• Principle Healthcare Associates


    Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

    Contact us at PHA email and be sure to visit us at PHA Website

  • Like PHA

Engaging Specialty Practices in the Patient Centered Medical Neighborhood

Engaging Specialty Practices in the Patient Centered Medical Neighborhood

Building on last week’s post about embracing change for healthcare transofrmation, it was intriguing to learn about the NCQA’s new patient centered medical home program for specialty practices.  Kicking off  March 25, the Patient Centered Specialty Practice (PCSP) recognition highlights specialty practices committed to access, communication and care coordination as “neighbors” that surround and inform the medical home and colleagues in primary care, according to NCQA.  And I regret to say that I missed the informational webinar, including an NCQA advisor and guest speaker from one of the local healthcare systems.

Had I attended the webinar, I would have been better prepared to query the CEO of a hospital within the same healthcare system at a recent American College of Healthcare Executives (ACHE) function.  Interestingly, we had a lengthy conversation regarding the system’s desire to exchange data within the area; however, the CEO noted that current system architecture made it challenging enough to simply share information amongst health system participants.  With one of the key tenets for the PCSP recognition being timely exchange of data, this is a bit of a conundrum.  While the Direct project offers a simple solution, the ultimate goal will be to facilitate and encourage physicians to search for records in efforts to keep all parties abreast of the care plan.  And while this is a tremendous step, we also noted that retail & urgent care clinics, solo primary care practices and free-standing care centers need to get in on the game too.

I also see a need for ancillary providers to be included as well.  Not only would individuals benefit from the opportunity to view x-rays but, more to the point, visualizations, similar to the one here.  While Physical Therapists do an excellent job engaging patients in discussion, they would have far greater impact with the ability to illustrate their points on an interactive tablet app.  And thinking out loud, wouldn’t it be great for individuals to be able to reference the same app at home – to review the information and implement “their’ steps in the care plan?

 

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse PractitionerPhysician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates that stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Innovating Medicaid with the Medical Home Model

Innovating Medicaid with the Medical Home Model

After reading Cheryl Clark’s interview with Dr. Bruce Siegel, President & CEO of the National Association of Public Hospitals and Health Systems, she points out that if the entities existing in one of the 30 states now threatening to refuse to expand their Medicaid eligibility rules to 138% of the federal poverty leveldon’t receive assistance, they’ll continue to provide uncompensated care for many of their sickest patients.  For organizations already stretching to deliver care to the most vulnerable populations, it was encouraging to learn that seven more states have joined the Medicaid ACO project, which targets low-income populations for care improvements and cost reduction via the medical home.

Will a move away from managed care to care coordination payments provide enough incentive for chronically ill Medicaid patients to obtain necessary primary care versus waiting for an urgent or emergent situation to send them to the emergency department?  Dr. Lisa Letourneau, executive director of Maine Quality Counts, a regional healthcare improvement collaborative and  physician champion for the Maine Patient-Centered Medical Home pilot, thinks so.  In order for the 108 practices that have applied for the Medicaid health home pilot, they must have NCQA medical home recognition or have applied for it, maintain an EHR and commit to 10 core expectations of medical home that go beyond National Committee for Quality Assurance (NCQA) conditions.

Although there are already more than 100 ACOs that serve Medicare populations, the Medicaid population is notably sicker, poorer and requires more resources – a complex and challenging equation to say the least.  In efforts to utilize the most efficient resources, advanced nurse led medical homes with patient engagement technology provide an alternative worth considering for those rural locations struggling to meet budgetary requirements. With the brightest minds recently convening at the World Congress 2nd Annual Leadership Summit on Medicaid, one can only hope that they were discussing medical homes similar to Piedmont Health, North Carolina’s first community health center focused on delivering comprehensive primary care services and health education to its members.

With millions of dollars at stake and community health on the line, innovating Medicaid with the medical home model should be a priority today, and not tomorrow.

Engaging Patients in the Advanced Practice Nurse Led Medical Home

Engaging Patients in the Advanced Practice Nurse Led Medical Home

Is it any coincidence that the American Medical Association annual meeting came to a close earlier this week…only to be followed by a close start to the American Academy of Nurse Practitioners annual event?  I hope not.  Despite being conducted more than six years ago, this study’s findings continue to ring true:  Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care and the need to use scarce human healthcare resources has resulted in increased emphasis on primary healthcare.  Key to the findings were the fact that scope of practice, emphasizing the importance of role clarity and trust and ideological differences regarding disease prevention/ health promotion all remain integral to the evolution of collaborative relationships between physicians and nurse practitioners.

While these collaborative relationships have been important in the past, they are being pushed to the forefront as we hurdle to the finish line, eagerly anticipating which parts, if any, of the Patient Protection and Affordable Care Act (PPACA) will make it across the finish line.  As Michelle Papachrisanthou, RN, MSN, CPNP, DNP-S, outlines in her article, The DNP and the Healthcare Home, “an estimated 30% increase in U.S. medical school enrollment would be needed for the physician population to meet the population growth, aging and other healthcare factors that the United States faces. This equates to a shortage of 124,000 physicians by the year 2025. Moreover, the population is projected to grow by more than 50 million between 2006 and 2025 to 350 million. When universal healthcare is added to the above equation shortages, we are now an additional 31,000 providers short.”  Recognizing the need for primary care, the Centers for Medicare & Medicaid Services (CMS), recently announced a new initiative that will provide funds to eligible hospitals to increase the availability of clinical training settings that will bolster the skills and supply of APRNs.

With a requirement for participating organizations to deliver fifty percent of clinical training in non-hospital settings in the community, CMS appears to agree with Dr. Papachrisanthou’s assertion that, “the DNP emphasis on primary care and its streamlined clinical focus promotes itself as a solution to lead the way for healthcare homes and the future of healthcare.”  In addition, she points out that scope of practice and prescriptive authority still preclude some states from participating and must be amended for true transformative change.  Forging a step in the right direction, the National Committee on Quality Advancement (NCQA) began recognizing nurse led medical homes in 2011.  As witnessed in the video below, Nurse Practitioner led medical homes fill a mission-critical void by successfully engaging chronically ill patients that suffer from a myriad of psycho-social issues.  Marry this concept with technology that allows the providers to extend their engagement beyond the walls of the clinic…and we begin to see opportunity for marked improvement.  With record numbers of uninsured patients – most evident in the Southwest – poised to descend on the emergency department, isn’t it time for your organization to consider nurse led medical homes?

 

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates that stand head and shoulders above the competition.

 Contact us at PHA email and be sure to visit us at PHA Website