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Patient-Centered Primary Care Home Program

Oregon Health Authority Patient-Centered Primary Care Home Program Quality & Health Outcomes Committee August 2013. Patient-Centered Primary Care Home Program. HB 2009 established the PCPCH Program:

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Patient-Centered Primary Care Home Program

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  1. Oregon Health Authority Patient-Centered Primary Care Home ProgramQuality & Health Outcomes Committee August 2013

  2. Patient-Centered Primary Care Home Program HB 2009 established the PCPCH Program: Create access to patient-centered, high quality care and reduce costs by supporting practice transformation Key PCPCH Program Functions: • PCPCH recognition and verification • Refinement and evaluation of the PCPCH Standards over time • Communication and provider outreach • Coordination across OHA divisions, CCO development and health reform initiatives • Restructure primary care payment to align with the PCPCH framework • Technical assistance development

  3. Core Attributes of a Primary Care Home Oregon’s PCPCH model is defined by six core attributes, each with specific standards and measures

  4. As of August 2013 >425 recognized

  5. Updates to the PCPCH Recognition Criteria • PCPCH Standards Advisory Committee met in fall 2012 • Final report provided recommendations to: • Clarify current criteria, and • Incorporate new standards to improve the current model • Evidence-based • Each PCPCH standard supported in literature; full evidence base and sources available in final standards advisory committee report • Modified proposed revisions based on public comment • Updated criteria now available online and will be effective January 2014

  6. Summary of 2014 Criteria • Current minimum criteria to become a PCPCH will remain the same • More options available for clinics to achieve PCPCH recognition and higher Tier levels • Application renewal cycle will be expanded from annually to every two years • New opportunity for primary care homes to become Tier 3 “star” performers

  7. PCPCH Scoring • 10 must-pass standards that all clinics must meet in order to recognized at any Tier level Example: On-site language/cultural interpretation • Menu of optional standards worth varying amount of points - Examples: 5 pts - Access to care outside normal business hours 10 pts - CAHPS patient experience survey 15 pts – Meets benchmarks on quality measures • Expanded optional standards available in 2014 Example: Patient & Family Involvement in Quality Improvement – options worth 5, 10, or 15 points

  8. PCPCH Tier Levels • The total points accumulated determines a clinic’s overall Tier of PCPCH recognition: • Tier 1: 30 – 60 points and all 10 Must-Pass Standards • Tier 2: 65 – 125 points and all 10 Must-Pass Standards • Tier 3: 130 + points and all 10 Must-Pass Standards Lots of ways to get credit for the good things clinics are doing (or want to start doing)!

  9. Provider Resources and Technical Assistance • PCPCH Program Staff: PCPCH@state.or.us • Program website: www.PrimaryCareHome.oregon.gov • Technical Assistance and Reporting Guidelines (TA Guide) - 2011 criteria available now - 2014 criteria available mid-September • Online learning modules for 2014 criteria available fall 2013 • Patient-Centered Primary Care Institute - Public-private partnership supporting practice-level transformation

  10. PCPCI Technical Assistance Current Offerings • PCPCH Learning Collaborative - 25 clinics receiving in-person training, practice facilitation services, and stipends • Website of downloadable resources at www.pcpci.org • Monthly webinars on core practice transformation topics open to all - recorded & available online • TA expert learning network and leadership learning collaborative • Behavioral Health Integration Training (see handout) – Applications due Aug 30th!

  11. PCPCI Resources to Note • Behavioral Health Integration - In-person and onsite training - SBIRT tools, webinar, links to videos - Developmental screening – tools & webinar September 10th • Using Data for Quality Improvement – tools & webinar August 20th • Patient-Centered Interactions: Creating a truly Patient-Centered Primary Care Home – webinar September 17th

  12. Visit: www.PrimaryCareHome.oregon.govContact us: PCPCH@state.or.us Jeanene Smith MD, MPH Chief Medical Officer - Oregon Health Authority (OHA) Administrator, Office for Oregon Health Policy and Research, OHA jeanene.smith@state.or.us E. Dawn Creach, MS PCPCH Program lead for Recognition, Technical Assistance, and Communications dawn.creach@state.or.us Nicole Merrithew, MPH PCPCH Program Director nicole.merrithew@state.or.us

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