Today, healthcare providers are being required more than ever before, to coordinate patient care, improve quality and reduce costs. This is fundamental to ensuring success in the new value-based-reimbursement and quality-driven-healthcare environment. In addition, the Federal and State governments are also endorsing and promoting Patient-Centered Medical Home (PCMH) through their Medicaid State Programs commonly referred to as “health home” initiatives. Adoption of electronic health record technology and the PCMH model for Federally Qualified Health Centers (FQHC) are both strategic imperatives from HRSA and its Bureau of Primary Health Care (BPHC).  HRSA has recently funded an HIT support of Expert Panel of PCMH users in conjunction with the National Association of Community Health Centers (NACHC).

All of these models pave the way for the expected shift from a volume-based reimbursement model to one based on quality, efficiency and patient safety.

PCMH Recognition Programs are optional to providers, however, PCMH is considered to be the core foundation of health reform and the collaborative care model.  Many commercial insurance plans and State Medicaid Programs provide additional incentives and rewards as a result of practices achieving PCMH recognition.

Providers who meet performance standards on specific quality measures will be rewarded financially and acknowledged for their improved care collaboration by both commercial and public plans. How? Through organizations like NCQA, the governing body that allows practices to become PCMH certified. The overarching goal is to improve care quality, manage at risk patients and reduce costs, leading to a steady evolution toward fully coordinated care systems.

See how a NextGen client achieved PCMH and MU.

NextGen Healthcare launched new solutions in their EHR/KBM (KBM) 8.1.2 and our upcoming KBM 8.3) to assist clients in collecting the clinical and patient data needed to support patient centered medical home and care coordination.

For example, the NextGen Healthcare Care Coordination Home template is used within a specialty template for care coordination to meet collaborative care criteria.

Here are some of the new features within NextGen’s EHR software that helps facilitate the coordination of care for each patient:

  • Ability to view/document coordination of care
  • Enhanced workflow
  • Care Coordination team
  • Referral History
  • Barriers to care
  • Care Plan history
  • Enhanced communications
  • Ability to review population health management data

In support of the collaborative care model, the Care Plan Template features the functionality to enter an interdisciplinary care plan that documents within the EHR, patient-specific problems, goals, outcomes and interventions.  The cross functional care team can collaboratively review, evaluate, document and print interventions and progress within the patient’s Care Plan History.  This functionality assists providers to establish care coordination teams and most importantly, to adopt care coordination as their best practice in the day to day care provided to patients.

Finally, we are pleased to note that over 2,300 NextGen clients have already achieved PCMH Certification in Level 1, 2 or 3.

Joy Snyder
KBM Project Manager, NextGen Healthcare