-
pcmh.ahrq.gov/sites/default/files/attachments/Coordinating%20Care%20in%20the%20Medical%20Neighborhood.pdf
June 01, 2011 - In some cases, however, the most
appropriate care may be located in other communities, or patients may … Health is a
community issue,
and medical
neighborhoods
can impact
community
health
Financial … Pharmacists in independent retail
pharmacies in communities, for example, are likely to deal with very … reflecting the
specific circumstances of their communities. … Bridging primary care practices and communities to promote healthy behaviors.
-
pcmh.ahrq.gov/sites/default/files/attachments/coordinating-care-in-the-medical-neighborhood-white-paper.pdf
June 01, 2011 - In some cases, however, the most
appropriate care may be located in other communities, or patients may … Health is a
community issue,
and medical
neighborhoods
can impact
community
health
Financial … Pharmacists in independent retail
pharmacies in communities, for example, are likely to deal with very … reflecting the
specific circumstances of their communities. … Bridging primary care practices and communities to promote healthy behaviors.
-
pcmh.ahrq.gov/page/coordinating-care-medical-neighborhood-critical-components-and-available-mechanisms
June 01, 2011 - In some cases, however, the most appropriate care may be located in other communities, or patients may … 2 lists the activities to improve the medical neighborhood, reforms to promote high-functioning neighborhoods … A high-functioning medical neighborhood also can serve as a learning community that leads to relationships … reflecting the specific circumstances of their communities. … Bridging primary care practices and communities to promote healthy behaviors.
-
pcmh.ahrq.gov/page/coordinating-care-medical-neighborhood-critical-components-and-available-mechanisms-table-2
June 01, 2011 - Coordinating Care in the Medical Neighborhood: Critical Components and Available Mechanisms June 2011 … Potential activities, reforms, and supports to improve the functioning of medical neighborhoods Activities … Reforms to Promote High-Functioning Neighborhoods Payment Reforms (Payers) Direct payments for care … Tools and Resources (All) Use of pooled community resources for patient support (e.g., community health … teams) Community collaboration Use of community-based information from multi-payer databases Resource
-
pcmh.ahrq.gov/page/coordinating-care-medical-neighborhood-critical-components-and-available-mechanisms-table-4
June 01, 2011 - Coordinating Care in the Medical Neighborhood: Critical Components and Available Mechanisms June 2011 … Performance measures relevant to the medical neighborhood Performance Measure Relevance to the Medical … Neighborhood Existing Examples *CAHPS-PCMH measures are slated to be released in summer 2011 (see AHRQ … for ambulatory sensitive conditions Rates of preventable readmissions More highly functional medical neighborhoods … reports on care coordination Patient reports on care transitions Patients in well-functioning medical neighborhoods
-
pcmh.ahrq.gov/evidencenow/projects/heart-health/about/cooperatives/nyc.html
March 01, 2021 - higher mortality rates from almost all diseases, including CVD, compared with residents of higher income neighborhoods … "Working in these very small practices, we are seeing how much they are part of their communities. … The doctors live in the same neighborhoods as their patients. They speak the same language. … When you support a practice like this, you are supporting the wellbeing of a community." … New York City Community Health Survey. http://www.nyc.gov/html/doh/html/data/survey.shtml .
-
pcmh.ahrq.gov/sites/default/files/wysiwyg/evidencenow/cooperatives/evidencenow-executive-summary-nyc.pdf
November 01, 2017 - mortality rates from
almost all diseases, including CVD, compared with residents of higher income
neighborhoods … Investigator
“Working in these very small practices, we are seeing how
much they are part of their communities … The doctors live in
the same neighborhoods as their patients. They speak the
same language. … When you support a practice like this, you
are supporting the wellbeing of a community.” … New York City Community Health Survey.
-
pcmh.ahrq.gov/page/coordinating-care-medical-neighborhood-critical-components-and-available-mechanisms-table-3
June 01, 2011 - Coordinating Care in the Medical Neighborhood: Critical Components and Available Mechanisms
June 2011 … Payment reforms to enhance incentives for a better functioning medical neighborhood
Payment Reform … How It May Help Medical Neighborhood Functioning Examples
Sources:
www.cms.gov/DemoProjectsEvalRpts … hospitals with high readmission rates
PCMH payment models with new care management fees
Care transition community
-
pcmh.ahrq.gov/page/coordinating-care-medical-neighborhood-critical-components-and-available-mechanisms-table-1
June 01, 2011 - Coordinating Care in the Medical Neighborhood: Critical Components and Available Mechanisms June 2011 … Barriers to information flow and accountability in the medical neighborhood No (or few) financial incentives … care coordination Lack of staff and time for investment in coordination (at the practice and broader community
-
pcmh.ahrq.gov/cahps/news-and-events/events/2020-meeting-summary.html
December 01, 2020 - Lisa Franchetti, MA, CPHQ, Customer Experience Manager, Neighborhood Health Plan of Rhode Island
Topic … : Improving enrollee experience with a health plan’s customer service
Neighborhood Health Plan (Neighborhood … Neighborhood identified a need to focus on improving customer service by oversampling plan members, analyzing … As a result of these interventions, Neighborhood has achieved and been able to maintain improvements … Natalie McNeal, MBA, MHA, Executive Director, Wellstar Community Hospice
Topic: Improving patient experience
-
pcmh.ahrq.gov/page/citations-database-definitions
all elements of the broader health system, including specialty care, hospitals, home health care, and community … Topics include provider integration, accountable care organizations, medical neighborhoods, incentivizing
-
pcmh.ahrq.gov/news/newsletters/e-newsletter/890.html
November 01, 2023 - AHRQ in the Professional Literature
Neighborhood built environment and sleep health: a longitudinal … study in low-income and predominantly African-American neighborhoods. … Improving identification of Medicaid eligible community-dwelling older adults in major household surveys
-
pcmh.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/mcc-summit/mcc-summit-arlene.pdf
November 17, 2020 - on
preventing decline, maximizing functioning, and
improving quality of life
7
8
Medical Neighborhood … 9
Health Community
10
Research:
The Science of Care
• What works AND how do we make it work … • Patient Advocates
• Clinicians
• Researchers
• Health System Leaders
• Community Organizations
• Professional … with MCC
�Addressing MCC Across �the Continuum of Risk
Shared Principles of Primary Care
Medical Neighborhood … Health Community
Research: �The Science of Care�
Research Challenges
Who is here today?
-
pcmh.ahrq.gov/ncepcr/research/care-coordination/index.html
September 01, 2022 - Literacy
Quality Improvement
Data Resources
Tools and Resources
Research Communities … crucial components of the medical home, including patient-centeredness, care coordination, the medical neighborhood
-
pcmh.ahrq.gov/pcor/strategic-framework/stakeholder-engagement.html
July 01, 2023 - Stakeholders include family members and caregivers, patient advocates, community members and organizations … Communities can be defined in social, economic, or geographic terms, such as patient communities, racial … /ethnic communities, percent of the population living below the Federal poverty level, or residents of … an urban or rural neighborhood. … Stakeholder engagement can help define appropriate community representatives to include in the work.
-
pcmh.ahrq.gov/cahps/quality-improvement/index.html
October 01, 2023 - benefits of expanding teamwork to include patients and families, health care practices, and medical neighborhoods
-
pcmh.ahrq.gov/ncepcr/research/care-coordination/pcmh/define.html
August 01, 2022 - Literacy
Quality Improvement
Data Resources
Tools and Resources
Research Communities … Building on the work of a large and growing community, the Agency for Healthcare Research and Quality … , will build virtual teams linking themselves and their patients to providers and services in their communities … elements of the broader health care system, including specialty care, hospitals, home health care, and community … Engaging Patients and Families in the Medical Home (PDF, 651 KB)
Coordinating Care in the Medical Neighborhood
-
pcmh.ahrq.gov/sops/databases/pharmacy/submission.html
November 01, 2023 - Pharmacy
Participating in the Community Pharmacy Database
Ambulatory Surgery Center … Pharmacy Survey Database
The SOPS ® Community Pharmacy Database is a central repository for … The SOPS Community Pharmacy Database Report presents aggregated results for all participating community … pharmacies as well as results by community pharmacy and respondent characteristics. … , mass merchandiser pharmacy, or neighborhood drug store pharmacy.
-
pcmh.ahrq.gov/talkingquality/explain/share-info/index.html
November 01, 2018 - with; these can include organizations for population subgroups defined by age, gender, race/ethnicity, neighborhood
-
pcmh.ahrq.gov/page/practices-and-practice-facilitators
December 01, 2011 - the release of this manual, AHRQ also created a Primary Care Practice Facilitation (PCPF) learning community … As a part of this learning community, AHRQ hosted a series of webinars on practice facilitation, all … all elements of the broader health system, including specialty care, hospitals, home health care, and community … Topics include provider integration, accountable care organizations, medical neighborhoods, incentivizing