⊕Changing the quality of health care [SPONSORED]

Patient-centered model trending in UC

In the practice of medicine, the focus is now on the quality of health care delivery. Patient satisfaction care coordination, population health management and health care costs are among the top buzz words we hear today, but what do they really mean, and how will they be combined effectively? The answer lies in the patient-centered medical home (PCMH) model as one major solution to cut costs while increasing quality – the primary care provider is the quarterback, using a team approach to care for patients, who are at the center core.

According to the Commonwealth Fund Report published in 2014, the U.S. ranks worst among 11 wealthy nations in terms of “efficiency, equity and outcomes” despite having the world’s most expensive health care systems. Frankly, this is sad and unacceptable since more than 17 percent of our gross domestic product (GDP) is spent on health care. Clearly the U.S. health care system is flawed, and it’s no surprise that patients and providers, who are caught in the crossfire, are unhappy. How can they move patients, providers and payers toward more efficient, effective and sustainable care models?

The PCMH model is emerging as a potential catalyst for multiple health care reform efforts that can lead to higher quality and lower costs and can improve patients’ and providers’ experience of care. Approximately 10 percent of practices are characterized as PCMH in the nation, but this model is rapidly becoming a powerful engine for health care delivery, reimbursement and primary care. This model is a way of organizing primary care that emphasizes care coordination and communication to transform primary care into what patients want it to be – focusing on patients themselves and all of their health care needs as the foundational core. They also are pillars for a health care system that gives additional value by achieving the “triple aim” of better quality, experience and cost.

Fortunately, in the Upper Cumberland, we don’t shy away from a challenge and are progressive in transforming our primary care delivery. In our area, primary care practices face many health care challenges associated with quality, efficiency, coordination and cost-effectiveness. There is a need for an innovative approach in treating our complex, high-risk Medicare and Medicaid population who have many co-morbidities resulting from socioeconomic barriers. As a result, practices such as Cookeville Medical Clinic (CMC), have jumped on this progressive bandwagon with transforming themselves into the PCMH model.

Specifically, CMC not only had a clear vision to transform its primary care clinic into a PCMH but also achieve the highest level of recognition from National Committee of Quality Assurance (NCQA): PCMH Level 3. While this has been an extensive process, we achieved this distinction in June, and it’s been a tremendously rewarding journey to create value for our patients and to bring that value to fruition in the community where patients are the center of care in a team based approach.

“We cannot be more thrilled about achieving this recognition, which would not have been possible without my wonderful team,” said Dr. Pushpendra K. Jain, MD, founder, CEO and medical director of CMC. “The PCMH model is the ideal approach for primary care delivery and is perfectly aligned with our goal to enhance patient-centric care that fosters better health outcomes and more importantly strengthens patient engagement and increases provider and patient satisfaction in their care.”

CMC strongly believes that PCMH recognition is not an end point, but a transformative process for validating that its primary care practice is poised for continuous quality improvement in the community.

Overall, strong primary care is the backbone of our health care system. The PCMH model has major benefits in our community, including better quality, patient experience, continuity, prevention and disease management. This not only results in reduced emergency visits and hospital readmissions but also reduced income-based disparities in care and provider burnout. It’s imperative that our community continues to develop plans that enhance quality care to our members – and the PCMH model is a blueprint for success to facilitate partnerships between providers and patients to achieve the level of quality care the Upper Cumberland not only needs but deserves.

To find clinicians and practices with NCQA PCMH recognition, visit http://recognition.ncqa.org.

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Natasha Jain is chief operating and marketing officer/practice administrator for Cookeville Medical Clinic and Physicians Urgent Care, 225 N. Willow Ave., Cookeville, and 402 E. Gore St., Gainesboro. For more information, visit www.cookevillemed.com or www.cookevilleurgentcare.com.