Quality Improvement (QI) is essential for a Patient-Centered Medical Home (PCMH) practice, both in obtaining recognition and more importantly, in maintaining it. QI can help improve patient care and may help you qualify for the PCMH Performance-Based Payment Program for additional financial incentives.
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Engaging in QI activities is critical to achieving the quadruple aim of improving the health of the population, enhancing patient experiences and outcomes, reducing the per capita cost of care, and improving provider experience. Many providers, insurers, delivery systems, and QI organizations are focused on improving the performance and safety of primary care.
For many practices, QI is likely to be a new activity. As with the implementation of many new ideas and processes, practices will need new skills to meet their improvement goals. External supports can help practices learn these new skills and better implement QI. These supports include data feedback on key indicators and practice facilitation (or coaching) to help build the capacity for QI.Learn about QI supports
Community Health Network of Connecticut, Inc. (CHNCT) has a team of trained staff to help and support you!
They will assist you with your practice needs for PCMH and QI. This service is at no cost to your practice.
Continuous Quality Improvement (CQI) begins with the culture of improvement for the patient, the practice, and the population in general. The culture begins with a QI team led by a clinical practice champion.
Your assigned Community Practice Transformation Specialist (CPTS) can support you as a practice facilitator. They can assist you with completing an assessment to help you identify current needs and develop your practice’s capacity for improvement to address these needs. A facilitator can tailor QI efforts to your practice and help implement them.Practice Facilitator Support
PCMH involves numerous changes – to processes, workflows, scheduling systems, and the care team structure. PCMH supports QI in primary care by acknowledging the core concepts set forth by the NCQA. QI is integrated into each of the six NCQA PCMH concepts. The concepts contain specific criteria that outline the features of the practice’s transformation to a PCMH.
The Plan-Do-Study-Act (PDSA) cycle is a tool for CQI. The goal of the PDSA cycle is to test a change – by planning it, trying it, observing the results, and acting on what is learned.
Many Electronic Health Records (EHRs) can help you with QI in ways that save your practice time and money. Although each EHR system is unique, below are links that may assist with QI. EHRs can improve health care quality. EHRs can also make healthcare more convenient for providers and patients.Improve Care Using EHRs
Electronic Health Records allow your practice to:
Give the right care at the right time
Ensure that everyone gets the care they need
Provide timely and credible performance feedback
Deliver reliable and efficient care
The quality improvement process has a specific set of steps. Here are the steps to follow as your practice goes through the process of achieving or sustaining NCQA PCMH recognition.
If your practice is working towards initial NCQA PCMH recognition, you can use the Quality Improvement Worksheet to demonstrate the continuous quality improvement process. The worksheet is found in the current NCQA PCMH standards and guidelines which you can order from the NCQA store at no cost.NCQA PCMH Standards and Guidelines
If your practice is sustaining PCMH NCQA recognition, you can report your Quality Improvement activities using the Annual Reporting Quality Improvement Worksheet which you can order from the NCQA store at no cost.Annual Reporting Requirements
NCQA has a PCMH Measures Crosswalk that may be helpful with your QI projects. The crosswalk shows the overlap between quality measures from common measure sets.PCMH Measures Crosswalk
Qualifying practices can earn performance-based payments for their participation in the HUSKY Health Person-Centered Medical Home (PCMH) program based on results of select PCMH health measures. There are two components to the Performance-Based Payment program: the performance payment and the improvement payment.The Performance-Based Payment Program
This portion of the HUSKY Health website is managed by Community Health Network of Connecticut, Inc., the State of Connecticut’s Medical Administrative Services Organization for the HUSKY Health Program. For the general HUSKY website gateway, please visit portal.ct.gov/husky. HUSKY Health includes Medicaid and the Children’s Health Insurance Program, and is administered by the Connecticut Department of Social Services.
To update your information, please select your HUSKY Health Program type. Once you select your program, you will need to login to access and review your personal information.
To see whether you belong to HUSKY A, B, C, D, or LB simply look at your HUSKY ID Card. The big, bold letter is your HUSKY program.