PCMH Support Teams and the Readiness Evaluation Questionnaire.

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Presentation transcript:

PCMH Support Teams and the Readiness Evaluation Questionnaire

Support Teams Support in assisting you with completion of the Readiness Evaluation Questionnaire and the PCMH process are provided by CHNCT’s regional teams : o Regional Network Managers (RNMs) o Community Practice Transformation Specialists (CPTS)

Role of the Regional Network Manager PCMH Application Process CHNCT employs three Regional Network Managers with assigned territories covering the State Their principal functions related to PCMH are: o Recruitment o Provider PCMH Education o Active Assistance in the proper completion of a Readiness Evaluation Questionnaire and a PCMH Application o Support in alignment of DSS/HP data with practice billing information to ensure payment of fee differentials Recruitment processes rely on Medicaid revenue profiles and provider specialties –telephone contact is used to screen for interest and readiness 3PCPRE

Role of the Regional Network Manager (cont.) Face-to-Face appointments to educate practice about DSS PCMH program details and NCQA RNM assists practice in completion of Readiness Evaluation Questionnaire from HUSKY Health website Second Meeting includes CPTS for Review of Glide Path (GP) Process Practice makes participation decision and proceeds to completion of PCMH Application with RNM oversight for data matches with HP Completed PCMH Application is submitted electronically Application screened for accuracy and submitted to DSS by RNM 4PCPRE

Role of the Community Practice Transformation Specialist CHNCT employs 11 Community Practice Transformation Specialists throughout the State CPTS principal functions include: o Collaborating with Glide Path practices to enable NCQA recognition o Assisting PCMH and GP practices in their use of available resources to manage CMAP patients o Support practices in maintaining and benefiting from their DSS PCMH recognition status CPTS/Practice collaboration begins following contact by the RNM with the focus on: – Evaluating the practice for understanding of the NCQA recognition process – Completing the Glide Path Application. 5PCPRE

Role of the Community Practice Transformation Specialist (cont.) CPTS team members are specially trained in NCQA PCMH standards and perform the following activities: o Monitor progress on the GP Work Plan Tasks, including gap analysis o Provide resources and support to address gaps and deficits o Direct practices in education/training on NCQA requirements o Provide access to patient utilization data CPTS’ work around practice schedules and provide support in person, by , and by phone Throughout the entire GP process the CPTS is available to the practice to offer advice and counsel on any matter related to the NCQA and DSS PCMH process Support from your CPTS is always free 6PCPRE

Additional Role of the Community Practice Transformation Specialist Assists Practices to Integrate Care Coordination Into Their Model of Care o Provides educational materials on concepts of care coordination o Instructs practices to designate a professional to assume the role of care coordination for their practice o Educates practices on utilization of a team concept that supports a division of care coordination duties among clinical and non-clinical staff o Introduces the practice to the ASO programs such as ICM and HSS to assist with care coordination needs o Facilitates on-site meetings with ICM and HSS if requested by practices 7

PCMH Readiness Evaluation Questionnaire The Readiness Evaluation Questionnaire helps CHNCT’s regional teams : o Understand and evaluate practices that have chosen the journey to PCMH and those that are just getting started

Understanding the Needs of the Practice Reviewing and Completing the Readiness Evaluation Questionnaire will provide both the practice and the regional teams with: o A better understanding of a practice’s needs o Direct engagements to the areas of NCQA, PCMH, DSS programs, and Health Information Technology (HIT) requirements

Information Requested There are 4 questionnaire sections that gather practice information in order to begin or continue to assess where the practice is in the process of becoming a Person-Centered Medical Home A. Practice Demographic Information B. Additional Practice Information C. Person-Centered Medical Home (PCMH) D. Health Information Technology (HIT)

Where to locate the Questionnaire Left side menu: click on For Providers Left side menu: click on Person-Centered Medical Home Center of screen: click on PCMH Readiness Evaluation Questionnaire Click on ‘download the Readiness Evaluation Questionnaire’ Click on ‘Download the PCMH Readiness Evaluation Questionnaire’ (yes, again) PDF will open Save by clicking on picture of diskette and save locally

Complete the various sections relating to demographics, NCQA PCMH familiarity, and HIT practice inventory Fill in the practice name and the name and address of the person completing the form Enter date and then click on the SUBMIT button A copy is sent to CHNCT and a confirmation will be sent to the person completing the form A RNM will reach out if contact has not yet been made with the practice Filling out And Submitting the Questionnaire

Questionnaire Results The Readiness Evaluation Questionnaire results are used to make efficient use of time and resources for both the practice and CHN Regional Teams The RNM will direct a practice on whether they are ready to move forward in the application process or if the practice needs to take more time with NCQA, PCMH, or HIT The RNM will schedule an onsite meeting with the practice and/or recommend a CPTS to meet with the practice to provide support and assistance with the NCQA process

For more Information Contact the Regional Network Manager listed on the regional map according to your location An assigned RNM will assist you in completing your REQ and PCMH Application An assigned CPTS will assist you in completing your GP Application Contact: Visit the website for the National Committee for Quality Assurance, and review the information on PCMH recognitionwww.ncqa.org