A Multi-payer Patient Centered Medical Home Initiative in Pennsylvania

宾夕法尼亚州的多支付者以患者为中心的医疗之家计划

• 批准号: 8119069
• 负责人: ROBERT A GABBAY
• 金额: $ 29.47万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8119069
• 关键词: Multi; payer; Patient; Centered; Medical

DESCRIPTION (provided by applicant): This application proposes to evaluate the first regional roll-out of a unique statewide, multi- stakeholder-based implementation of Patient Centered Medical Home (PCHM) on practice redesign for chronic illness care in Pennsylvania. This is intervention is distinctive with significant multi-payer-based provider incentives facilitated by the PA Governor's Office for Healthcare Reform (GOHCR). This application proposes to study the 25 practices involved in the first of the regions of this statewide initiative, Southeastern PA (SEPA). The SEPA intervention began in May 2008 and includes a 3-year learning collaborative, Improving Performance in Practice (IPIP) practice coaches, and required monthly registry and narrative reports. Significant financial incentives for implementation are paid to providers from the region's major health insurers and are assured by contracts between practices, providers and GOHCR. Varied practice types are included in the collaborative including family medicine, internal medicine, residents, and Federally Qualified Health Center (FQHC) practices varying in size. A multi-method evaluation will include quantitative assessments of clinical outcomes and service utilization and cost, and qualitative approaches will be used to identify unanticipated constructs of interest and obtain perceptions of quality, implementation processes and procedures, and variables that affect PCMH implementation and performance on a daily basis. The goal is understand the impact of this intervention and identify barriers and facilitators for the initiative to help disseminate the process to improve primary care in other settings. PUBLIC HEALTH RELEVANCE: The purpose of this application is to evaluate a multi-stakeholder primary care redesign initiative facilitated by the Pennsylvania Chronic Care Commission focused on improved care for diabetes. The initiative is based on the Patient Centered Medical Home model to coordinate all aspects of patient care and improve patient-physician interaction and satisfaction. The goal is understand the impact of this intervention and identify barriers and facilitators for the initiative to help disseminate the process to improve primary care in other settings.

描述(由申请人提供)：本申请建议评估宾夕法尼亚州以患者为中心的医疗之家(PCHM)对慢性病护理实践重新设计的独特的全州范围内、基于多方利益相关者的独特实施情况。这是干预的独特之处，在宾夕法尼亚州州长医疗改革办公室(GuchR)的推动下，以多支付者为基础的供应商激励措施显著。本申请建议研究这一全州范围内倡议的第一个地区--东南宾夕法尼亚州(SEPA)--涉及的25项实践。SEPA干预始于2008年5月，包括为期3年的协作、提高实践绩效(IPIP)实践教练的学习，并要求每月登记和叙事报告。该地区主要医疗保险公司向医疗服务提供者支付了实施的重大财政奖励，并通过诊所、医疗服务提供者和GuchR之间的合同予以保证。合作项目包括不同的执业类型，包括全科医学、内科、住院医生和联邦合格医疗中心(FQHC)，这些诊所的规模各不相同。多方法评估将包括对临床结果、服务利用和成本的定量评估，定性方法将用于识别感兴趣的意外结构，并获得对质量、实施过程和程序的看法，以及影响PCMH实施和日常绩效的变量。目标是了解这一干预措施的影响，并确定该倡议的障碍和促进者，以帮助传播在其他环境中改善初级保健的进程。 公共卫生相关性：本申请的目的是评估宾夕法尼亚州慢性护理委员会推动的一项多利益相关者初级保健重新设计倡议，重点是改善糖尿病的护理。该倡议基于以患者为中心的医疗之家模式，以协调患者护理的所有方面，并提高患者与医生的互动和满意度。目标是了解这一干预措施的影响，并确定该倡议的障碍和促进者，以帮助传播在其他环境中改善初级保健的进程。

项目成果

Implementing effective care management in the patient-centered medical home.

在以患者为中心的医疗之家实施有效的护理管理。

• 发表时间: 2013
• 期刊: The American journal of managed care
• 作者: Taliani,CatherineA;Bricker,PatriciaL;Adelman,AlanM;Cronholm,PeterF;Gabbay,RobertA
• 通讯作者: Gabbay,RobertA

How nurse-led practices perceive implementation of the patient-centered medical home.

护士主导的实践如何看待以患者为中心的医疗之家的实施。

• DOI: 10.1016/j.apnr.2017.02.005
• 发表时间: 2017
• 期刊: Applied nursing research : ANR
• 作者: Frasso,Rosemary;Golinkoff,A;Klusaritz,Heather;Kellom,Katherine;Kollar-McArthur,Helen;Miller-Day,Michelle;Gabbay,Robert;Cronholm,PeterF
• 通讯作者: Cronholm,PeterF