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The Compliance Team
The Value of PCMH from the Provider Perspective
By Kate Hill, RN, VP Clinical Services, The Compliance Team

Patient Care in the United States is quickly moving towards a value-based system. The Patient Centered Medical Home (PCMH) model of healthcare offers a holistic approach to traditional medicine by taking into account more of the patient’s needs than just his/her immediate health issue. PCMH is gradually becoming one of the standards for measuring value-based healthcare in the clinic environment. Taking the step to attain PCMH accreditation puts clinics in the position of being better tuned to our evolving health care system.

A feature of PCMH is that it puts the patient first and foremost. The benefit is that it offers patients more personalized care and increased access to quality medical care. These ultimately lead to better overall health outcomes for the patient.

The PCMH model also improves the fundamental operations of the clinic, both in terms of practitioner satisfaction and business improvement.

I recently interviewed PCMH Accreditation Liaisons, from two of our new PCMH clinics, to find out how PCMH has changed their practices.

Raigan Brown
Raigan Brown is the Clinic Nurse Manager at Memorial Medical Clinics in Carthage, Illinois. Memorial Medical Clinics has been PCMH accredited since February 2017.
KH: Tell us about some of the changes you have noticed since becoming PCMH accredited.
RB: After working on the reporting for our seven clinics, I found that, for the month of March 2017, we had 665 same-day appointments. Before we moved to PCMH, we might have had 200 same-day appointments for the same period.
KH: What is the most beneficial change?
RB: The most beneficial aspect of PCMH has been that our follow-up calls are keeping our patients out of the ER. In the past three months, out of 58 patients that were utilizing the ER more than 3 times per quarter, only three of the patients were in the ER more than three times.*
KH: How does this happen?
RB: We bring the patients in more frequently until we have better control over their health. An added benefit of this is that we are quickly building stronger relationships with them and they are more honest with us in describing their health issues. By building a stronger provider-patient relationship, we have increased the trust level.
KH: If you had to do it over again, what would you do differently?
RB: I would be sure to assign a full-time care coordinator at the start of the accreditation process.
KH: What is Memorial looking to gain from PCMH in the near future?
RB: We hope to decrease the amount of healthcare dollars being spent and continue to provide better overall care for our patients. We are also hoping/expecting to see an increase in our patient base and ultimately an increase in revenue. We have already seen an increase in patient volume.
Sara Wells
Sara Wells is the Clinical Director of the Kirby Medical Group based in Monticello, IL. Kirby Medical Center has been PCMH accredited since April 2017.
KH: Tell us about some of the changes you have noticed since becoming PCMH accredited.
SW: We have seen a significant change in the engagement by our patients with the practice overall. Patients are now better able to communicate and have more open conversations with the physicians and staff. This gives us more depth of information to better treat them. The providers are much more aware of patients’ needs. We have had good success with the patient email portal. The patient emails the provider and the provider emails back. This gives the patient more convenient and faster access to the providers and their care teams. We also have a full-time mental health counselor, employed at the clinic, who can help with care plan meetings and care transitions for the patients who need her services.
KH: What is the most beneficial change?
SW: We have changed the way we communicate with patients. If a patient is not showing up to his or her appointment, we contact the patient and ask why. We want to know how we can help them get to their appointments. Socioeconomic support and locating community resources is a big part of The Compliance Team’s model for PCMH. We strive to achieve that. We also have many patients who wait until Friday to call us. Before, if we did not address their needs quickly, they would go to the ER. Now, we focus on Friday callers. We call them all back on Friday no matter how long it takes. We call it Focus Friday.
KH: If you had to do it over again, what would you do differently?
SW: To help get the staff motivated and more quickly on board, I would identify quick wins by showing our staff what we are already doing right. Most places already measure quality and have policies in place for scheduling. If I could do it again, I would focus first on those measures which I would need the most support from other departments instead of first completing those things I know I can do without multi-departmental input or support. If what you need to accomplish will take an EMR build or administrative approval, for example, those items may take much longer than a form or policy you could write independently.
KH: What is Kirby Medical Center looking to gain from PCMH in the near future?
SW: We are looking for savings over time and an increase in revenue. By keeping our patients in the medical home, they will be more likely to receive services that are offered within the entire organization. This means they have the potential to visit more departments and use more of our preventative care services, such as mammograms, colonoscopies, and vaccinations.

* Reducing the number of ER visits saves payers a lot of money. Instead of visiting the ER, patients can now see their primary care physicians in a timely fashion.

For information on The Compliance Team’s PCMH Exemplary Provider accreditation,
call 215-654-9110, or click here to fill out an inquiry form.
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