The patient-centered medical home model has caused big changes in primary care practices and given physicians the opportunity to earn a bit more money for care coordination. Now the same forces are at work on the specialty side of medicine.
One year after the National Committee for Quality Assurance (NCQA) launched its "Patient-Centered Specialty Practice Recognition" program, 23 practices and 287 clinicians have achieved the 3-year recognition.
Margaret O’Kane
"Coordination is a two-way street," Margaret O’Kane, NCQA president, said during a webinar to highlight lessons learned during the first year of the program. "You can’t just do this on the primary care side."
Dr. Andrew Chapman, director of regional cancer care at Jefferson Medical Oncology Associates in Philadelphia, said receiving NCQA recognition through the new specialty-focused program was the first step toward achieving a "shared model of care" with the primary care physicians in his community.
In the past, the model in oncology was that once a cancer diagnosis was made, all of the care would be assumed by the oncologist. But that model is no longer viable, Dr. Chapman said, and integrating specialists into the medical home can improve quality and safety.
"What we do now has become so complex that taking care of many of the issues that an internist or a family medicine physician is really expert at, is really out of our realm," he said.
The NCQA recognition program is based on the concept of the medical home "neighbor" that was developed by the American College of Physicians and follows the same model as the NCQA’s patient-centered medical home recognition program for primary care physicians.
Kristin Bell
To qualify, practices must meet several standards for care coordination and information sharing, including tracking and coordinating referrals, providing extended hours and electronic access to the practice, tracking patients as they visit the hospital and emergency department, and providing previsit planning and medication management.
Specialty practices must also measure their efforts on clinical quality, utilization, care coordination, and patient satisfaction.
The model is a good fit for obstetrics and gynecology practices, according to Kristin Bell, the practice manager for Women’s Healthcare Associates in Portland, Ore.
In pursuing NCQA recognition, the practice made a number of changes aimed at improving coordination. To start, they trained a staff member as a referral navigator and tasked her with streamlining the process of gathering records, scheduling patient appointments, and ensuring that records were returned to the referring physician.