Transcript Document 7143775

FY 2011 Supplemental Funding
for Quality Improvement and
Patient-Centered Medical Home
Development in Health Centers
U.S. Department of Health and Human Services
Health Resources and Services Administration
Bureau of Primary Health Care
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Agenda
• Overview of PCMH Health Center Supplemental Funding
• Application requirements
• Electronic submission process
• Readiness assessments to determine where to target the
funding
• PCMH domains
• Third-party recognition as a PCMH
• Questions & Answers
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Supplemental Funding Overview
• Purpose:
– To improve the quality of care, access to services, and
reimbursement opportunities for health centers by supporting
the costs associated with enhancing quality improvement
systems and becoming patient-centered medical homes
(PCMHs)
• One time supplement of $35,000 (Note: This amount of funding
may be increased up to $50,000 depending on the number of
successful applicants)
• Project period: 1 year
• HRSA Electronic Handbook (EHBs): 8:00 PM EST on August
22, 2011
• Eligible applicants are existing Health Center Program grantees
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Goals of the Supplemental Funding
Opportunity
• Health centers assess their operations through the lens of
the patient-centered medical home model of care
• Health centers move toward the PCMH model with an
upfront investment in quality-related activities
• Health centers submit a Notice of Intent (NOI) to gain thirdparty PCMH recognition
• Health centers enhance and/or maintain their current
PCMH practice
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Application Requirements
• Completion of the Project Narrative
• Completion of Excel Application Form
– Do NOT unlock, edit, or manipulate the application
• Completion of the Budget
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Application Requirements
Application Form
• Submission of an NOI to a patient-centered medical home
initiative (Federal or state) within the next 12 months (for
grantees who are not yet PCMH)
• Submission of progress reports after 6 and 12 months
– Choose at least 1 PCMH domain
– Complete narrative for each domain
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Application Requirements
Project Narrative
• Project narrative
– Describe proposed activities, projected outcomes and
how these activities align with current quality
improvement efforts
– Describe key clinical and non-clinical activities that
support achievement of PCMH recognition and projected
outcomes of these activities
– Describe efforts to gain recognition and how activities
will support PCMH recognition
• Timeline and key personnel
– Identify key staff/personnel responsible for
implementation and an estimated completion date
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Budget Presentation
• Budget Form (SF-424A)
– One-year budget period
• Budget narrative/line-item justification
– Describe each cost element and explain how it
contributes to meet project objectives
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Submission Process
• E-mail notifications that the PCMH supplemental funding
request is available for submission have been sent to
Health Center Project Directors.
• The funding request will be completed in HRSA’s Electronic
Handbooks (EHB) only.
• Grantees submit the supplemental funding request in EHB
using the Prior Approval Request module within the H80
Grants Handbook. The User Guide is included with the
Supplemental Funding Announcement.
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Readiness Assessments
• Primary Care Development (PCDCC) PCMH assessment tool:
http://www.pcdcny.org/data/org/128/media/doc/9994_standard_version
_pcmh_baseline_self_assessment_tool_-_updated.xls
• Safety Net Medical Home Initiative: PCMH-Assessment:
http://www.qhmedicalhome.org/safety-net/upload/PCMH-A_public.pdf
• Medical Home Implementation Quotient (MHIQ) from TransforMED:
http://www.transformed.com/userLogin.cfm
• NCQA and other accreditation survey materials
• Others
– Cooley Medical Home Index
– State pilot tools
• Health centers who have already been recognized may use their PCMH
survey results as a foundation for the proposed project.
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6 PCMH Domains
• Enhanced access and continuity
• Identifying and managing patient populations
• Planning and managing care
• Providing self-care and community support
• Tracking and coordinating care
• Measuring and improving performance
Source: http://http://www.ncqa.org/tabid/1034/Default.aspx
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Enhanced Access and Continuity
• Open scheduling
• Expanded hours
• Innovative modes of communication between patients,
providers, and staff, i.e., electronic access
• Example of a possible project
– Your health center is interested in pursuing an open
access model of care. You propose funding to hire a
consultant team to help re-engineer your appointment
scheduling system for front office and provider staff.
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Identifying and Managing Patient
Populations
• Searchable system for patient information
• Practice uses patient information, clinical data, and
evidence-based guidelines to generate lists of patients and
to proactively remind patients/families and clinicians of
recommended services
• Example of possible project
– Your health center just purchased an Electronic Health
Record system. You are in the process of tailoring the
system to your practice but realized you need to
purchase three more work stations and train your
support staff. You propose to utilize the supplemental
funds to cover these costs.
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Planning and Managing Care
• The practice systematically identifies individual patients and
plans, manages and coordinates their care, based on their
condition and needs and on evidence-based guidelines
• Creation of a care team
• Proactive identification of high risk patients
• Example of possible project
– Your health center would like to hire a consultant to
provide guidance on how to best create patient care
teams that include medical providers as well as other
types of staff such as care coordinators, behavioral
health specialists, community health workers, and
nutritionists.
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Providing Self-Care and
Community Support
• The health center provides self-care plans, tools,
educational resources and ongoing support to patients
• Self-management tools and evidence-based counseling
• Referrals to community resources
• Example:
– Your health center provides care for a large number of
diabetic patients. You have a health educator who
facilitates weekly diabetes support and education
sessions. You propose to utilize the supplemental funds
to collaborate with other local health care facilities to
share resources for diabetes education.
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Tracking and Coordinating Care
• Care is coordinated and integrated across all health care
systems and the patient’s community
• Laboratory testing and follow-up
• Referral tracking and follow-up
• Practice manages care transitions
• Example:
– Your health center would like to work on their referral
tracking system. You propose to utilize the supplemental
funds to purchase an updated referral tracking system
and to train staff on its use.
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Measuring and Improving
Performance
• Health center uses performance data to identify opportunities
for improving clinical quality, efficiency and patient experience
• Ongoing quality improvement process
• Electronic reporting of ambulatory clinical quality measures
• Example:
– Your health center noticed that your clinical quality
measures on hypertension control could use improvement.
You would like to conduct Plan, Do, Study, Act (PDSA)
cycles with the health educator to evaluate and improve
your patient’s home blood pressure monitoring. You
propose to utilize the supplemental funds to provide extra
time for your QI committee to examine and take action on
this issue.
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PCMH Recognition
• National Committee for Quality Assurance (NCQA)
• The Joint Commission
• Accreditation Association for Ambulatory Health Care
(AAAHC)
• State pilot programs
• Insurance programs (e.g., Care First Blue Cross Blue
Shield)
• URAC
• Other
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Contacts
• Electronic submission questions
– BPHC Helpline: [email protected] or 1-877-974-2742
• PCMH supplemental grant requirements
– For more information: [email protected]
• HRSA Initiative on NCQA Recognition
– For more information: [email protected]
– http://bphc.hrsa.gov/policiesregulations/policies/pal201101.ht
ml
• HRSA Accreditation Initiative
– For more information: [email protected]
– http://bphc.hrsa.gov/policiesregulations/accreditation.html
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