It is important for practices to participate in patient-centered programs in order to focus their culture on improving the patient experience.
The Patient-Centered movement is nothing new; it's been around for more than a decade. In fact, it was included in the six aims for improvement in the Institute of Medicine's "Crossing the Quality Chasm" report in 2001. The aim of patient-centered care is to strengthen the patient-clinician relationship by promoting better communication about things that matter to the patient; helping patients know more about their own health; and facilitating patients' involvement in their own care - resulting in better compliance with their treatment plan and addressing lifestyle issues that can reduce healthcare risk factors.
In 2007 consortium of the American Academy of Family Physicians, the American Osteopathic Association, the American Academy of Pediatrics, and the American College of Physicians introduced the seven guiding principles of the Patient-Centered Medical Home (PCMH). The patient-centered movement has been further fueled by the Affordable Care Act, with the government taking a position to financially incentivize primary-care practices that assume additional responsibility as a Patient-Centered Medical Home.
The Patient-Centered Medical Home
Several PCMH recognition programs emerged over the past five to seven years, but the National Committee for Quality Assurance has become the front runner, www.ncqa.org. Achieving PCMH recognition through NCAQ requires the practice to meet specific care elements in six standard categories:
1. Enhancing access and continuity;
2. Identifying and managing patient populations;
3. Planning and managing care;
4. Providing self-care support and community resources;
5. Tracking and coordinating care; and
6. Measuring and improving performance.
Matrices continue to emerge that measure different facets of the patient experience including communication, patient involvement in healthcare decisions, and improvement in clinical outcomes. This requires improving coordination of care between the inpatient and outpatient setting, home healthcare, and patient support groups.
The Patient-Centered Specialty Practice
In 2013 NCQA introduced the Patient-Centered Specialty Practice (PCSP) recognition program. The impetus behind this new program was the discovery of reporting discrepancies between the referring physician and the specialist. For example, referring physicians reported that 25 percent to 50 percent of the time they didn't know whether the referred patient actually was seen by the specialist. And although specialists claim they provide a post-consult report to the primary-care physician 80 percent of the time, primary-care physicians claim they receive this information only 60 percent of the time.
Two of the four main requirements of the PCSP are to develop and maintain referral agreements and care plans with primary-care practices. Specialists are also expected to provide patient-centered care that includes the patient and possibly the family member or caregiver, when appropriate. This specialty program also evaluates medical management, test tracking and follow up, and the flow of information during care transitions, with consideration of the clinical outcome and patient experience.
The Patient-Centered Future
It is expected that these programs will be further expanded over time and will gain recognition among payers. Because improved patient outcomes result in future cost savings, additional financial incentives are likely to emerge for the physicians that contribute to this effort. Such programs will continue to make a contribution to improving patient satisfaction and clinical outcomes.
Results will be measured and monitored over time in an effort to unite the patients and the clinical team to influence healthy life styles; apply more preventive care measures; and partner with patients to improve compliance and better clinical outcomes. It is important for physicians and practice managers, regardless of specialty or practice size, to explore opportunities to participate in patient-centered programs and offer practice-wide training in order to shift the culture of the practice to focus on continually improving the patient experience at every touch point.
Judy Capko is a practice-management consultant with Capko & Morgan in San Francisco. She is the author of "Secrets of the Best-Run Practices" and co-author of "The Patient-Centered Payoff." Capko participates in writing the company's management tips blog: www.capko.com/blog. She can be reached at firstname.lastname@example.org.