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How Chapters are Leading the Way
Examples of how some of our Chapters are helping to forward the PCMH movement.
We have aggressively sought opportunities for PCMH pilot development throughout the state and are pleased to report on a pilot we are developing in Fresno. We are working with the representatives of a large, self-insured employer and hope to launch a three-year pilot initially involving 50 physicians and 2,500 patients in early 2012. We obtained a grant to support the education and transformation part of this project and will continuously seek opportunities for broader implementation as the pilot progresses.
We are pursuing demonstrations and pilot opportunities made available through health care reform and seeking ways to advance the medical home model by promoting its development within ACOs.
Finally, we are sponsoring legislation to define the PCMH based on the “Joint Principles of the Patient-Centered Medical Home.”
In addition, multiple Colorado AFP members are participating in a multi-payer, multi-state PCMH pilot. And to help members better understand how to transform their practices, the Chapter produces a monthly PCMH newsletter, CAFP Medical Home Muse.
In addition, the FAFP is co-hosting, along with Dr. Paul Grundy, the development of the Florida Primary Care Patient-Centered Home Collaborative. Joining the FAFP at the meeting were representatives from the Florida Chamber of Commerce and Florida-based businesses.
The pilot practices receive matching funds for their contracted relationship with an IAFP-approved coach. IAFP has recruited ambassadors from around the state with expertise in the medical home (including many who are already NCQA recognized providers) to help engage their colleagues in medical home principles.
A virtual library of educational resources and regular, dedicated communications will support the PIN initiative and engage more members across the state. An outside grant will fund additional CME programs on chronic illness care and diabetes group visits.
IAFP’s participation in Illinois Health Connect, Your Healthcare Plus and the state’s work on Health Information Exchange serves as a strong foundation to educate and support practices as they transform their clinical and practice management models towards patient centered medical homes. IAFP is committed to educating lawmakers, providers and the public about the benefits of the patient-centered medical home through the PIN initiative.
Currently the Indiana Chapter is involved in a three-year Medical Home Learning Collaborative with the Indiana State Department of Health, Indiana University School of Medicine and the Indiana Academy of Pediatrics. The learning collaborative is funded by a grant from the Federal Maternal and Child Health Bureau. Nine family physician practices across are involved in the Medical Home Learning Collaborative. These practices are regularly visited by a team of medical home experts who provide advice on transformation and change, have bi-weekly phone conferences to discuss change with the other practices in the learning collaborative, and attend two specialized educational conferences a year.
Although the Indiana Chapter is advocating for increased medical home payments, currently there are no increased payment rates for medical home certification in Indiana.
The initiative will include enhanced physician engagement, public awareness and a pilot project for eight practices. A coalition of primary care physicians groups developed the Kansas PCMH Initiative proposal. The organizations involved in the Kansas Primary Care Physician Coalition are: the Kansas Academy of Family Physicians, Kansas Association of Osteopathic Physicians, Kansas Chapter of the American Academy of Pediatrics, Kansas Chapter of the American College of Physicians and Kansas Medical Society.
The Coalition will hold the Kansas PCMH Initiative Summit 2011 in the fall of 2011, which is designed to improve health outcomes in Kansas by engaging health care providers and health care consumers in a higher level of health care dialogue.
Maryland AFP has assisted in the recruitment of approximately 50 practices for the PCMH Pilot project coordinated by the Maryland Health Care Commission. The program offers services to over 200,000 Marylanders and holds much promise for addressing some of our greatest health care challenges. By establishing a Patient-Centered Medical Home Program, we will begin to change how health care is delivered by focusing on the whole patient and improving access for the healthy and the chronically ill.
a state level through several large stakeholder coalitions and continues to
advocate for the PCMH model in the state legislature. The MAFP has formed a
PCMH Task Force in an effort to educate the public as well as members on the
model and help members implement elements of the PCMH into their practice
The MNAFP is monitoring activities by the Minnesota Department of Health and the Department of Human Services in the development of Health Care Home certification requirements and payment methodologies.
In addition, the primary care state medical societies (family physicians, pediatricians and general internists) and the Nebraska Medical Association have all signed on to a PCMH core principals document that specifies the need to move to a payment model for care based on the joint principles document and supported by a blended payment model (combination of patient management fees, fee for service and incentive payments).
A joint committee has also been set up under the umbrella of the Nebraska Medical Association to meet with insurers to advocate for private insurance payment for the PCMH. So far, Blue Cross Blue Shield of Nebraska is starting its second phase of PCMH pilots, which will expand to about 200 providers in 2011. Other insurers have yet to step up. The committee is also looking into potential legislative options for the 2012 legislative year.
In addition, the New Hampshire Endowment for Health is providing grant support to the Center for Medical Home Improvement to advance medical home efforts within the state.
We have participated in discussions with legislative leaders regarding policy to support the medical home model. We have also incorporated advocacy for higher reimbursement for practices that achieve medical home status into our public policy advocacy efforts. We have included PCMH presentations in our educational conferences and have published information regarding state and national developments regarding the PCMH in our newsletter and on our website.
We are in the process of meeting with health insurance plans to obtain support for a care coordination project we have developed which incorporates some elements of the PCMH, and which would align the Academy with plans in identifying interventions that could enhance the ability of a practice to function as a medical home.
Along with the other members of Ohio Coalition of Primary Care Physicians, a PCMH definition for Ohio has been developed. OAFP continues to “be at the table” with all PCMH activity throughout Ohio.
The PAFP Foundation has many resources to help practices to become patient-centered medical homes, including CME and programs such as the Pennsylvania Improving Performance in Practice (PA IPIP), PA REACH East Program, PA IPIP Residency Collaborative, CRC Screening Collaborative and the Chronic Care Initiative.
Rhode Island is a small but energized chapter. There was good turnout for their meeting and the group very enthusiastic. David Ashley is the current chapter president and has made PCMH the priority for his term. With his leadership, the Rhode Island has leaped ahead in PCMH implementation.
Recently, an AAFP update was provided at the opening of their CME sessions and also spoke on health care reform at the Saturday luncheon.
The CME sessions were excellent, covering a range of clinical topics. Friday afternoon was dedicated to PCMH. Rhode Island Lt. Governor Elizabeth Roberts, Paul Grundy and the RI BCBS Chief Medical Officer were all participants. Each gave an initial presentation with the group then doing a panel discussion. This is a small chapter to watch and be a role model for smaller chapter PCMH efforts.
In addition, TAFP has created the Section on the Medical Home that meets twice a year to explore topics and develop policy relevant to this effort. The Texas Chapter continues to support and promote action at the state level and in our state agencies to expand the PCMH.
The WAFP is the sub-awardee of the Beacon Community project of Inland Northwest, where it will provide coaching support and strategic guidance. Additionally, WAFP has partnered with the Washington State Medical Association and the Puget Sound Health Alliance to create the Clinical Performance Improvement Network (CPIN), which is an educational program designed to assist physician practices focus efforts on quality improvement.
WAFP is actively involved in supporting program communications for the Washington and Idaho Regional Extension Center (WIREC), serves on the Provider Outreach and Health IT Advisory Council, and is involved in tracking the Health Information Exchange progress in Washington State.
Through these efforts, Washington State is seeing improved patient health outcomes and improved performance in practices.
This Patient-Centered Medical Home section of the AAFP web site was supported in part by a grant from Merck & Co.