CCE Quarterly: Care Mgmt Criteria, Strategies and Techniques
CCE Quarterly: Care Management Criteria, Strategies, and Techniques
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.
- Practice care teams.
- Practice manager.
- 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.
Christina Borden, PCMH CCE
Christina Borden has spent a majority of her career working to improve patients and providers’ healthcare through implementing more rigorous standards for Patient Centered Medical Home. She has overseen, managed and implemented specific standards and initiatives at a Medicaid managed care association, on Capitol Hill and at NCQA. Christina is the Director for NCQA's Recognition Programs Policy and Resources (RPPR). In her ninth year with NCQA, Christina oversees the development, implementation, and promotion of NCQA’s Recognition Programs (RP). She maintains and improves NCQA programs as clinical measures and standards change. Additionally, she works to educate stakeholders, interpret and maintain guidelines for RP programs and ensure NCQA’s programs properly align with federal guidelines and the healthcare industry as a whole. When appropriate, Christina represents the department publicly, including in forums for sponsors, state and federal agencies, professional organizations and other partners. Before joining NCQA, Christina worked at the Association for Community Affiliated Plans (ACAP) representing non-profit safety net health plans and as a health liaison on Capitol Hill.
Amanda Ciadella, MPH, PCMH CCE
Amanda joined The Verden Group in 2017 as Senior Consultant, with a focus on the Florida Chapter of the American Academy of Pediatrics statewide PCMH project where she has supported over 27 practices with their PCMH goals. Her combined background in health administration and her recent work in population health management bring a wealth of knowledge and expertise to her clients. Amanda’s education in health care began with a bachelor’s degree in health administration and a master’s of public health from the University of West Florida. She was also Office Manager in a pediatrics practice in Crystal River, Florida, where she participated in the Blue Cross Blue Shield Florida pilot PCMH program and helped the practice earn NCQA Recognition. Dedicated to expanding her knowledge of PCMH and helping clients navigate the path to NCQA Recognition, Amanda has been a PCMH CCE since 2014 and has supported practices under the PCMH 2011, 2014 and 2017 standards.
This live webinar provides maintenance of certification credit (2 points) under "required continuing education" for PCMH CCEs.
This is a non CME/CNE/CPE activity.
- 1.00 Participation
- 2.00 PCMH CCE