Incentive programs, greater participation

Patient Centered Medical Homes emphasize preventive and team-based coordinated care, patient engagement and cost containment for improved outcomes and population health. While the medical home has a long history in healthcare, the concept has recently grown in prominence as payers embrace new recognition and accreditation programs.

The National Committee for Quality Assurance (NCQA), for example, now recognizes more than 7,000 PCMH programs, leading an increasing number of payers to incentivize

• Quality measure reporting

• Preventive and chronic care benchmarks

• Reductions in emergency department (ED) visits and hospital readmissions

Medical homes have typically focused on primary care; however, today’s expanded medical home recognition programs now offer the same opportunities in specialty medicine.

Patient-centered strategies for financial health

Running parallel with the growth of patient-centered care is the rise of patient consumerism, which itself can affect the financial health of provider organizations.

Medical homes emphasize care plan adherence and patient retention and growth strategies through engagement, similar to the multiple patient education and engagement measures in meaningful use Stage 2, but the need for sophisticated, consumer-oriented strategies goes further. For example, although a sizable majority of surveyed patients are willing to explore group visits and virtual care, their number far surpasses that of family physicians offering such services.

As increasingly savvy and cost-conscious patients seek alternative care, shop by price and expand their use of mobile technologies and applications, medical homes will continue to advance engagement and retention strategies.

Patient-centered medical home solutions

Ensuring success as a PCMH includes a strong partner that supports the goals of patient engagement, coordinated care, interoperability and quality outcomes reporting. edgeMED offers solutions that align with the National Committee for Quality Assurance (NCQA) PCMH program, which provides a foundation for accountable care development and is a key to improving care coordination and outcomes. Additionally, our available PCMH package provides a resource manual to assist through the recognition submission process, and a manual with easy-to-follow instructions on how to access required NCQA reports.

With our EHR, PCMHs experience the robust integration, usability and point-of-care workflows necessary for the evidence-based, long-term patient care and coordination needed for PCMH status. The system allows for the additions of standards-based interoperability and quality reporting functions required of other private and public payer programs such as the Physician Quality Reporting System (PQRS) and meaningful use, as the incentive reporting criteria of PCMH overlaps with those of meaningful use and CMS Shared Savings ACOs.