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Patient-Centered Medical Home and SBHCs

Patient-Centered Medical Home and SBHCs

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Patient-Centered Medical Home and SBHCs

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  1. Patient-Centered Medical Home and SBHCs IlianaKiourkas Program Associate, NASBHC

  2. Introduction

  3. 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

  4. 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

  5. NASBHC Activities related to the PCMH

  6. 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

  7. 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

  8. PCMH activities at state level

  9. 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

  10. 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