PCMH Congress is an annual conference hosted by the National Committee for Quality Assurance (NCQA) where healthcare providers and program experts share successes, challenges, and innovations in patient- centered medical home (PCMH) model implementation. This year, NCQA invited NYC REACH to share its expertise with attendees. NYC REACH program experts shared best practices and lessons learned from working with New York City providers to adopt and sustain the PCMH model.

The PCMH program supports practices with providing patient-centric care, improving quality outcomes, and succeeding under value-based payment (VBP) arrangements. Practices that transform into patient-centered medical homes strengthen their population health capabilities, simplify practice workflows, and improve performance in other programs. New York providers adopt the New York State PCMH, a framework designed exclusively for New York providers.

Presentations and case studies of PCMH practices largely focused on how providers can:

• Ensure that PCMH operations are financially sustainable
• Use VBP and other revenue sources to drive practice improvements
• Leverage electronic health record (EHR) technology to streamline PCMH operations
• Effectively integrate behavioral health into primary care

Providers from all practice sizes shared tips for sustaining PCMH operations.

NYC REACH Presentations

NYC REACH experts delivered two presentations: one on the importance of integrating VBP with PCMH operations and one on their efforts to help school-based health centers (SBHCs) achieve school-based medical home (SBMH) recognition.

Value-Based Payment

NYC REACH presenters discussed the link between VBP and PCMH. A VBP arrangement ties practice revenue to quality outcomes and patient cost of care. Performing well under VBP arrangements requires that practices build or enhance their population health management skills in order to adopt a systematic approach to improving quality of care and reducing patient costs. PCMH provides a framework for a primary care practice of any size to effectively manage population health.

In other presentations, providers demonstrated how PCMH prepares providers for VBP arrangements. PCMH also supports participation in the Merit-Based Incentive Payment System (MIPS). PCMH puts providers on track to met MIPS requirements throughout the year so that practices meet requirements well in advance of the reporting deadline.

School-Based Medical Home

Presenters shared how NYC REACH is working to implement the SBMH model at SBHCs throughout the city. These centers provide a range of free healthcare services; serving either as a complement to primary care providers (PCPs) or the main source of primary care for low-income students. SBMH incorporates the PCMH framework to apply a team-based approach to student care and ensure efficient, coordinated care with PCPs in students’ home communities.
NYC REACH encourages PCPs and community-based organizations to initiate collaboration by finding out and keeping track of all the locations where their student patients receive care, including local SBHCs.

Support
To learn more about VBP, SBMH, or PCMH, contact pcmh@health.nyc.gov. NYC REACH provides free support with practice transformation through technical assistance, trainings, on-site visits, and more.