Medical Home Monitor
February 16, 2010
Vol. II, No. 20
Medical Home Q&A's:
Essential Practice Tool
Measuring Patient Satisfaction
Q: Should a physician practice issue its own patient satisfaction
surveys or use an outside entity, and how frequently should a satisfaction
survey be issued?
There are a lot of good surveys available on a paid basis and provided by
independent parties. Most importantly, make sure that respondents are selected
randomly, meaning that there is no unconscious bias or pattern in who gets the
survey. That is one of the problems with having individuals in the practice
distribute the survey. Devise a way to make sure that individuals involved in
the practice setting are not distributing the satisfaction survey.
When a practice is first starting up, you may want to do the patient
satisfaction survey as often as every three or four months once or twice, or
every six months. That frequency presumes that you are getting a smaller
sample, which won't be as statistically valid but will give you a quick way to
evaluate your patients' reaction to the changes. Another approach is to select
and ask some patients within your practice to be your testers of practices and
to give informal feedback on the new practice changes. That can be very
effective because you can do it almost immediately after the changes are
implemented as long as those patients come in regularly.
(Barbara Wall, president and CEO of Hagen Wall Consulting)
For more patient education and engagement strategies, please visit:
Q: Which practice tool is essential for the medical home model?
A: Number one, practices need to have the ability to take in
information from some type of registry function — something that
identifies the population, gaps in care and how far away they are from the
goals of the chronic disease that they're managing. They need to be able to
bring that data into their workflow system, respond to it, act on it, update
activities that have occurred and get their next measurement. Every physician
should be able to go on the computer and click on an icon to get to the
registry and see their panel of patients.
(James Barr, M.D., is a practicing family physician and medical director
for the Central Jersey Physician Network IPA and Partners in Care physician
For more on using a patient registry, please visit:
Framing a Florida Medicaid Medical Home
Following a review of other states' medical home programs, a state-appointed
task force has recommended the framework for a medical home program for
Florida's Medicaid population. In a new report, the Medicaid Medical Home Task
Force recommends the use of NCQA standards for patient-centered medical homes
(PCMH) as a guide when defining Florida's medical home model and working with
community-based networks and providers to gather feedback on the type of
medical homes they can provide to Medicaid recipients.
The task force had reviewed existing medical home programs from North Carolina,
Pennsylvania, Oklahoma and other states before submitting its recommendations,
which also include:
Identifying at least one rural area and one urban area with an academic
setting/medical school to be included as pilot sites.
Creating a medical home advisory board to help determine which Medicaid
recipients would best be served by the medical home pilot and using a mixed
model that includes MediPass providers, community networks, hospitalists,
specialists and managed care organizations, incorporating strong
Ensuring medical home pilot services include primary care providers who provide
and/or coordinate all healthcare for the recipient, are available on a 24/7
basis and include developmental, mental and behavioral healthcare.
Giving strong consideration to reimbursement models that include enhanced fees
for services, case management fees and pay for performance/incentive payments
to ensure sufficient participation in the pilot project and that any program
design should investigate payment methodologies to ensure ROI.
For more information, please visit:
HealthSounds Podcast: The Backbone of Evidence-Based Care Delivery
Despite the challenges, cost and uncertain return from EHRs, practices should
move quickly to adopt this tool, recommends Dr. Richard J. Baron, president and
CEO of Greenhouse Internists, where the EHR is the backbone supporting delivery
of evidence-based care.
To listen to this HIN podcast, please visit:
Washington Grants Shore Up Short- and Long-Term Medical Homes
Six grants totaling $450,000 will help maintain programs in Washington State
that enhance access to medical treatment, the efficient use of healthcare
resources, and quality of care with a focus on continuity of care and
establishing medical homes.
Six non-profit community-based healthcare organizations are recipients of grants
from the state's Community Health Care Collaborative (CHCC), which supports
efforts of community coalitions to increase access to appropriate, affordable
healthcare for Washington residents, particularly the uninsured or
The grant recipients include:
Choice Regional Health Network: $100,000 to coordinate patient care through
culturally competent outreach, navigation, provider recruitment, electronic
shared care plans, case management and connect to medical homes with focus on
medical, dental and mental health capacity and non-emergent ED use.
Community Health Association of Spokane: $50,000 to the Spokane Emergency
Department Diversion Program to decrease inappropriate use of ED services and
promote medical home access.
Community Health Partners: $100,000 to Cowlitz Free Medical Clinic to serve
uninsured adults needing short-term, chronic care and care management services
for diseases such as asthma, diabetes, or hypertension. The clinic will serve
patients until a primary care provider and a medical home is established.
Neighborcare Health: $50,000 to Lake City Community Health Collaborative to link
patients to a healthcare home through partnerships with a health center, free
clinic, volunteer providers and other social services. A full range of services
including primary care, specialty care, behavioral health and other supportive
services are offered by the diverse array of partners.
Port Gamble S'Kallam Tribe: $75,000 to the Community Health Care Collaborative
Chronic Care Management Project to design and implement evidence-based (EB)
medical home model for intensive care coordination of chronic disease. The
project includes development of responsibilities for care team members,
disease-specific EB guidelines, standardized protective care visits, patient
self-management support, intensive coordination of multi-specialty care and
assistance in accessing care and obtaining insurance.
Yakima Neighborhood Health Services: $75,000 to Yakima County Kids Connect to
collaborate between a community health center, hospital EDs, educational
services districts and county government to reduce uninsured children in Yakima
City by matching kids with healthcare homes and reduce avoidable ED visits.
For more information, please visit:
HIN Survey of the Month: Health & Wellness Incentives Use
More than 60 healthcare companies have already described how they use incentives
to promote health and wellness by completing HIN's second annual Survey of the
Month on this topic. Tell us how your organization uses incentives to drive
engagement and results from wellness and prevention programs by February 28,
2010 and get a free executive summary of the compiled results. Your responses
will be kept strictly confidential.
Complete the survey by visiting:
Healthcare Trends Update: New Healthcare Case Management Benchmarks
Healthcare case managers are playing a larger role in the coordination of all
phases of patient care. This just-published HIN white paper examines the
expanding focus, responsibilities, work locations and impact of case management
in healthcare, from populations benefiting from case management to metrics on
case loads, ROI and performance measurement through responses provided by 187
To download this complimentary white paper, please visit:
Save 10% on 2/24 Webinar: Embedded Case Managers for Navigating Care
Transitions, Gaps in Care and Patient Compliance
Whether embedded in a primary care practice, hospital or nursing facility,
co-located case managers are helping patients to navigate the healthcare
system, improving care transitions and compliance to care plans in the process.
During this 45-minute webinar on February 24, 2010, the director of clinical
performance management at Dartmouth-Hitchcock Clinic will describe
Dartmouth-Hitchcock's embedded case manager program and its benefits for
patients, providers and payors.
Use ordering code MHMP to save 10 percent on this specially priced
resource by visiting:
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