Earlier this year, St. James Healthcare in Butte, Montana received level 3 NCQA Patient-Centered Medical Home (PCMH) Recognition for using evidence-based, patient-centered processes that focus on highly coordinated care. The NCQA PCMH is a model of primary care that combines teamwork and information technology to improve care, improve patients’ experience of care and reduce costs. Many healthcare organizations choose to evolve into PCMHs and seek NCQA recognition to capitalize on opportunities for compensation, as several private payers and state Medicaid programs recognize and reward medical homes through care coordination fees, increased payment for evaluation and management services, or quality and outcome bonuses.
HealthTeamWorks partnered with St. James Healthcare to guide the organization through the NCQA recognition process. Emilie Buscaj, MPH is one of HealthTeamWorks’ NCQA PCMH Certified Content Experts who worked with the organization over several months. Together they identified and discussed implementation strategies for NCQA Standards and Guidelines around topics including team-based care, patient self-management support, identifying patients in need of additional care management, effective quality improvement teams, identifying goals for CQMs and behavioral health integration. As part of the process, HealthTeamWorks provided a comprehensive application review and gap analysis, and delivered both on-site and remote support. St. James Healthcare submitted its application for recognition in February of 2016, and received notification in March of 2016 that they had achieved level 3 recognition.
“We’re very proud of our NCQA PCMH recognition and the high-quality care it promotes by emphasizing access, health information technology and coordinated care focused on patients,” said Kristin Chiamulera, project lead at St. James Healthcare. “This recognition is an official acknowledgement that we have the tools, systems and resources to provide our patients with the right care, at the right time. We appreciate the guidance and support provided during this application process by our HealthTeamWorks Certified Content Expert. Emilie provided clear explanations and feedback on our application materials, as well as great suggestions for making our application stronger.”