Care Management Criteria, Strategies, and Techniques

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Overview

There are many paths to becoming a successful PCMH—they do not all look alike and generally depend upon the local circumstances, preferences and quality landscape in a particular region. NCQA has identified several attributes that contribute to PCMH success:

  • Organization leadership, a team-based approach, health information technology and delegating self-management education and proactive care reminders to non-physician team members.
  • Involving patients and families in practice improvement efforts through advisory committees, ombudsmen or navigators.
  • A systems approach to QI that results in data, standard measurements, technical assistance, leadership and personnel.
  • Financial assistance, technical assistance, or both, to help create and sustain the transformation.

Care management within a PCMH Context evaluates how a practice systematically tracks tests, referrals and care transitions to achieve high quality care coordination, lower costs, improve patient safety and ensure effective communication with specialists and other providers in the medical neighborhood. A PCMH’s ability to successfully achieve comprehensive care management increases as its strategies align with the PCMH attributes of success.

The Care Management Criteria, Strategies and Techniques webinar will offer a comprehensive look at NCQA’s PCMH care management requirements and outline best practice approaches within different care delivery settings. Faculty will review core criteria, outline how to dual purpose documentation to meet multiple criteria and walk through the process for how to build a foundation of favorable attributions, develop a project plan, implement strategies and prepare evidence for virtual review.

After this program you will be able to:

• Describe PCMH Recognition Care Management Criteria and requirements.

• Construct a strategy to meet care management goals within different practice settings.

• Prepare care management criteria for presentation to NCQA through the virtual review process.

Who Should Attend

• CCE’s.

• Consultants.

• Practice care teams.

• Practice manager.

• Payers.

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