Tool to Assess Ongoing Costs of PCMH

评估PCMH持续成本的工具 项目总结/摘要 以病人为中心的医疗之家（PCMH）模式有望帮助实现这三个目标 获取、质量和成本效益。实践到PCMH模型的转换 需要许多变化，包括增加新的工作人员来执行新的服务，新的工作流程 和系统，以实现病人访问的新途径，和新的系统，以管理 患者人群的健康。许多这些活动和基础设施，以支持 目前的偿还模式不包括这些人。 随着实践向PCMH模式转变，必须预先提供充足的 提供投资，以便实践能够建立必要的基础设施， 支持高质量、安全、持续、协调、全面的护理。关键是要发展 了解PCMH所需新服务的持续维护成本 模型有了这个项目，我们有一个重要的机会，有助于有效的小学 保健支付改革和初级保健改革的可持续性， 确定维护PCMH实践的成本。 本项目将应用PCMH成本维度工具，以评估成本， 在21个实践中， 在以下方面存在差异：1）NCQA PCMH认可状态（III级或非III级），2）所有权 （中央拥有的做法或独立做法的网络），3）支付者（按服务收费 商业计划，医疗保险，医疗补助，联邦合格的健康中心），以及4）患者 人口（社会经济状况、健康状况）。将PCMH成本维度工具应用于 这些不同的设置将使我们能够检查实践及其相关的方法， 不同环境的成本结构各不相同。 这项研究的结果将对各种利益攸关方有用。它们将有助于 付款人在建立财政激励措施的做法，以实施和经营PCMH 实践它们将有助于政策制定者制定鼓励和 支持PCMH实践的发展。它们将有助于实践预测 他们在维持一个转变的PCMH实践中可能经历的成本。

Tool to Assess Ongoing Costs of PCMH Project Summary/Abstract The Patient-Centered Medical Home (PCMH) model is expected to help achieve the triple aims of access, quality, and cost effectiveness. Transformation of a practice to a PCMH model requires many changes, including addition of new staff to perform new services, new work flows and systems to implement new avenues for patient access, and new systems to manage the health of a population of patients. Many of these activities and the infrastructure to support them are not covered by current reimbursement models. As practices are transforming to a PCMH model, it is essential that sufficient up-front investments be made available so that practices can create the infrastructure necessary to support high-quality, safe, continuous, coordinated, comprehensive care. It is critical to develop knowledge about the costs of on-going maintenance of the new services required in a PCMH model. With this project, we have an important opportunity to contribute to effective primary care payment reform and to the sustainability of primary care transformation by rigorously defining costs for maintaining PCMH practices. This project will apply a PCMH Cost Dimensions Tool developed to assess the costs to practices associated with activities to achieve PCMH recognition status in 21 practices that differ with regard to their: 1) NCQA PCMH Recognition status (Level III or not), 2) ownership (network of centrally owned practices or independent practices), 3) payers (fee-for-service commercial plans, Medicare, Medicaid, Federally Qualified Health Centers), and 4) patient populations (socio-economic status, health status). Applying the PCMH Cost Dimension Tool in these diverse settings will allow us to examine the ways in which practices and their associated cost structures differ across settings. The findings from this study will be useful to a variety of stakeholders. They will be useful to payers in establishing financial incentives for practices to implement and operate PCMH practices. They will be useful to policy makers in establishing programs that encourage and support the development of PCMH practices. They will be useful to practices in predicting the costs they may experience in maintaining a transformed PCMH practice.