(Hartford, Conn. March, 2011) - The National Committee for Quality Assurance (NCQA) officially recognized two members of Saint Francis HealthCare Partners (SFHCP) as designated Physician Practice Connection—Patient-Centered Medical Homes.
The patient-centered medical home is an approach to providing comprehensive primary care that facilitates partnerships between individual patients, their primary care physicians, and ancillary health services that include specialists, rehabilitation facilities, and home care providers. The provision of medical homes is intended to enable better access to health care, increase satisfaction with care, and improve patient education and understanding. By streamlining care and reducing medical errors, the medical home concept can collectively aid in addressing the new demands of impending healthcare reform.
Established in 2010, West Hartford Internal Medicine, LLC, became the first practice to be recognized as a Level 1 PCMH. The practice has a dedicated staff and 2 primary care physicians, Sally Ardolino, MD and Varalakshmi Venkatachalam, MD. Prime Healthcare-East Hartford Internal Medicine, which began operations in 1998, was recognized as a Level 3 PCMH, the first practice in the greater Hartford area to be recognized at a Level 3 and is one of only three practices in the state to achieve this distinction. The practice is led by 1 primary care physician, Ronald Kimmel, MD and has 2 APRNs and a dedicated staff.
To achieve this national recognition, practices must meet specific NCQA criteria. In 2008, NCQA introduced nine measurement standards consisting of 30 elements and over 100 factors. Each element has a specific point value. In addition, 10 of these 30 elements are designated as MUST PASS elements. The standards are designed to address practice procedures relating to access and communication, patient tracking and registry functions, care management, patient self-management and support, electronic prescribing, test tracking, referral tracking, performance reporting and improvement, and advanced electronic communications.
To be successful in meeting a MUST PASS element, a practice must demonstrate compliance with at least 50% of the associated factors. In addition to the MUST PASS requirement, points are allocated based on the degree of compliance the practice is able to demonstrate for each element. Recognition requirements for each level become increasingly stringent. At a minimum, a Level 1 practice must meet requirements for 5 of the 10 elements and achieve a score of 25 points. Level 2 recognition indicates that 10 of the 10 MUST PASS elements were met, and the practice achieved an overall score of at least 50 points.
To achieve a Level 3, the practice must successfully meet all of the requirements and obtain an overall score of at least 75 points. Meaningful use of an integrated electronic health record (EHR) with a robust reporting capability is an important aid in achieving a Level 3.
A common tenet of the PCMH is providing appropriate incentives and reimbursement to physicians who provide this enhanced level of care. In its role as a resource provider, Saint Francis HealthCare Partners assists its members in the rigorous effort to achieve PCMH recognition. Because of the time and effort involved, SFHCP assists individual practices with the entire process, from initiation to submission. Initial activity is a practice assessment or gap analysis. Following this, SFHCP collaborates with the practice to develop policies, change procedures, monitor results, and obtain the necessary documentation to complete the submission process.
Along with many other SFHCP physician members, the physicians at these two PCMH practices have achieved recognition in other NCQA programs, namely, the Diabetes Physician Recognition and the Heart/Stroke Physician Recognition programs. However, this PCMH recognition, the most complex to date, showcases the quality efforts of the practices’ entire healthcare team.
"SFHCP is committed to helping our physician members understand, embrace and implement PCMH model of care. These prestigious designations represent physicians at the leading-edge of progressive healthcare delivery," said Rose Stamilio, RN, MSN, Director of Quality & Care Coordination.
About Saint Francis HealthCare Partners
Founded as Saint Francis Physician Hospital Organization (SFPHO) in 1993, Saint Francis HealthCare Partners currently serves over 600 physicians in more than 200 medical practices, 1 acute care hospital and 1 rehabilitation hospital in the greater Hartford, Conn. area. It provides a full complement of services such as clinical integration; contract management; credentialing; electronic health records (EHR) governance; medical reviews; payor education; quality and network management and community outreach. Over its 15-year history, the organization has expanded its mission to include enhancing the quality and efficiency of healthcare services provided by its members. For more information on SFHCP, go to www.sfhcp.com.
About Saint Francis Hospital and Medical Center
Founded in 1897, Saint Francis is a major teaching hospital licensed for 617 acute inpatient beds and 65 bassinets. It is the largest Catholic hospital in New England. For more information on Saint Francis, go to www.stfranciscare.com.