NYC DOH PCIP (PCMH) Patient Centered Medical Home Primary Care Information Project

Patient Centered Medical Home Primary Care Information Project

Background

Patient-Centered Medical Home (PCMH) is a care model in which the primary care physician, supported by staff, coordinates the care of patients across the health system. The National Committee for Quality Assurance (NCQA) launched a certification program for practices that embrace the principles of the Patient-Centered Medical Home. Achieving this certification could allow health plans and patients to recognize your care coordination and quality improvement work within this groundbreaking model of care.
When a patient appoints a primary care doctor as the leader of his or her Patient-Centered Medical Home, that provider coordinates appropriate referrals to labs, diagnostic imaging, specialist care, and follows up on emergency room visits; maintaining a comprehensive medical record for the patient. Access to these records and the continuity of the doctor-patient relationship allow a Patient-Centered practice to deliver appropriate care and keep up with preventive services for their patients. In fact, early studies of Patient-Centered primary care suggest that patients who have a primary care clinician coordinating their care and tracking outcomes are much more likely to receive evidence-based preventive care, and enjoy better health outcomes.

Researchers have proven that specialty medical care is more likely to be appropriate and effective when it is spurred by coordinated referrals from a patient’s primary care doctor. In response to this evidence, 74% of health care leaders in business, government and health care delivery support compensating practices that serve as patient-centered medical homes, according to a 2008 Commonweath Health Leaders survey.

Funding

Providers now have two more reasons to apply for PCMH certification. Empire BlueCross BlueShield and New York State Medicaid both recently announced plans to pay providers who meet the NCQA criteria. Empire will pay each certified primary care provider based on the number of Empire patients they see and the level of certification they have achieved.

While all the details of the two programs are not available yet, PCIP strongly encourages all practices to submit their paperwork to ensure they are eligible.

Get Started

If you are a PCIP-participating provider, we are delighted to inform you that you are already eligible for at least a Level I PCMH certification through NCQA. To receive your certification you must submit a basic application to NCQA. You may even be eligible to have PCIP cover the cost of your PCMH application. In addition, our Quality Improvement Specialists look forward to working with your practice to improve patient access and tracking, develop new office policies, and help refine your office workflows. As you take these steps towards improved quality of care, you will earn an even higher level of certification.
For details email Laura Breiner (lbreiner@health.nyc.gov).


Visit these links for detailed information the PCMH criteria.

National Committee for Quality Assurance
Primary Care Development Corporation - PCMH Handbook
On The Record - PCMH Forum

More Information you may also email: pcip@health.nyc.gov