Oregon Health Authority Patient-Centered Primary Care Home

Program

Quality & Health Outcomes Committee August 2013

Patient-Centered Primary Care Home Program

HB 2009 established the PCPCH Program:Create access to patient-centered, high quality care and reduce costs by

supporting practice transformation

Key PCPCH Program Functions:• PCPCH recognition and verification• Refinement and evaluation of the PCPCH Standards over time• Communication and provider outreach• Coordination across OHA divisions, CCO development and health

reform initiatives• Restructure primary care payment to align with the PCPCH framework• Technical assistance development

Core Attributes of a Primary Care Home

3

Oregon’s PCPCH model is defined by six core attributes, each with specific standards and measures

4

As of August 2013 >425 recognized

5

• PCPCH Standards Advisory Committee met in fall 2012• Final report provided recommendations to:

– Clarify current criteria, and – Incorporate new standards to improve the current model

• Evidence-based– Each PCPCH standard supported in literature; full evidence

base and sources available in final standards advisory committee report

• Modified proposed revisions based on public comment• Updated criteria now available online and will be effective

January 2014

Updates to the PCPCH Recognition Criteria

Summary of 2014 Criteria

• Current minimum criteria to become a PCPCH will remain the same

• More options available for clinics to achieve PCPCH recognition and higher Tier levels

• Application renewal cycle will be expanded from annually to every two years

• New opportunity for primary care homes to become Tier 3 “star” performers

6

PCPCH Scoring

• 10 must-pass standards that all clinics must meet in order to recognized at any Tier level

Example: On-site language/cultural interpretation• Menu of optional standards worth varying amount of points -

Examples:5 pts - Access to care outside normal business hours10 pts - CAHPS patient experience survey15 pts – Meets benchmarks on quality measures

• Expanded optional standards available in 2014Example: Patient & Family Involvement in Quality

Improvement – options worth 5, 10, or 15 points

PCPCH Tier Levels

• The total points accumulated determines a clinic’s overall Tier of PCPCH recognition:

8

Tier 1: 30 – 60 points and all 10 Must-Pass StandardsTier 2: 65 – 125 points and all 10 Must-Pass StandardsTier 3: 130 + points and all 10 Must-Pass Standards

Lots of ways to get credit for the good things clinics are doing (or want to start doing)!

Provider Resources and Technical Assistance

• PCPCH Program Staff: PCPCH@state.or.us• Program website: www.PrimaryCareHome.oregon.gov• Technical Assistance and Reporting Guidelines (TA Guide)

- 2011 criteria available now- 2014 criteria available mid-September

• Online learning modules for 2014 criteria available fall 2013

• Patient-Centered Primary Care Institute- Public-private partnership supporting practice-level transformation

9

PCPCI Technical Assistance Current Offerings

• PCPCH Learning Collaborative - 25 clinics receiving in-person training, practice facilitation services, and stipends

• Website of downloadable resources at www.pcpci.org• Monthly webinars on core practice transformation topics

open to all - recorded & available online • TA expert learning network and leadership learning

collaborative • Behavioral Health Integration Training (see handout)

– Applications due Aug 30th!

PCPCI Resources to Note

• Behavioral Health Integration- In-person and onsite training - SBIRT tools, webinar, links to videos- Developmental screening – tools & webinar September 10th

• Using Data for Quality Improvement – tools & webinar August 20th

• Patient-Centered Interactions: Creating a truly Patient-Centered Primary Care Home – webinar September 17th

Jeanene Smith MD, MPHChief Medical Officer - Oregon Health Authority (OHA)Administrator, Office for Oregon Health Policy and Research, OHAjeanene.smith@state.or.us

E. Dawn Creach, MSPCPCH Program lead for Recognition, Technical Assistance, and Communicationsdawn.creach@state.or.us

Nicole Merrithew, MPH PCPCH Program Directornicole.merrithew@state.or.us

Visit: www.PrimaryCareHome.oregon.govContact us: PCPCH@state.or.us