PCMH-Neighbor Concept Builds on Patient-Centered Medical Home Momentum

Specialists working day to day with primary care medical homes will move more easily into the role of patient-centered medical home neighbor (PCMH-N) than those who have not, notes Robert Krebbs, WellPoint’s director of payment innovation. WellPoint recently launched a medical neighborhood pilot for three specialties with clear care coordination alignment opportunities with primary care medical homes.

The neighborhood model requires education on the part of specialists and patients who have not been part of integrated delivery systems so they can better benefit from the new patient-centered medical world, Krebbs explains in this audio interview.

Robert Krebbs shared the key components of WellPoint’s Enhanced Personal Health Care for specialty care program during a May 15, 2014 webinar, Care Compacts: Forming the Foundation of Care Teams with PCPs and Specialists, a 45-minute program sponsored by The Healthcare Intelligence Network.

Length: 4:31 minutes

Medical Home Neighborhoods: Uplinking Specialists To Create Integrated Systems of Care

If payment inequities can be addressed, communication and technology tools in place in large physician multispecialty groups make them ideal candidates for a medical neighborhood, suggests Terry McGeeney, MD, MBA, director of BDC Advisors. Dr. McGeeney, who spent 13 years of his practice career in a large multispecialty group, has also seen some FQHCs and managed Medicaid programs that do a good job of linking community and social supports required in medical neighborhoods.

As for engaging patients in this emerging integrated care delivery system, try explaining the medical neighborhood’s value proposition for them, he suggests. Patients already get why the integrated approach is good for physicians and insurance companies but need to hear why they should buy in to team care, patient portals and other aspects of centralized care coordination.

Dr. McGeeney shared his expertise in developing medical home neighborhoods during a November 20, 2013 webinar, Medical Home Neighborhoods: Uplinking Specialists To Create Integrated Systems of Care.

Length: 6:16 minutes

Aligning Value-Based Reimbursement with Physician Practice Transformation

In its quest to transform 70 to 80 percent of its physician practices to a patient-centered medical home (PCMH) over the next three years, WellPoint has adopted a “meet the practices where they are” philosophy, reports Julie Schilz, director of care delivery transformation for WellPoint. Each practice is at a different place in the transformation effort and requires specialized supports, she adds.

Smoothing the transformation rollout is the simultaneous participation of 500 WellPoint practices in CMS’s Comprehensive Primary Care (CPC) program, whose goals dovetail with key PCMH principles — as though WellPoint had another partner in its transformation initiative, Schilz notes.

Just as important as practice support is transparency with health plan members, Schilz adds, especially when it comes to explaining the concept of the medical home neighborhood — where care coordination is a collaboration between primary care and the specialist.

Ms. Schilz shared the key features of WellPoint’s transformation initiative, including results from its pilot program that have led to a system-wide rollout, during an October 24, 2013 webinar, Aligning Value-Based Reimbursement with Physician Practice Transformation.

Length: 5:29 minutes