Fall QCLC - Public Recognition for Advanced Primary Care is Underway

PDF | | Print | | E-mail

In our last eNewsletter, we introduced plans to advance public reporting of Primary Care quality across the state. Maine Health Management Coalition's (MHMC) Pathways to Excellence (PTE) initiative endorsed measurement of "Advanced Primary Care", using 6 components: office systems and clinical outcomes (which are currently reported), cost of care, patient experience, informed referrals, and behavioral health integration. Patterned after the Patient Center Medical Home initiatives, PTE plans to recognize practices working in these areas in 2011, with recognition for performance results in future years. This supports the MHMC stated direction: To motivate transformation of all primary care practices in Maine to become high quality and cost efficient patient centered medical home/ advanced primary care practices in a primary care based healthcare system. The term “Advanced Primary Care” is meant to include all the different primary care transformation efforts going on in Maine.

The PTE Physicians Steering Committee has been working on the overall components of Advanced Primary Care for the past year, and is planning to phase in the measurement components over the next several months. Office systems and clinical outcomes are already being reported through PTE. Plans are to report practices working on cost of care as of December 2011. Reporting for practices meeting criteria for working on behavioral health integration and patient experience of care are planned for March-April 2012, with informed referrals sometime in the future. Details will be posted under the PTE section of www.mehmc.org in early October, with practices being notified by email and post cards that the information is available.

Plans for the different components are on different timelines. Following is a proposed phase-in schedule:

Public reporting of participation:

(a) Cost of Care: Dec 1, 2011

(b) Patient Experience: April 2012

(d) Informed Referrals: TBD

For more information on MHMC’s Advanced Primary Care and how you can participate in the public recognition program, please contact: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Measuring Patient Experience: Practices will be recognized for measuring patient experience using a validated survey instrument and a rigorous process to incorporate the results of the survey into practice, OR by utilizing a Patient-Family Advisory Group and meeting certain PCMH core expectations:

- Patients and family members are a regular part of leadership meetings or some advisory process to identify needs and implement creative solutions. There are tangible supports to enable patients and families to participate in this process (e.g., after hours events, transportation, stipends, etc.)

- Practice systematically learns about patients and draws upon patient and family input at least annually (e.g., via mail survey, phone survey, point of care questionnaires, focus groups, etc.) to design and implement office changes that address needs and gaps in care.

- Group consists of 4+ patients/family members and meets at least 4 times a year OR submits an alternate plan that meets the intent of this section
- Group addresses a practice improvement initiative of its own choosing and submits an action plan.

Measuring Behavioral Health Integration into Primary Care: As part of public recognition through Advanced Primary Care, measures of behavioral health integration will be reported. Reporting will begin with process measures.

1. Looking specifically at the primary care practice’s Level of Integration Score (Requiring a Level II or higher) as captured in the question below:

Please answer the following questions about your practice.

Does your practice have a mental health clinician located onsite (in this case defined as within the physical walls of the practice)?

If yes, you are done.

If no, please complete questions 2 and 3.

2a. This practice has a written agreement with one or more mental health clinicians or practices regarding access of our patients for mental health care:

Yes _____

No_______

2b. If yes, please list the mental health clinicians or practices with whom you have such an agreement established: ____________________________________________________________

3a. This practice has a written agreement with one or more mental health clinicians or practices regarding content and frequency of communication for shared patients:

Yes _____

No ______

3b. If yes to either, please list the mental health clinicians or practices with whom you have such an agreement established: _____________________________________________________

2. The administration of annual depression screening (using the PHQ-2 or PHQ-9) with 50% or more of the practice’s patients with diabetes and/or heart disease (per BTE/NCQA definitions).

This edition of the QCLC Provider eNewsletter includes practical strategies to advance work on these two components of Advanced Primary Care.