaction.  Once this framework is in place, practices tend to excel in all quality payment programs, including Advanced Payment Models, MIPS, Medicare Star, HEDIS, and various payer specific Pay for Performance programs.

PCMH Application Review

A PCMH Certified Content Expert will review the applicaiton or annual report and provide feedback to the practice.

180

PCMH Applications

170

Level 3 Practices

12

Years of Experience

WHY IS IT IMPORTANT...

Transitioning from Volume to Value

In 2017, US healthcare spending made up 17.9% of the nation’s Gross Domestic Product.1 Chronic diseases are among the most prevalent and costly health conditions in the United States. Startlingly, “Nearly half (approximately 45 percent) of all Americans suffer from at least one chronic disease. According to the Centers for Disease Control, in the US alone, chronic diseases account for . . . 96 cents per dollar for Medicare (spending) and 83 cents per dollar for Medicaid (spending).”2

It is clear that the traditional fee-for-service payment model has failed to lower costs and improve care and quality of life for patients suffering from chronic conditions.  As a result, the Center for Medicare and Medicaid Services and other payers have started to adopt value-based care models that reward value over volume.

Many governmental and commercial payers have endorsed the National Committee for Quality Assurance’s (NCQA) Patient Centered Medical Home (PCMH) Recognition Program as a pathway that guides practices through a stepwise approach to move from the traditional fee-for-service payment model toward a model that can support risk and value-based care. Value-based care is the key to cost reduction and a more sustainable system.

In fact, NCQA’s PCMH Recognition Program is the most widely adopted PCMH evaluation program in the country. Approximately 13,500 practices (with over 63,700 clinicians) are recognized by NCQA. Additionally, more than 100 payers and four medical boards have also supported the NCQA’s PCMH Program.3, 4

Contained within NCQA’s PCMH Standards and Guidelines are a number of strategies focused on continuous quality improvement.  These strategies help practices establish the fundamental infrastructure necessary to excel in a number of quality programs and ultimately drive down costs through the focus on prevention, care management, care coordination, and establishing protocols that drive outcomes.

 

The steps to achieve NCQA PCMH recognition offers practices the opportunity to evaluate and standardize processes across multiple practices.  Methodically going through the steps to become a PCMH practice will improve outcomes on dashboards leading to greater marketability for practices as well as additional leverage to negotiate more lucrative contracts.

QHC will not only prepare clients to be successful in value-based contracts, but will also generate savings by training team members to lead future PCMH transformation efforts.

WHAT THEY SAY...

What are our clients are saying about us?

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Kirt Caton, MD Palmetto Primary Care Physicians - Charleston, SC

Jennifer and I worked together for 7 years at Palmetto Primary Care Physicians. She’s a wealth of information, easy to work with, and enabled me to streamline my practice while meeting standards.

Family Health Center is a Family Medicine Residency program which recently received recognition as a Patient Centered Medical Home-Level 3. As the Assistant Director, I worked closely with our coach, Jennifer, who was the most important component of our journey. Jennifer has a wealth of knowledge and experience as a coach. She coached and mentored us through the certification process, assisted us with meeting standards, and pushed us when we felt overwhelmed. Jennifer took a family medicine residency program from a point in time of not knowing how to attain certification to the highest level of recognition, Level 3.

Steve Bailes, MD Westgate Family Physicians - Spartanburg, SC

One of the most difficult parts of practicing medicine today is actually not just providing good care to our patients, it is staying abreast with quality measures, special requirements from payers, data mining, and the like. Today, especially in any type of primary care, it will be crucial that physicians learn to meet some of these quality measures and also take a hard look at their practices for weak areas. Like many of you, we at Westgate Family Physicians felt like we were drowning attempting this. Jennifer came to our rescue. I can honestly say, I have never met anyone more gifted to helping physicians and hospitals accomplish these difficult tasks. We are a Patient Center Medical Home, a task that quite honestly we would probably never accomplish without Jennifer. We have also been able to begin to set and meet quality measures that not only will help us with demands of payers and ultimately with how we are reimbursed for our services, but more importantly, and I say this sincerely, it is making us better doctors in some of these quality areas. Jennifer is absolutely invaluable to any physician or group that finds themselves lost or at a standstill with becoming a Patient Centered Medical Home or with meeting NCQA measures.

Crystal Weeks, MHA ReGenesis Health Care - Spartanburg, SC

I would like to thank Jennifer for helping ReGenesis Health Care achieve PCMH Level 3 recognition from NCQA for our five clinics.  Jennifer’s expert knowledge of the PCMH guidelines, criteria, and acceptable documentation was priceless.  Jennifer was a consummate professional. She was always available when I needed her.  Jennifer also acted as a “Counselor” to reassure me that I was not alone in the process. She assured me that I would get through it.  I am forever grateful for her assistance throughout this application process. As a result of her insight, I am pleased to announce that my organization received PCMH Level 3 recognition for all five clinics including three of our clinics that were previously awarded Level 2 recognition. We also received PCMH Level 3 recognition for our two new clinics.  Jennifer is a hidden jewel. It was a privilege to work with her!

Diane Weiss, M.S. - Office Manager Weiss Pediatric Care - Sarasota, FL

Weiss Pediatric Care is a single pediatrician practice located in Sarasota, Florida.  When we opened our doors a little over 4 years ago, we were determined to achieve NCQA PCMH recognition.  We began the application process twice, only to give up because the task seemed insurmountable.  We simply didn’t have the time, staff, or resources that it would take to navigate the complex PCMH standards. Enter Jennifer Martin in March of 2017.  With the deadline for 2014 PCMH looming on October 1, Jennifer assessed where we were and what we needed to do to make it to the finish line in a few short months.   She created a timeline and a to-do list and walked alongside us through our successful submission on September 28, two days ahead of schedule! Last week, we received notification that we achieved Level 3 NCQA PCMH recognition.  We did it, and it is largely because of the brilliant guidance, coaching, and encouragement that we received from Jennifer.  She helped interpret the nuances and intricacies of the application in ways that made them actionable.  She responded to our S.O.S. emails and phone calls quickly, and always with patience.  And when it felt like the finish line was simply unattainable, her confidence and encouragement kept us going.  Weiss Pediatric Care is so grateful to Jennifer for helping us achieve the highest level of NCQA PCMH recognition.

Tracy Edwards, MD HMDC Edwards Medical Practice - Hiawassee, GA

The requirements for PCMH recognition are many and can be confusing, but Jennifer did a great job from the start to the finish of laying out the process step by step in a very clear manner. She is very knowledgeable about PCMH and is pleasant during every interaction. Because of her assistance, we were able to achieve PCMH recognition in less than a year. Best wishes to you as you pursue PCMH recognition. Jennifer is a great asset, and I'm confident you will be pleased.

GET IN TOUCH...

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