A key factor in the patient-centered movement gaining traction is the Affordable Care Act and its intention to improve population health and reduce healthcare costs in the United States. This is expected to be accomplished through improved patient satisfaction, coordination of care and better clinical outcomes.
The Patient-Centered Medical Home (PCMH) is viewed as a path to accomplish this and CMS is offering financial incentives to primary care practices that become recognized as a PCMH. The idea of PCMH was developed through a consortium of the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Osteopathic Association. Together they developed joint principles for the PCMH including the provision that each patient would have their personal physician and their care would be directed by the practice, ensuring care was coordinated and/or integrated as deemed appropriate with an expected level of quality, safety and enhanced access, as well as establishing appropriate payment for these efforts.
There is national growth in practices achieving recognition as a PCMH with the front-runner of recognition programs being offered by the National Committee for Quality Assurance. In 2011 NCQA’s standards increased to include guidance on developing chronic care management programs, enhancing patient engagement and improving patient outreach, and aligning with EHR and the new healthcare Meaningful Use criteria. NCQA’s program promotes goals to:
- Improve the patient experience
- Recognize clinicians’ efforts
- Provide confidence for purchaser: value for money spent on quality care
CMS led the pack with financial incentives for the PCMH, but other payers have also emerged with bonus and payment systems that recognize the PCMH, improved outcomes and patient satisfaction
In 2013 NCQA announced the Patient-Centered Specialty Practice recognition program. The development of this program was motivated by the discovery of reporting discrepancies between referring physicians and specialist. The PCSP program is designed to improve communication and access.
Yes, there’s a lot of buzz about the focus on being patient-centered and improving the patient experience, but the programs are only growing in importance. If you haven’t already done so, it’s time to get information, make the commitment and make your practice ready for the future.
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