The PCMH is a relatively new model of healthcare provision that can be challenging to understand and incorporate into clinical practice. This session will place the PCMH into perspective within the broader healthcare quality movement, present evidence regarding the effectiveness of the PCMH in delivering quality healthcare, provide guidance regarding the transition from current fee-for-service model to the national PCMH-like model of care, and examine how PCMH principles will impact primary care practices starting in 2015.
The changing landscape of healthcare has unsettled patients as well as clinicians. Recent ethical guidelines require scaling back of scarce resources, and accountable care organizations (ACOs) require payment and delivery reforms that seek to tie reimbursements to quality metrics and reductions in the total cost of care. These changes can unsettle patients, who have concerns about the impact of physician compensation on their healthcare. This presentation offers perspective on the evolving healthcare model and provides strategies for communicating with patients regarding their concerns.
In this age of immense technological and scientific advances, the time-honored patient-clinician relationship can, at times, feel under siege. In examining how changing practice patterns have altered the ritual, Dr. Verghese will discuss some aspects of the relationship that are both timeless and critical to diagnosis and cost-effective care.
Dr. Carrasquillo, an expert in community health worker (CHW) research, addresses two recent studies conducted at University of Miami focused on the efficacy of CHWs in patient health.
In this activity, Dr. Symes will illustrate how to use patient decision aids and evidence-based medicine in your everyday practice. He will highlight resources for evidence-based medicine and demonstrate the calculation of the measures of association and the assessment of evidence in the context of the bigger clinical picture.
ICD-10 will replace the out-dated ICD-9 coding system this year. As of October 1, 2015, all Medicare claims must be submitted with a valid ICD-10 code or they will be rejected for payment by CMS. Additionally, many practices are participating in ACO ‘at-risk’ contracting. In order to be successful with such contracts, in is imperative that appropriate HCC (Hierarchical Conditions Categories) documentation is used to risk adjustment patients and help predict medical expenditures for a patient. While these changes are significant, the Electronic Health Record (EHR) can play an important role in meeting these billing/coding requirements. This presentation will overview the key issues related to using the new ICD-1O and HCC codes for primary care practice using a case-based approach and highlight how the EHR serves as a tool to insure success.