"Obtaining Patient-Centered Medical Home (PCMH) Recognition: A How-To Manual" Presentation to the PCPCC Cent

1. "Obtaining Patient-Centered Medical Home (PCMH) Recognition: A How-To Manual" Presentation to the PCPCC Center for Public Payer Implementation Primary Care Development Corporation January 18, 2011

2. About PCDC • Non-profit formed in 1993 • Mission: expand and improve primary care in underserved communities • Work with organizations through programs in three areas: • Capital Access – financing to build primary care capacity • Performance Improvement (Practice Redesign, Medical Home, EHR Adoption, Emergency Preparedness) • Primary Care Policy Leadership • Learn more and contact us at: www.pcdc.org

3. Origins of the Manual • 2008-2009 saw emergence of PCMH through demonstrations, Medicaid incentives, and inclusion in PPACA • Broad acceptance of NCQA principles and recognition process • Evidence that many safety net providers needed guidance in recognition/transformation process • Core funding from the New York Community Trust

4. What the Manual Does • Deconstructs the NCQA PCMH recognition process. • Helps to organize information • Helps answer key questions: How do I approach PCMH recognition? How long will it take? What resources will I need? • Puts process in context of larger goals of the organization. • Assists in project management

5. How it is Organized Introduction: Orientation to the Manual Section 1: the PCMH Framework Section 2: NCQA and the PCMH Recognition Process Section 3: Communicating with Board and Staff Section 4: What Are Your Trying to Accomplish? Section 5: Identify Your Project Team Section 6: Assess Your Internal Resources Section 7: Make a Plan Section 8: Understanding the NCQA PCC-PCMH Survey Process Section 9: Hints to Your Success Additional Tools and Resources, including PCMH Self-Assessment Tool, Documentation and Data Needs Grid, Action Plan Template

6. Who has Used the Manual • Downloaded over 10,000 times from PCDC’s website • Safety net and non-safety net • Primary care associations, hospital associations, FQHCs, hospital-based providers, group practices • Used by PCDC in PCMH/MU Collaboratives and assisting providers through the process

7. How the Manual is Being Used

8. How Effective? • Most effective • Straightforward and well-organized • Attention to detail on NCQA requirements • Comprehensive • Least effective • Needed examples of what NCQA is looking for (i.e. appropriate documentation) • Narrow focus on NCQA

9. Some Comments • “The manual served as a comprehensive collection of documentation to help guide the process. It was used as a reference document for various parts of the process.” • “Very well organized and easy to understand.” • “Helped clarify some of the questions we had after reviewing NCQA resources.” • “I wish it was indexed, so that I could pull up all of the ‘MUST PASS’ elements, or pull up the elements specific for our practice.” • “I would have liked to have seen more examples of acceptable documentation needed for the application.”

10. What’s next? • Gathering Feedback • Incorporate lessons learned/best practices • Planning development of new version(s) • PCMH-EHR Meaningful Use • Other medical home accreditation (i.e. Joint Commission) • Hospital-based PCMH • Mental health integration • Online applications

11. Discussion and Feedback Contact: Cari Reiner, Senior Program Manager, PCDCcreiner@pcdcny.org 212-437-3912