Download or read book Transforming a Primary Care Practice Into a Patient Centered Medical Home written by Heloise Lim and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient-Centered Medical Home (PCMH) recognition is a process and a road map to improving quality of and access to care. Extant studies have shown that adoption of the PCMH model of care has lowered healthcare expenditure by 15-20% (Nielsen, Langner, Zema, Hacker, & Grundy, 2012). In an effort to reduce healthcare cost in the United States, private and public sectors have embraced the philosophy of PCMH by developing national programs and initiatives for primary care practices to obtain PCMH recognition. A number of payers and health plans have used PCMH recognition as a means to validate high-performing practices and reward them with increased reimbursement in exchange for this qualification (Nielsen, Olayiwola, Grundy, & Grumbach, 2014). Policymakers have invested in PCMH transformation through various PCMH initiatives, such as those of Center for Medicare and Medicaid Services (CMS) and Affordable Care Act (Nielsen et al., 2012). This paper describes the situation, gaps, and identified needs for improvement, as well as solution and evaluation of steps that a small primary care practice in San Francisco, California, has and is still undertaking to transform its practice with the aim of aligning all processes with the PCMH framework. With this recognition, it is anticipated that substantial financial savings will be obtained through increasing the preventive care rate, enhancing patient and professional satisfaction, and improving ability to generate reports on performance measures and quality metrics to meet grant requirements. Keywords: patient-centered medical home, transformation, US healthcare, challenges, implementation, strategies, primary care, practice change

Download or read book Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care Health Systems and Health Policy written by Mark W. Friedberg and published by Rand Corporation. This book was released on 2013-10-09 with total page 149 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report presents the results of a series of surveys and semistructured interviews intended to identify and characterize determinants of physician professional satisfaction.

Download or read book Implementation of the Patient Centered Medical Home PCMH Model written by Anna Farnsworth and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: As health systems strive to become more patient-centered, primary care practices are encouraged to transform through innovative practice redesign. In the attempt to promote quality improvement with sustainable methods of primary care, the sector is faced with multiple high-performing models from which has evolved the Patient Centered Medical Home (medical home) or PCMH. The comprehensive medical home design has developed from various early model elements as the course of PCMH dissemination dates back to 1967. This study examines the patient centered medical home model through its evolution, mode of implementation (i.e. 10 Building Blocks (Bodenheimer et al.)), and its associated outcomes observed within primary care. The purpose of this study is to describe the role of the medical home model in the redesign of U.S. primary care and summarize the effectiveness of PCMH implementation aligned with quality improvement efforts through its 5 functions as defined by the Agency for Healthcare Research and Quality: Comprehensive Care, Patient-Centered Care, Coordinated Care, Accessibility, and Quality and Safety. A systematic literature review of (n=21) studies were conducted to examine the following research question: Are the associated changes in care quality worth the total investment, cost and training endured during patient centered medical home transformation? Three common themes were identified across studies included in the review: the role of disparities, continuous training and personnel effort. Study findings highlight the importance of primary care redesign as a vital investment used to sustain the larger United States health care system.

Download or read book Physician Perspectives on the Influence of Medical Home Recognition on Practice Transformation and Care Quality for Children with Special Health Care Needs written by U.S. Department of Health and Human Services and published by CreateSpace. This book was released on 2015-02-16 with total page 30 pages. Available in PDF, EPUB and Kindle. Book excerpt: Although the medical home concept emerged in the 1960s as a model for improving care for children with special health care needs (CSHCN), policy interest in the medical home has accelerated in recent decades within and outside of pediatrics. Early evidence suggests that organizing primary care practices as patient-centered medical homes (PCMHs) has the potential to improve quality and reduce total health care costs in a variety of patient populations and primary care medical societies, payers, providers, and consumer groups endorse the model. Pediatric practices that have implemented components of the PCMH model may provide better care to CSHCN than those without such components. A number of organizations have emerged to recognize practices as PCMHs. This process is much like an accreditation process through which practices are recognized if they meet specific criteria. Although multiple organizations offer processes to recognize primary care practices as PCMHs, the National Committee for Quality Assurance (NCQA) has emerged as the "market leader" and its guidelines have become the de-facto standard for many transformation efforts. Although the number of practices obtaining PCMH-recognition from NCQA has increased quickly, few studies have examined the extent to which physicians in such practices believe the recognition process influenced practice transformation and care quality for CSHCN. The objective of this study was to examine the perspectives of primary care physicians who serve CSHCN on changes they and their practices made in order to achieve the highest level of NCQA PCMH-recognition. Specifically, the study used information from physicians in pediatric and family practices that obtained Level 3 NCQA PCMH-recognition prior to 2011 to address two questions: (1) Did physicians and practices undergo any explicit changes in order to achieve PCMH-recognition? (2) Did any of the changes lead to higher quality care for CSHCN?

Download or read book 2 the Patient Centered Medical Home written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-03-22 with total page 216 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States spends a greater proportion of its gross domestic product on health care than any other country in the world (17.6 percent in 2009), yet often fails to provide high quality and efficient health care. U.S. health care has traditionally been based on a solid foundation of primary care to meet the majority of preventive, acute, and chronic health care needs of its population; however, the recent challenges facing health care in the United States have been particularly magnified within the primary care setting. Access to primary care is limited in many areas, particularly rural communities. Fewer U.S. physicians are choosing primary care as a profession, and satisfaction among primary care physicians has waned amid the growing demands of office-based practice. There has been growing concern that current models of primary care will not be sustainable for meeting the broad health care needs of the American population. The patient-centered medical home (PCMH) is a model of primary care transformation that seeks to meet the variety of health care needs of patients and to improve patient and staff experiences, outcomes, safety, and system efficiency. The term “medical home” was first used by the American Academy of Pediatrics in 1967 to describe the concept of a single centralized source of care and medical record for children with special health care needs. The current concept of PCMH has been greatly expanded and is based on 40 years of previous efforts to redesign primary care to provide the highest quality of care possible. The chronic care model, a conceptual model for organizing chronic illness care that is associated with improved health outcomes, is the cornerstone of PCMH. Interventions based on the chronic care model (CCM) and focused on single conditions such as diabetes mellitus, asthma, chronic obstructive pulmonary disease, or depression have been shown to improve patient outcomes and/or quality of care. PCMH builds on this model and is intended to address the full range of patient-focused health care needs. As defined by physician and consumer groups, the core principles of the PCMH are wide-ranging team-based care, patient-centered orientation toward the whole person, care that is coordinated across all elements of the health care system and the patient's community, enhanced access to care that uses alternative methods of communication, and a systems-based approach to quality and safety. As part of the Closing the Quality Gap: Revisiting the State of the Science series of reviews by Evidence-based Practice Centers (EPCs), this systematic review was commissioned to identify completed and ongoing efforts to evaluate the comprehensive PCMH model, summarize current evidence for this model, and identify gaps in the evidence. Because the PCMH model is being implemented widely but the number of completed studies was expected to be small, the identification of ongoing studies was an important goal of this review. The Key Questions include: KQ 1. In published, primary care–based evaluations of comprehensive PCMH interventions, what are the effects of the PCMH on patient and staff experiences, process of care, clinical outcomes, and economic outcomes? KQ 2. In published, primary care–based evaluations of comprehensive PCMH interventions, what individual PCMH components have been implemented? KQ 3. In published, primary care–based evaluations of comprehensive PCMH interventions, what financial models and implementation strategies have been used to support uptake? KQ 4. What primary care–based studies evaluating the effects of comprehensive PCMH interventions on patient and staff experiences, process of care, clinical outcomes, or economic outcomes are currently underway? In these ongoing studies, what are the study designs, PCMH components, comparators, settings, financial models, and outcomes to be evaluated?

Download or read book Analyzing Qualitative Data written by H. Russell Bernard and published by SAGE Publications. This book was released on 2016-06-23 with total page 577 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fully updated Second Edition of Analyzing Qualitative Data: Systematic Approaches by H. Russell Bernard, Amber Wutich, and Gery W. Ryan presents systematic methods for analyzing qualitative data with clear and easy-to-understand steps. The first half is an overview of the basics, from choosing a topic to collecting data, and coding to finding themes, while the second half covers different methods of analysis, including grounded theory, content analysis, analytic induction, semantic network analysis, ethnographic decision modeling, and more. Real examples drawn from social science and health literature along with carefully crafted, hands-on exercises at the end of each chapter allow readers to master key techniques and apply them to their own disciplines.

Download or read book Restoring Primary Care written by Anton J Kuzel and published by CRC Press. This book was released on 2018-04-19 with total page 162 pages. Available in PDF, EPUB and Kindle. Book excerpt: To many practitioners, managers and patients, US primary care is in crisis. Primary care physicians are often overworked and undervalued, and both patients and care providers can feel locked into structures that lack compassion and are unfit for their intended purposes. Healthcare reforms aim to resolve the situation, but changes may take years to deliver and are contingent on numerous outside factors. What steps are within care providers' power to take now? This book lays out a course to deliver compassionate care, quality, and efficiency that - unlike many current patient-centred medical home initiatives in the US - does not require outside funding. After reflecting on avoidable problems and harms in primary care, the book offers stories of hope from innovative clinicians across the US before presenting ten practical, deliverable steps to lift primary care provision from 'poor' or 'mediocre' to 'great'. This book will be of interest to practicing family physicians and general internists, but will also be useful reading for health system leaders, healthcare insurance purchasers and insurance company executives.

Download or read book The Future of Nursing written by Institute of Medicine and published by National Academies Press. This book was released on 2011-02-08 with total page 700 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.

Download or read book Interprofessional Education in Patient Centered Medical Homes written by C. Scott Smith and published by Springer. This book was released on 2015-08-24 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book discusses the application of complex adaptive systems theory to the design and evaluation of patient-centered medical homes (PCMHs). The three defining goals of PCMHs are to spread patient-care roles among healthcare team members, focus on disease prevention and include the patient in the healthcare team. It explains why some PCMH pilots are highly successful while others do not show much benefit, covers specific sub-theories that allow for bracketing of different aspects of the clinic system and highlights strategies by which institutions can engage in this process. Inter professional Education in Patient-Centered Medical Homes is a valuable resource for faculty and managers of health professions teaching clinics, deans of medical and health professional schools and medical administrators.

Download or read book Transforming Health Care Scheduling and Access written by Institute of Medicine and published by National Academies Press. This book was released on 2015-08-24 with total page 226 pages. Available in PDF, EPUB and Kindle. Book excerpt: According to Transforming Health Care Scheduling and Access, long waits for treatment are a function of the disjointed manner in which most health systems have evolved to accommodate the needs and the desires of doctors and administrators, rather than those of patients. The result is a health care system that deploys its most valuable resource-highly trained personnel-inefficiently, leading to an unnecessary imbalance between the demand for appointments and the supply of open appointments. This study makes the case that by using the techniques of systems engineering, new approaches to management, and increased patient and family involvement, the current health care system can move forward to one with greater focus on the preferences of patients to provide convenient, efficient, and excellent health care without the need for costly investment. Transforming Health Care Scheduling and Access identifies best practices for making significant improvements in access and system-level change. This report makes recommendations for principles and practices to improve access by promoting efficient scheduling. This study will be a valuable resource for practitioners to progress toward a more patient-focused "How can we help you today?" culture.

Download or read book Evaluation of the Department of Veterans Affairs Mental Health Services written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-29 with total page 467 pages. Available in PDF, EPUB and Kindle. Book excerpt: Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

Download or read book Patient Centered Primary Care written by Alexander Blount and published by Springer. This book was released on 2019-06-22 with total page 243 pages. Available in PDF, EPUB and Kindle. Book excerpt: There have been great strides made in designing the administrative structures of patient-centered care, but it is still difficult to design truly patient-centered clinical routines that the entire healthcare team can enact. The kind of partnership, in which patients are fully part of the team that guides their own care, goes against so much of the training and socialization of health professionals and, for that matter, the expectations of many patients. This is particularly true for patients we sometimes call “complex.” In other contexts, we call them “high utilizers,” “disadvantaged,” “heartsink patients,” or “people with trauma histories.” Blount calls them “multiply-disadvantaged” patients. To successfully serve these patients requires our best versions of team-based care, including behavioral health and care management team members, though every member of the team needs help in engaging these patients and mutual support in adapting to the rapid changes in roles that new team approaches are creating. This book offers a summary of the approaches that are currently in growing use, such as health literacy assessment, motivational interviewing, appreciative inquiry, shared decision making, minimally disruptive care, trauma informed care, enfranchisement coaching, relationship-centered care, and family-informed care. Finally, it offers a transformative method, based on familiar elements, that is Transparent, Empowering, Activating, and Mutual: the T.E.A.M. Way.

Download or read book Primary Care and Public Health written by Institute of Medicine and published by National Academies Press. This book was released on 2012-07-19 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ensuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health. Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention. This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health.

Download or read book Patient centered Medical Homes written by and published by . This book was released on 2012 with total page 2 pages. Available in PDF, EPUB and Kindle. Book excerpt: The patient-centered medical home (PCMH) is an important strategy within larger efforts to revamp the way care is delivered and paid for. By centering an individual's health care experience around strong primary care, PCMH seeks to bring order to a health care system that is dangerously fragmented. This Action Brief outlines the scope and impact of PCMH as well as how health plans are supporting the transformation based on data from eValue8TM--a resource used by purchasers to track health plan performance. Also provided are actions employers can take to play an important role in the prevalence and strength of PCMH.

Download or read book Patient Centered Medical Home written by and published by Transformed/Mgma. This book was released on 2010 with total page 73 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The comprehensive patient-centered medical home model unites the enduring relationship-centered values of primary care practice with new technologies and approaches to enable practices to better serve patients' needs. This workbook reviews the key elements--including leadership, teamwork, communication, and change planning--that will impact a practice considering the PCMH model."--Provided by publisher.

Download or read book Geriatrics Models of Care written by Michael L. Malone and published by Springer. This book was released on 2015-05-22 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book describes geriatrics practice models that are used to guide the care of older adults, allowing seniors to remain at home, prevent functional disability and preserve quality of life. The models include specific interventions which are performed by health care workers to address the needs of older persons and their caregivers. These models respect patient values, consider patient safety and appreciate psychosocial needs as well. Divided into six parts that discuss hospital-based models of care, transitions from hospital to home, outpatient-based models of care and emergency department models of care, this text addresses the needs of vulnerable patients and the community. Geriatric Models of Care is an excellent resource for health care leaders who must translate these programs to address the needs of the patients in their communities.

Download or read book U S Health in International Perspective written by National Research Council and published by National Academies Press. This book was released on 2013-04-12 with total page 421 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.