HMG celebrates "first in the state" multi-specialty group achievement in the patient-centered medical home model of care.
September 1, 2011
KINGSPORT, Tenn.—With an audience of legislators, government officials, and managed care thought-leaders present, Holston Medical Group (HMG) President Scott R. Fowler, MD, JD, announced a “first in the state” achievement at a September 1, 2011 morning news conference, held at the HMG Medical Plaza, Kingsport. The milestone announcement marks a paradigm change in the delivery of health care, resulting in improved patient wellbeing, greater patient satisfaction and reduced costs.
“It is now my privilege to announce that Holston Medical Group has become the first multi-specialty group in the state of Tennessee to receive the National Committee for Quality Assurance’s (NCQA) recognition as a Level 3 Patient-Centered Medical Home,” said Fowler, adding that the announcement connects HMG to “one of the most exciting developments in patient care in the last 20 years.”
The patient-centered home approach to care is an emerging national model that provides a coordinated team approach to patient care, attaining and retaining health and wellbeing.
The result, according to HMG leaders, is improved patient wellbeing, greater patient satisfaction and reduced costs, most notably in the treatment of chronic conditions, such as asthma, diabetes, hypertension and heart disease.
“According to the Centers for Disease Control and Prevention, health care for individuals with chronic diseases accounts for 75% of our nation’s total health care costs,” said Fowler, calling the statistic alarming. “That’s why we are here today. HMG believes the medical profession carries with it a duty and responsibility to advocate for a healthcare system that offers solution. One that is not merely responsive but proactive and forward-thinking.”
Fowler called NCQA recognition the “gold standard in quality measurement by the nation’s foremost organization,” advancing evidence-based, nationally-recognized standards of care.
To achieve NCQA recognition, organizations must exceed nine rigorous standards and ten elements. HMG scored so well that the group achieved a Level 3 status, the nation’s highest level of recognition.
“This singular achievement by both the administrative and provider staff is testament to Holston Medical Group’s commitment to improved efficiency, quality of care, and most importantly, to the patents of Northeast Tennessee,” says Donald W. Fischer, PhD, president and CEO of the American Medical Group Association.
The patient-centered medical home model of care is a physician-led, team approach that centers care around the patient, utilizing health coaches (specially trained nurses) who provide compassionate interaction with patients, reviewing records and closing the gaps on preventive measure that may be missing from a patient’s health record.
“Instead of being reactive, we are looking ahead, anticipating future needs and promoting proactive wellness with intentional and strategic follow-up care plans,” said HMG primary care provider Wendy Oberdick, MD. “This means we are seeing you as a patient today and as a patient and a friend in good health when we see you tomorrow.”
Patient-Centered Medical Homes are developed around the complete patient experience. The model uses sophisticated technology, such as electronic medical records, email portals and data exchanges, to enhance communication.
According to Oberdick, the patient-centered medical home model of care is designed to replace a broken, costly and burdensome system where you have “fragmented care that addresses acute episodes, tending to the urgent problem while the totality of patient care suffers and costs soar.”
HMG collaborative partner, Blue Cross Blue Shield of Tennessee, says the driving focus is “better health through better quality, improved costs and overall better outcome for our members.”
“We congratulate HMG on this tremendous accomplishment and look forward to continuing our partnership, ensuring our chronic care patients have the access they need, when they need it,” said BCBS’s Kevin Raynor, manager, provider performance management.
HMG’s collaborative patient-centered medical home relationship with commercial managed care providers includes Blue Cross Blue Shield of Tennessee, Cigna and Humana.
According to Fowler, working with managed care partners, HMG is taking the lead in “moving away from a model of care that has the goal of greater volume—more tests, more visits, more labs—to a model of care that has the goal of better outcomes, improved value and reduced costs.”
“Our managed care partners are telling us they want transparency. They want measurable outcomes. They want to avoid unnecessary hospitalizations and emergency room visits,” said Fowler. “They want us to consistently treat patients using evidence-based guidelines. And, they are willing to partner with us, coming to the table and reward us for that success.”
According to BCBS, a patient-centered medical home model of care results in five measurable results: decreased per-person health costs, reduced visits to the emergency room, fewer hospital admissions, fewer injuries and illnesses and improved patient satisfaction.
“Based on measurable results, we’re leading the way across our region, our state and our nation,” said Fowler, “It’s a better way.”
“And our patients love the compassionate, highly-integrated level of care they are receiving,” said Oberdick. “It’s an honor and a privilege to serve in a culture of change that provides proven and proactive wellness for patients in all stages of life.”
Government and community leaders in attendance celebrated the community’s first-in-the-state achievement.
“This is certainly a shared success for everyone to celebrate. Holston Medical Group’s achievement is indicative of the excellent healthcare in our region and certainly exemplifies why the Move to Kingsport program continues to entice and attract others to make this part of the country home,” said Kingsport Area Chamber of Commerce President and CEO, Miles Burdine.
To obtain NCQA Level III PCMH recognition, HMG had to adhere to nine major standards in excellence including:
• Access and Communication
• Patient Tracking and Registry Functions
• Care Management
• Patient Self-Management Support
• Electronic Prescribing
• Test Tracking
• Referral Tracking
• Performance Reporting & Improvement
• Advanced Electronic Communications
According to the NCQA, standards are aligned with PCMH, the American College of Physicians, the American Academy of Family Physicians, the American Pediatrics and the American Osteopathic Association. Level III is the highest level achievable for a medical home, and the recognition is valid for three years.