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Patient-Centered Medical Home and SBHCs. Iliana Kiourkas Program Associate, NASBHC. Introduction. Concept of patient-centered medical home . Concept of patient-centered medical home (PCMH)

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patient centered medical home and sbhcs

Patient-Centered Medical Home and SBHCs


Program Associate, NASBHC

concept of patient centered medical home
Concept of patient-centered medical home
  • Concept of patient-centered medical home (PCMH)
    • Definition—Patient Centered Medical Home (PCMH) is an approach to providing comprehensive primary care for children, youth, adults and their families. The PCMH is a health care setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient’s family.
    • Focuses on team-based, whole person, comprehensive, ongoing, and coordinated patient-centered care.
  • Common elements
medical home provisions in the patient protection and affordable care act ppaca
Medical Home Provisions in the Patient Protection and Affordable Care Act—PPACA
  • Health Homes in Medicaid → Section 2703
  • Centers for Medicare and Medicaid Innovation → Section 3021
  • State Grants to Promote Community Health Teams that support PCMH → Section 3502
  • Community-based Collaborative Care Network Program → Section 10333
  • Pediatric Accountable Care Organization Demonstration Project → Section 2706
  • Community Health Center Expansion
nasbhc activities
NASBHC Activities
  • Development of Position Statement and Policy Brief.
    • In progress, final edits being made.
  • Developed a mechanism to assess the field’s knowledge of and participation in the PCMH recognition process.
    • Policy team conducted survey in March of 2011 that was disseminated to state leaders.
  • Identified partner organizations to work with in providing technical assistance to SBHCs on patient centered medical homes.
    • NCQA
    • AAAHC
  • In process of developing webinar series related to PCMH and SBHCs
  • In process of developing webpage on our new site devoted to PCMH and SBHCs
nasbhc activities cont
NASBHC Activities (cont.)
  • Researching various recognition/accreditation programs and how they apply to SBHCs based on model of care and sponsoring health organization type
    • NCQA, AAAHC, Joint Commission
    • Those sponsored by FQHCs, Hospital/Medical Center, Local Health Department, etc
  • Conducting in-depth, state-by-state analysis of and report on policies regarding the patient-centered medical home and its relevance to SBHCs
state demonstration projects
State demonstration projects
  • Many focused on Medicaid beneficiaries, state CHIP enrollees
  • Several have implemented payment policies, such as Per Member Per Month (PMPM)
    • Using standards from various recognition programs e.g. NCQA, JC (also for provider participation requirements)
    • Some using HEDIS measures for enhanced payments
state associations and affiliates
State Associations and Affiliates
  • Policy agendas include strategies or activities related to medical homes in your state
  • Some state associations are in process of developing white papers and conducting case studies on state medical home projects and SBHCs’ role
  • Some state associations are actively partaking in demonstration projects using SBHCs as medical home sites
  • Activities related to PCMH are in several of states’ upcoming work plans