additionally, to meet accreditation requirements, a practice is required to provide written policies and procedures as further evidence of PCmH implementation. This level of documentation is frequently underdeveloped if not entirely absent. In our experience, success in PCmH transformation depends on a number of factors: • Resources: Practices must have the financial resources to make staff time available for change, acquiring electronic systems, etc. • Leadership: Typically, a clinician must lead the process with co-leadership by an administrative or operations person who manages the process of change. • Culture and Focus: The practice must align its values and focus its organizational effort with patient-centeredness and care coordination. • Policies and Procedures: Written statements of how a practice expects to operate are crucial in guiding the process and providing documentation for accreditation. • Performance Improvement: measuring performance, identifying A More Secure Way to store files 14 HBma BIllIng • maRCH.aPRIl.2014 wasteful or ineffective processes, and making appropriate changes must become a routine part of how the practice operates. • Transformation Support: many practices need a facilitator who is familiar with best practices, measurement, systems, change management, and the transformation process. Opportunities for Revenue Enhancement To encourage PCmH transformation, public and private payors are increasingly providing financial incentives. These incentives generally take three forms: 1. PAyMENT FoR ACHIEvEMENT oF PCMH RECoGNITIoN: Designed to reimburse for startup costs associated with transformation, these can take the form of direct payment, bonuses, or escalation of fee-for-service (FFs) or per member per month (PmPm) payments. To receive such payment, most payors require that a practice achieve recognition/accreditation from one of the organizations that offers such certification. For example, Blue- Cross Blueshield of Hawaii pays $2.50 PmPm for each patient in a primary care physician’s panel if (The Patient Centered Medical Home continued) (continued on page 16) 500+ medical billing o ces nationwide use eBridge’s HIPAA-compliant, secure cloud-based document management system to streamline operations, save money, and reclaim space. t Provider scanning and retrieval t E! ortless work queue management t Quick and easy batch scanning t Compliant audit trails to track user access t Full-text keyword searches for ultra-fast retrieval Call 813-387-3870 today for a demo. Because your business is about more than just paper. www.eBridge.com 813-387-3870 LHaywood@eBridge.com
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