One area that Mayer has seen improvement in due to the NCQA PCMH process is team-based care. "We had it, but we weren't maximizing it," he says, adding everyone now works to the highest level of their degrees, including medical assistants, nurses, and front desk personnel.
"Nurses used to just take vital signs and put people in a room," he says. "Now they look for gaps in care, such as patients being due for mammograms, colonoscopies, and vaccines. In the past it was my job as the doctor, but on a busy day, I didn't always ask."
As the medical team starts to gather metrics on these coordinated care efforts, they are noticing significant improvements. For example, only half the patients who should have been getting colonoscopies were, and now that number has increased to 85%, Mayer says. "The nurse makes one click in the EMR system and the front desk personnel know to schedule the procedure," he says.
Ann D. Brown, MD, FACP, vice president of practice transformation and innovation, Physician Alignment, at Methodist Le Bonheur Healthcare, which has more than two dozen primary care locations in the Memphis area, first started working with a subset of 11 practices to gain NCQA PCMH recognition in 2013.
"We looked at trying to transform all the practices at once," Brown says, but she found it more practical to hand-select and target practices familiar with population health. She persuaded physicians to participate by explaining PCMH as a tool that would help them remain in practice and help them enjoy practicing. She added that PCMH would spread some of the patient's care to the entire medical team with proper education, training, and participation.