Proactive Patient Care: Patient Centered Medical Home

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The Cincinnati/Dayton Region has been selected to participate in The Comprehensive Primary Care Initiative (CPCi), a national initiative through the Centers for Medicare and Medicaid Innovation Center (CMMI). CPCi has the potential to completely change the way primary care is delivered in approximately 75 medical practices in Greater Cincinnati and Dayton. It is expected TriHealth Physician Partners will play a significant role in this transformative four-year initiative.

The concept of CPCi truly exemplifies patient centeredness because it aligns reimbursement incentives with doing what's right for the patient. The goal of the Centers for Medicare and Medicaid (CMS) is to impact the health of entire regions, which is why they awarded the grant to communities, not providers.

"This is an exciting opportunity that could position southwest Ohio and TriHealth as national leaders in transforming health care," said John Prout, president and CEO of TriHealth. "This is not just another project. It has the potential to change the way we practice medicine and care for patients."

CPCi gives us the tools we need to achieve our mission of improving the health status of the people we serve. The effort also supports TriHealth's vision of becoming a truly integrated health system and exemplifies who we are: physicians, hospitals and communities working together to help you live better.

The targeted launch date for implementation is fourth quarter of calendar year 2012. TriHealth's leadership in system-wide adoption of the Patient-Centered Medical Home (PCMH) model of care within employed primary care practices has the system well-positioned to be successful pilot sites for CPCi.

What is Patient-Centered Medical Home?

  • The Medical Home model is an approach to providing comprehensive primary care. It unites the physician and other care providers in a single, coordinated team taking a 'whole person' orientation toward a patient – providing easier access to care, improved coordination and integration of care, and increased efforts to ensure safety and quality.
  • Imagine the benefit of generating a report in minutes to discover which diabetic patients are overdue for a recommended check-up or are showing a pattern of decline in vital statistics over time. Then imagine the benefit of physician practices instantly using that data to improve patient health through simple action steps like check-up reminder calls or complex steps such as revising treatment programs and engaging needed specialists. PCMH provides the infrastructure to accomplish this.
  • Studies have shown that the Medical Home model improves quality of care, enhances patient satisfaction and engagement, and creates a more rewarding practice experience for Primary Care Physicians including general practitioners, internists and family practice specialists. In a medical home practice environment, both patients and physicians see a variety of improvements in the delivery of primary care:
  • Care follows a proactive plan to meet patient needs focusing on preventative care and disease management without waiting for acute symptoms; this includes check-up reminders or things like vaccination schedules.
  • A knowledgeable and prepared team of health care professionals coordinates all patient care. This results in an enhanced experience for patients, including less waiting time, more scheduling flexibility and better traction of medical history and records.
  • Quality of care can be measured, enabling providers to make improvements more readily.
  • Patients become partners in care, moving from reactive to proactive involvement, accommodating patient's treatment preferences, life situations and language barriers.

What is CPCi?

  • A four-year transformative initiative fostering collaboration between public and private health care payers to strengthen primary care
  • A pilot to align PCP incentives with common goals focused on appropriate care for each patient, rather than incentivizing volume
  • An effort to impact the "triple aim" of better health, better healthcare and lower cost
  • Additional source of funding for TriHealth's implementation of Patient-Centered Medical Home (PCMH) and integration of our delivery system

Why was Cincinnati/Dayton selected to participate?

  • Collaboration and cooperation for alignment of funding among the Centers for Medicare and Medicaid (CMS) and major commercial payers in the Cincinnati market: Anthem Blue Cross Blue Shield, HealthSpan, Humana, Medical Mutual of Ohio and United Health Care. Buckeye Community Health Plan, CareSource and Ohio Medicaid are participating, as well.
  • TriHealth's pioneering efforts in adopting PCMH as its standard for primary care provided assurances to CMS that our region has the volume of practices with appropriate infrastructure to pilot this type of transformative initiative.
  • The Health Collaborative offers an ongoing forum to bring together payers, employers and providers to discuss issues and drive change.
  • HealthBridge gives southwest Ohio the ability to share health information community-wide by providing a secure IT platform.
  • Bethesda Inc. accelerated TriHealth's PCMH capabilities by providing significant grant money for implementation and also helped Cincinnati to demonstrate its collaborative focus on quality through a separate grant to the Health Collaborative.

We are physicians, hospitals and communities working together to help you live better.