MHA507 3 MOD CASE

MHA507 Module 3 - Case

Patient-Centered Medical Home, Ambulatory Care, Community Health Centers, Complementary and Alternative Medicine, and Mental Health

Assignment Overview

A major aspect and focus in health care is quality. Quality, as defined by Lohr and Schroeder (1990), is “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” Quality is often measured through data and quantitative methods. Health care delivery methodologies are embedded in elements of quality management. As a health care professional, one of your numerous responsibilities will be to uphold a high standard of quality within your organization or department. Lohr, K. N., & Schroeder, S. A. (1990). A strategy for quality assurance in Medicare. New England Journal of Medicine, 322(10), 707. Available in the Trident Online Library.

Case Assignment

For this assignment, you will create a five-question quantitative survey and survey 5-8 people anonymously. Your questions should be created based on the five medical home functions and attributes presented in the Module 3 Background. In addition, the survey questions should be indirectly or directly related to quality. See below for an example question:

Patient-Centered Care is defined as the care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions. Based on this definition, of your four most recent visits to a health care organization/facility, how many were patient-centered?

1. One

2. Two

3. Three

4. Four

5. Not able to identify

(Note: If you use the example question as a survey question in your survey, you must have a total of 6 questions, instead of 5.)

Use Survey Monkey ( https://www.surveymonkey.com/) , the complimentary service, to assist with building your survey and sending out your survey electronically (web address link). Once you have your results from your quantitative survey, complete the following in a 3- to 4-page paper:

1. Provide the five questions you created.

2. Evaluate data using the quantitative methods and summarize the survey data (provide assumptions to the responses you receive).

3. Supply a summary of how the information could be useful for a health care organization or department.

Assignment Expectations

1. Conduct additional research to gather sufficient information to support the creation of your questions and evaluation.

2. Limit your response to a maximum of 4 pages.

3. Include an introduction and conclusion in your paper.

4. Support your case with peer-reviewed articles, using at least 2-3 references. Use the following link for additional information on how to recognize peer-reviewed journals: http://www.angelo.edu/services/library/handouts/peerrev.php.

5. You may use the following source to assist in formatting your assignment: https://owl.english.purdue.edu/owl/resource/560/01/.

DISCUSSION:

History of Patient-Centered Medical Homes

Review the following source outlining the history of patient-centered medical homes:

Patient-Centered Primary Care Collaborative. (n.d.). History: Major milestones for primary care and the medical home. Retrieved from https://www.pcpcc.org/content/history-0

Discuss what you believe the future holds for patient-centered medical homes. Include in your discussion at least two trends that you believe will be a necessary attribute in patient-centered medical homes in the future. Be sure to support your thoughts and analysis with scholarly sources

History

Major milestones for primary care and the medical home

The patient-centered medical home, while not a new concept, has evolved to define a model of primary care excellence that is patient-centered, comprehensive, coordinated, accessible, and committed to quality and safety. Below is a description of key events over the primary care medical home's lifetime.

Key Events

1967   

The American Academy of Pediatrics (AAP) introduces the term “medical home” to describe primary care that is accessible, family-centered, coordinated, comprehensive, continuous, compassionate, and culturally effective.

1978   

The Declaration of Alma-Ata is introduced at the International Conference on Primary Health Care, and is the first international declaration of primary health care's key role in promoting the health of all people. The World Health Organization (WHO) lends its support of this principle in their Primary Health Care report of the same year.

1996    

Influenced by the Declaration, The Institute of Medicine (IOM) publishes Primary Care: America's Health in a New Era and redefines primary care as "the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health needs, developing a sustained partnership with patients, and practicing in the context of family and community." The publication also mentions medical home.

2002   

· The seven national family medicine organizations launch The Future of Family Medicine (FFM) project and produce The Future of Family Medicine: A Collaborative Project of the Family Medicine Community. The report recommends that health system change will "include taking steps to ensure that every American has a personal medical home [... and] developing reimbursement models to sustain family medicine and primary care."

· The Chronic Care Model is born and emphasizes the critical role of primary care to prevent, manage, and treat chronic illness.

2005    

Renowned researcher and primary care champion Dr. Barbara Starfield publishes Contribution of primary care to health systems and health, a seminal work that acknowledges the six primary care mechanisms that benefit health: (1) greater access to needed services (2) better quality of care (3) a greater focus on prevention (4) early management of health problems (5) the cumulative effect of primary care delivery; and (6) the role of primary care in reducing unnecessary or harmful specialty / inpatient services.

2006

· The American College of Physicians (ACP) develops The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of Health Care and proposes fundamental changes in the way primary care is delivered and paid for.

· The Patient-Centered Primary Care Collaborative (PCPCC) is founded by a group of large employers, including IBM, and the major primary care physician associations: American Osteopathic Association (AOA), American Academy of Family Physicians (AAFP), American College of Physicians (ACP), and American Academy of Pediatrics (AAP). The organization is charged with building a national movement that promotes widespread adoption of the patient-centered medical home.

2007

The major primary care physician associations develop and endorse the Joint Principles of the Patient-Centered Medical Home.

2008

· The National Committee for Quality Assurance (NCQA), URAC, Joint Commission, and the Accreditation Association for Ambulatory Health Care (AAAHC) launch medical home accreditation programs.

· The Commonwealth Fund launches the five-year Safety Net Medical Home Initiative designed to help 65 community health centers in five states transform into patient-centered medical homes.

2010

The Patient Protection and Affordable Care Act (ACA or health care reform law) is signed into law by President Barack Obama on March 23rd, and includes numerous provisions for enhancing primary care and medical homes, such as primary care payment increases through Medicare and Medicaid, expansion of insurance coverage, and signifcant investments in medical home pilots, workforce development and training, prevention and wellness, community health centers, and additional care delivery innovations.

2011

As a result of the Affordable Care Act:

· Primary care providers receive a 10% Medicare bonus payment for primary care services.

· A new Medicaid state option is created to permit certain Medicaid enrollees to designate a provider as a health home, and states taking up the option receive 90% federal matching payments for two years for health home-related services.

· Small employers receive grants for up to five years to establish wellness programs.

· The Center for Medicare & Medicaid Innovation launches the Pioneer Accountable Care Organization (ACO) Model and Advance Payment ACO Model, which offers shared savings and other payment incentives for selected organizations that provide efficient, coordinated, patient-centered care.

· States begin planning for the establishment of American Health Benefit Exchanges and Small Business Health Options Program Exchanges, which facilitate the purchase of insurance by individuals and small employers.

· Teaching Health Centers are established to provide payments for primary care residency programs in community-based ambulatory patient care centers.

2012

· According to the National Academy for State Health Policy, 47 states have adopted policies and programs to advance the medical home.

· Representing more than 1,000 members, the PCPCC publishes Benefits of Implementing the Medical Home: Cost and Quality Results providing cost, quality and outcomes data for more than 40 medical home initiatives throughout the U.S.

2013

As a result of the Affordable Care Act:

· States indicate to the Secretary of HHS whether they will operate a health insurance marketplace.

· Medicaid payments for primary care services increase to 100% of the Medicare payment rate through 2014.

· Providers receive a one percentage point increase in federal matching payments for preventive services.

· Essential Health Benefits in the health insurance marketplaces include prevention, wellness, and chronic disease management.