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Patient-Centered Medical Home

Transforming Primary Care in Nevada

NVPCA is engaged in supporting their members and the entire safety net medical home community in Nevada regarding practice transformation. 

NVPCA provides technical assistance and training, working to improve the health status and quality of health care provided to patients.  Specifically, NVPCA is interested in working to inform, educate and provide varying forms of technical assistance to FQHCs and other organizations who are interested in seeking recognition as a patient centered medical home (PCMH). Through population health and primary care improvements we know that more people in Nevada can maintain a higher quality of life.

Our quality improvement programs support our mission to increase health equity and access to comprehensive health care for low-income and vulnerable people in Nevada.

Supporting your Practice as a PCMH

The Patient Centered Medical Home (PCMH) is an approach for providing comprehensive, coordinated primary care to adults, youth and children of all ages.  It facilitates partnerships between individual patients, and their personal physicians, and when appropriate the patient’s family. PCMH is emerging as a key strategy to improve health outcomes, reduce total costs, and strengthen primary care. Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.

NVPCA as funded by HRSA BPHC is obligated to provide training and technical assistance to FQHCs so that ALL become recognized as a PCMH.

A subset of FQHCs nationally are part of a CMS demonstration project to support readiness and assure that the participating FQHCs obtain recognition. This program started in 2011 and concludes October 2014. NVPCA members are able to benefit from this project without directly participating. NVPCA staff have participated in a Learning Collaborative for PCAs and as a result have had access to additional information, training and national experts to support practice transformation PCMH efforts in Nevada.

How to obtain PCMH Technical Assistance in Nevada

NVPCA’s contracted PCMH practice transformation, PCMH and QI consultant is supporting all FQHCs in Nevada and other members upon request. She is a PCMH certified content expert (CCE) through National Commission for Quality Assurance (NCQA) with experience as a practice transformation coach regarding quality improvement and PCMH. All four of the Nevada FQHCs are at different points in their practice transformation journey and in seeking PCMH recognition from NCQA for PCMH recognition.  

  • Community Health Alliance, Inc. (formerly HAWC) worked in 2012 and 2013 to obtain recognition at their Wells clinic site in Reno.  Their application was submitted in September 2013 and as of April 2014 results were still pending by NCQA. They plan to seek recognition for three other clinic sites in 2014.  
  • First Med Health and Wellness Center in Las Vegas began their planning, gaps analysis and practice transformation in 2014 and intend to submit by the first quarter of 2015.
  • Nevada Health Centers, Inc. worked in 2012 and 2013 to seek recognition at their Martin Luther King clinic site in Las Vegas and they obtained level 3 recognition in January 2014.  Six other clinic sites have recognition surveys and application with NCQA that are pending review.  They plan to submit for all sites in 2014 so that all 16 become recognized.
  • Northern Nevada Hopes, Inc. in Reno NV worked in 2013 to obtain recognition at their single site. Their survey and application were submitted to NCQA in April 2014.

NCQA ’s Patient-Centered Medical Home (PCMH) 2011 and 2014 standards and guidelines outline an innovative program for improving primary care. The 2011 standards can be used for seeking recognition through March 2015.  The set of standards describe clear and specific criteria, and the program gives practices information about organizing care around patients, working in teams and coordinating and tracking care over time. The 2014 NCQA Patient-Centered Medical Home standards have more emphasis on team-based care, care management, integration of behavioral health and sustained transformation.

Patient Centered Medical Home Resources

Located within the NVPCA website is a wealth of educational and resource materials on a variety of topics relevant for Nevada Health Centers and other safety net provider clinics to assist in the delivery of primary and preventive care to medically underserved populations. 

Getting Started (Learn Key Aspects of PCMH)

Before you start your journey of practice transformation and seeking recognition as a PCMH, review these resources.

Change Concepts
Are you interested in a detailed explanation of the Patient-Centered Medical Home Change Concepts from Dr. Ed Wagner himself? Are you curious about best practices for developing your providers' panels of patients? Resources on these topics and many others, including videos, podcasts, webinars, articles, and tools, are available to any health center interested in Medical Home transformation by clicking on the Qualis Health Medical Home website.

The Primary Care Development Corporation has developed an excellent resource for health centers seeking NCQA recognition as a medical home. A free resource, the 'Patient-Centered Medical Home Recognition Manual' includes tools for self-assessment and project management as well as templates for communication with various stakeholders and much more.

NCQA Patient-Centered Medical Home (PCMH) Recognition is the most widely-adopted model for transforming primary care practices into medical homes. NCQA’s requirements – developed with the input and support of employers, unions, health plans and consumers – are demanding. NCQA has purposely set the standard high to encourage organizations to continuously enhance their quality.

NCQA PCMH Recognition Webpage  
Click for information on how to get recognized by NCQA as a PCMH - from start to finish.

  Before: Learn It

  During: Earn It

  After: Keep It

Doing It (Specific Resources to Help you obtain PCMH Recognition)

Find tools, templates, websites, reports and fact sheets to help your practice get and stay organized to apply for PCMH Recognition.

Click to be taken to where you can download the standards and guidelines to become a NCQA PCMH organization/practice.
 This allows you to access the 2011 and/or 2014 standards.

Training Opportunities Provided by NCQA

PCMH Recognition Checklist 2013  |  PDF  | Source: Community Care North Carolina

Timeline to NCQA 
2013  |  Word  |  Source: J Hayes, InterCare Community Health Network
Timeline of Implementation of standards before submission to National Committee for Quality Assurance.

PCMH Self Assessment 
2013  |  Word  |  Source: Arkansas Primary Care Association
A factor by factor assessment tool

Sustaining (Continually measuring and improving your PCMH journey)

After you have received PCMH recognition, there are strategies and tools your practice can use to sustain the work accomplished and continue to improve.

PCMH Sustainability Toolkit-NEW
2013  |  Excel  |  Source: PCDC

Meaningful Use Core and Menu Set Measures Quick Links
2013  | PDF  |  Source: CMS, Modified by Primary Care Development Corporation
User friendly menu of links to view or download measures. This resource will save time by providing easy access.

NVPCA has not vetted or endorsed the documents listed above; they are open source documents.

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