Learn More About Our Members
Learn more about the community health centers that make up our network.
Care delivery in the United States is shifting. We are finding better and more innovative ways to coordinate care across the system, engage and empower patients, and manage costly chronic diseases. This shift starts with health information technology (HIT) and meaningful use. An institution that is a meaningful user of HIT can care for its patients with more powerful tools and data than ever before.
Patient Centered Medical Homes
With information at its fingertips, primary care practices can become Patient Centered Medical Homes (PCMH). The Patient Centered Medical Home is a health care setting that facilitates partnerships between individual patients and their personal physicians, and when appropriate, the patient’s family. 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. The U.S. Health Resources and Services Administration’s Patient-Centered Medical Health Home (PCMHH) Initiative encourages community health centers to undertake and document the practice changes that will enable them to gain recognition from the National Committee for Quality Assurance (NCQA) through their PCMH program. To promote quality improvement, the PCMHH Initiative provides access to survey-related education, training, and technical assistance resources that highlight the benefits of seeking recognition and common barriers to success. The fee for gaining NCQA PCMH recognition is waived for health centers that participate in HRSA’s PCMHH Initiative.
Accountable Care Organizations
On March 31, 2011, the U.S. Department of Health and Human Services (HHS) released proposed new rules to help doctors, hospitals, and other health care providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs). ACOs create incentives for health care providers to work together to treat an individual patient across care settings — including doctors’ offices, hospitals, and long-term care facilities. The Medicare Shared Savings Program will reward ACOs that lower health care costs while meeting performance standards on quality of care and putting patients first. Patient and provider participation in an ACO is purely voluntary.
For a variety of reasons, Federally Qualified Health Centers (FQHCs) will not initially be included in the Medicare Shared Savings Program ACO program. Alternatively, HHS announced on June 6, 2011, the Federally Qualified Health Center Advanced Primary Care Practice (FQHC APCP) demonstration project — a new Affordable Care Act initiative that will pay an estimated $42 million over three years to up to 500 FQHCs to coordinate care for Medicare patients through Patient Centered Medical Homes. The FQHC APCP demonstration will show how the PCMH model can improve quality of care, promote better health, and lower costs. Participating FQHCs are expected to achieve Level 3 PCMH recognition, help patients manage chronic conditions, as well as actively coordinate care for patients. To help participating FQHCs make these investments in patient care and infrastructure, they will be paid a monthly care management fee for each eligible Medicare beneficiary receiving primary care services. In return, FQHCs agree to adopt care coordination practices that are recognized by NCQA.
Clinical Integration Networks
While Accountable Care Organizations are one model of system integration, there are a variety of options to improve care and lower costs, most of which like ACOs are based upon the foundation of the Patient Centered Medical Home. Another example, a Clinical Integration Network (CIN) is a framework for otherwise competing physicians to collaborate in an effort to reduce costs and provide improved health care. There are four commonly cited indicators of a CIN:
1. They exchange health and other information electronically;
2. The providers develop and adhere to clinical protocols to direct care;
3. There is oversight of all care provided; and
4. There is an enforcement mechanism to ensure protocol adherence.
We, in the District of Columbia, are fortunate to have more than the basic framework for such an entity to be created. The DC Regional Health Information Organization (DC RHIO) is in its third year of operation and the great majority of DCPCA’s community health centers are well on the road to meaningful use of health information technology. As a result, the first index is already achieved. (Note: Similarly in an ACO, 50 percent of providers would have to be meaningful users.)
These are just examples of how the health care system in DC is changing, and you can look to DCPCA to help lead you on the path towards improved care delivery.
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