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PCPF Webinars | PCMH Resource Center
: A How-To Guide . … Jonathan Sugarman, President and CEO at Qualis Health in Seattle
Julie Schilz, Vice President for Care … at the Primary Care Development Corporation, New York
Kristin Geonnotti, Health Researcher at Mathematica … for Rural Policy at Humboldt State University
Part III: Supporting Leaders to Promote Quality and Patient … , and Improving Models of Primary Care Delivery
Training Primary Care Practice Facilitators
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Early Evidence on the Patient-Centered Medical Home - Table 1 | PCMH Resource Center
care physicians (PCPs), a hospital, the Department of Social Services, and the health department. … Case managers from a nonprofit work with PCPs in the network to coordinate care and undertake population … Improving Mood-Promoting Access to Collaborative Treatment for Late-Life Depression (IMPACT) A depression … referrals to specialists and hospitals; a local parent of a child with special health care needs provides … AcademyHealth State Health Research and Policy Interest Group, 2009; Chronic Care Management, Reimbursement
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The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 7 | PCMH Resource Center
The Medical Home: What Do We Know, What Do We Need to Know? … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Geriatric Resources for Assessment and Care of Elders 2 years: Improved 4 of 8 Short Form (SF)-36 scales … days in bed Improving Mood–Promoting Access to Collaborative Treatment 3 months; 6 months: Reduced … component score, quality of life, and general health 2 years: Overall impairment 1 Year: 16 process
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Practice Facilitation | PCMH Resource Center
strategy to improve primary health care processes and outcomes, including the delivery of wellness and … Redesigned Care: The Roles of Practice Facilitators and Care Managers ( PDF Version — 84KB) Efforts … but distinct roles in redesigning and improving care delivery
Curriculum and Training
Find a core … at improving primary care. … gaining initial buy-in from practices, maintaining meaningful and sustained engagement in QI efforts
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The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 3 | PCMH Resource Center
Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Health outcomes include measures of functioning, quality of life, and self-rated health status. … Professional experience includes the experience of staff and other health care professionals. a The … Resources for Assessment and Care of Elders Cluster RCT a Yes Yes Yes Yes Yes Yes Yes Yes Group … Cluster RCT Yes Yes Yes Yes Yes Yes Yes Improving Mood—Promoting Access to Collaborative Treatment
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The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 9 | PCMH Resource Center
The Medical Home: What Do We Know, What Do We Need to Know? … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Geriatric Resources for Assessment and Care of Elders a Year 3: Reduced 23% among high-risk patients … Improving Mood-Promoting Access to Collaborative Treatment for Late-Life Depression 4 years: All … patients VA Team-Managed Home-Based Primary Care Months 1–12: Increased 12%
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The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 12 | PCMH Resource Center
The Medical Home: What Do We Know, What Do We Need to Know? … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … setting, problem solving, patient activation mproving Mood–Promoting Access to Collaborative Treatment … Primary Care Year 1: Improved access to care, interpersonal experience, technical quality, communication … , and self-reported outcomes among nonterminal patients Year 1: Satisfaction with care among nonterminal
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Creating Patient-centered Team-based Primary Care
(pdf file)
Care www.ahrq.gov
National Center for Excellence
I N P R I M A R Y C A R E R E S E A R C H
National … Department of Health and Human Services. … ) as “…the provision of health services to individuals, families, and/or their
communities by at least … partners in care;
efforts to seek patient input to inform the organization and
delivery of care, and … Primary Care: Balancing Health Needs, Services and Technology.
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Prospects For Care Coord. Using Elect Data Sources 3-16-12
(pdf file)
care services.1 It has been recognized as a priority area for improving health care delivery in
the … local, State,
regional and national level.vi
Health Information Technology (Health IT) – The … panelists led us to the following recommendations for improving the ease of access to
data within health … across
disparate stakeholders at the local, State, regional and national level. … , and academic organizations
focused on improving the development and deployment of State-based all
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Early Evidence on the Patient-Centered Medical Home - Table 4 | PCMH Resource Center
Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … : Care Management Plus Yes Yes Processes of Care Interventions: Improving Mood–Promoting Access to Collaborative … and Care of Elders Yes Yes Health Outcomes Interventions: Improving Mood–Promoting Access to Collaborative … Assessment and Care of Elders Yes Yes Yes Cost Interventions: Guided Care Yes Cost Interventions: Improving … Mood–Promoting Access to Collaborative Treatment for Late-Life Depression Yes Cost Interventions: Veterans
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Early Evidence on the Patient-Centered Medical Home - Appendix | PCMH Resource Center
Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … without diabetes Processes of Care Interventions: Improving Mood–Promoting Access to Collaborative Treatment … days in bed Health Outcomes Interventions: Improving Mood–Promoting Access to Collaborative Treatment … 8 months: All patients Cost Interventions: Improving Mood–Promoting Access to Collaborative Treatment … solving, patient activation Patient Experience Interventions: Improving Mood–Promoting Access to Collaborative
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Early Evidence on the Patient-Centered Medical Home - Table 5.2 | PCMH Resource Center
Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … primary care clinics (4 family medicine and 3 internal medicine practices) in a large, integrated delivery … rural central Pennsylvania in a large IDS Yes 11 Yes Geriatric Resources for Assessment and Care of … Elders Primary care physicians in community-based health centers in urban area of Indiana in an IDS Yes … Access to Collaborative Treatment for Late-Life Depression Primary care providers in primary care clinics
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Module 3: The Primary Care Landscape
(pdf file)
U.S. history and the culmination of many previous efforts at
comprehensive national health care reform … seek access to primary
care services. … Conducts demonstration and pilot
projects aimed at improving the
health care delivery system. … , access,
and care management for their patients and have an opportunity to share in Medicare cost … Washington, DC: National Academy Press; 1996. http://iom.edu/Reports/1996/Primary-Care-
Americas-Health-in-a-New-Era.aspx
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Early Evidence on the Patient-Centered Medical Home - Table 3.1 | PCMH Resource Center
Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … and Care of Elders
Cluster RCT a
High: Health outcomes; mortality; costs, hospital use, and ED use … those with a hospitalization in the first year of the intervention)
Low: Health care professional experience … and study controlled for baseline values of the outcome)
Improving Mood–Promoting Access to Collaborative … baseline differences in the outcomes
Low: Patient experience of care at 18 and 24 months
Outcome based
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Citations Database Search Help | PCMH Resource Center
To begin, enter the search term or phrase in the text box and select “enter” or the search button. … to cover “Policy Issues” as a central subject will not appear in the search results. … For example, entering the term “pediatrics” in the text box, “Outcomes” as a subject, “Children” as a … At the top of the result page, you will see the number of items in the collection that match that value … If you find an article that meets your criteria, look at the citation to find out what other terms may
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Early Evidence on the Patient-Centered Medical Home - Table 5.1 | PCMH Resource Center
Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Yes Geisinger Health System (GHS) ProvenHealth Navigator Medicare Advantage (MA) enrollees in the Geisinger … Health Plan Yes Geriatric Resources for Assessment and Care of Elders Medicare patients with income … ’s sickest aged Medicare patients; 38% consent rate Yes Yes Yes Improving Mood–Promoting Access to Collaborative … in activities of daily living or a prognosis of terminal illness or homebound with CHF or COPD; 89%
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The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 13 | PCMH Resource Center
Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Guided Care a 6 months: Caregiver burden amongall caregivers 18 months: 1 of 6 measures of caregiver … experience with quality of care provided to patients among all caregivers, 4 of 6 measures among high-intensity … 5 of 6 measures of caregiver experience with quality of care provided to patients among all caregivers … 12 months: Improved caregiver experience with quality of care provided to patients among nonterminal
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Defining the PCMH | PCMH Resource Center
Defining the PCMH
The medical home model holds promise as a way to improve health care in America by … their patients to providers and services in their communities. … care system, including specialty care, hospitals, home health care, and community services and supports … times for urgent needs, enhanced in-person hours, around-the-clock telephone or electronic access to … Using Health Information Technology to Support Quality Improvement in Primary Care
Related White Papers
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The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 4.2 | PCMH Resource Center
Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … and comparison groups did not have equivalent outcomes at baseline Community Care of North Carolina … ; patient experience of care; health care professional experience Systematic confounding due to implementation … confounding due to implementation in only one clinic Pediatric Alliance for Coordinated Care Pre-post … of changes in the outcome to the intervention rather than other factors Pennsylvania Chronic Care Initiative
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The Medical Home: What Do We Know, What Do We Need to Know? A Review of the Earliest Evidence on the Effectiveness of the Patient-Centered Medical Home Model. Table 5 | PCMH Resource Center
The Medical Home: What Do We Know, What Do We Need to Know? … Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, www.ahrq.gov Contract … Number of evaluations that assessed each triple aim outcome and health care professional experience … Processes of Care
7
3
Health Outcomes
4
3
Mortality
2
2
Cost and Service Use
Costs (with … Patient
5
3
Caregiver
2
2
Health Care Professional Experience
Health Care Professional Experience