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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