MHA 507 Mod 3 Module 3 – SLP Patient Centered Medical Home

MHA 507 Mod 3 Module 3 – SLP Patient Centered Medical HomeMHA 507 Mod 3 submit to CE
Module 3 – SLP
Patient Centered Medical Home
SLP Assignment Expectations
For the Module 3 SLP, conduct some preliminary research on a Patient Centered Medical Home demonstration/pilot project in your state. The PCMH project can be a demonstration program initiated by your state government or by an insurance company. Write a 4- to 5-page paper answering the following questions:
1. Which populations (e.g., adults, children, or older adults) and what conditions/diseases are targeted?
2. Who are the participating payers?
3. What type of insurance product (e.g., HMO or PPO) do the participating payers include?
4. Who are the participating providers? (List only the type of providers, such as hospitals or community health centers.).
5. How are the participating providers reimbursed?
6. Briefly describe the result and the progress of this PCMH program (no more than 250 words).
Module 3 – Background
Patient Centered Medical Home
Required Reading
Bleser, William K., Miller-Day, Michelle, Naughton, Dana, Bricker, Patricia L., Cronholm, Peter F., Gabbay, Robert A. (2014). Strategies for Achieving Whole-Practice Engagement and Buy-in to the Patient-Centered Medical Home. The Annals of Family Medicine. 12(1), 37-45.
Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R. (2014). Patient-Centered Medical Home Transformation With Payment Reform: Patient Experience Outcomes. American Journal of Managed Care, 20(1), 782-785.
Herendeen, Neil, Deshpande, Prashant. (2014). Telemedicine and the Patient-Centered Medical Home. Pediatric Annals, 43(2). 28-32.
Jackson, George L; Kendrick, Amy S; Gray, Rebecca; Williams, John W., Jr, Powers, Benjamin J; Chatterjee, Ranee; Bettger, Janet Prvu; Kemper, Alex R; Hasselblad, Vic; Dolor, Rowena J; Irvine, R. Julian; Heidenfelder, Brooke L. (2013). The patient-centered medical home: a systematic review. Annals of Internal Medicine, 158(3), 169-178
Kennedy, Betty M, PhD, Moody-Thomas, Sarah, PhD, Katzmarzyk, Peter T, PhD, Horswell, Ronald, PhD, Griffin, Willene P, MSW, LCSW. et al. (2013). Evaluating a Patient-Centered Medical Home From the Patient’s Perspective. The Ochsner Journal 13(3), 343-351.
Wang, Jason J; Winther, Chloe H; Cha, Jisung; McCullough, Colleen M; Parsons, Amanda S; Singer, Jesse; Shih, Sarah C. (2014). Patient-centered medical home and quality measurement in small practices.The American Journal of Managed Care, 20(6), 481-489.
Module 3 – Home
Patient Centered Medical Home
Modular Learning Outcomes
Upon successful completion of this module, the student will be able to satisfy the following outcomes:
• Case
o Understand the difference between PCMH and HMO.
o Discuss the factors for the success of PCMH.
• SLP
o Explore the implementation of PCMH.
• Discussion
o Discuss the payment method for PCMH.
Module Overview
AHRQ’s Definition of the Medical Home
The medical home model holds promise as a way to improve healthcare in America by transforming how primary care is organized and delivered. Building on the work of a large and growing community, the Agency for Healthcare Research and Quality (AHRQ) defines a medical home not simply as a place but as a model of the organization of primary care that delivers the core functions of primary healthcare.
The medical home encompasses five functions and attributes:
• Patient-centered: The primary care medical home provides primary healthcare that is relationship-based with an orientation toward the whole person. Partnering with patients and their families requires understanding and respecting each patient’s unique needs, culture, values, and preferences. The medical home practice actively supports patients in learning to manage and organize their own care at the level the patient chooses. Recognizing that patients and families are core members of the care team, medical home practices ensure that they are fully informed partners in establishing care plans.
• Comprehensive care: The primary care medical home is accountable for meeting the majority of each patient’s physical and mental healthcare needs, including prevention and wellness, acute care, and chronic care. Providing comprehensive care requires a team of care providers. This team might include physicians, advanced practice nurses, physician assistants, nurses, pharmacists, nutritionists, social workers, educators, and care coordinators. Although some medical home practices may bring together large and diverse teams of care providers to meet the needs of their patients, many others, including smaller practices, will build virtual teams linking themselves and their patients to providers and services in their communities.
• Coordinated care: The primary care medical home coordinates care across all elements of the broader healthcare system, including specialty care, hospitals, home healthcare, and community services and supports. Such coordination is particularly critical during transitions between sites of care, such as when patients are being discharged from the hospital. Medical home practices also excel at building clear and open communication among patients and families, the medical home, and members of the broader care team.
• Superb access to care: The primary care medical home delivers accessible services with shorter waiting times for urgent needs, enhanced in-person hours, around-the-clock telephone or electronic access to a member of the care team, and alternative methods of communication such as e-mail and telephone care. The medical home practice is responsive to patients’ preferences regarding access.
• A systems-based approach to quality and safety: The primary care medical home demonstrates a commitment to quality and quality improvement by ongoing engagement in activities such as using evidence-based medicine and clinical decision-support tools to guide shared decision making with patients and families, engaging in performance measurement and improvement, measuring and responding to patient experiences and patient satisfaction, and practicing population health management. Sharing robust quality and safety data and improvement activities publicly is also an important marker of a system-level commitment to quality.
Source: Agency for Healthcare Research and Quality, Patient Centered Medical Home Resource Center. Available at: http://pcmh.ahrq.gov/portal/server.pt/community/pcmh__home/1483
Module 3 – Outcomes
Patient Centered Medical Home
• Module
o Discuss the principles of the patient centered medical home.
• Case
o Understand the difference between PCMH and HMO.
o Discuss the factors for the success of PCMH.
• SLP
o Explore the implementation of PCMH.
• Discussion
o Discuss the payment method for PCMH.

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