The Physician Care Alliance Quality Matrix:
Based on Medicare’s Roadmap for Implementing Value, national healthcare goals for value-based healthcare have been identified as: Financial viability to support transformation; joint accountability across healthcare team participants; evidence based effectiveness; access, safety, and transparency; well-coordinated transitions; and electronic information technology to achieve effective and efficient patient-centered high quality care.
Physicians face extensive challenges in managing the necessary changes to attain these value-based goals due to the increasing demands of chronic disease care, healthcare initiatives and their requirements, increasing patient engagement activities, and the complexity of care and service sites. The difficulty in applying a best practice disease-by-disease methodology and a population-centered approach is most evident when patients have significant co-morbidities and psychosocial issues that affect their health outcomes.
Transitioning a practice organization to achieve a high level of functioning requires a strong framework. Our PCA Practice Transformation Team has developed services and tools based on the core competencies of the PCA Quality Matrix. In order to successfully transition to a value-based system, our team will monitor and facilitate your progress through these core competencies:
- Foundational Tools: Engagement, Data, Team, Risk Adjustment and Process Improvement
- Coordinated Care: Access, Transitions, Chronic Care and Acute Care
- Complex Management: Extended Care, Wellness Coaching and Campaigns
- Cost Management: Value-Based Care and Utilization Management
The PCA Practice Transformation Team has extensive experience in national and regional initiatives including other Clinically Integrated Networks, Center for Medicare and Medicaid Innovation, the Robert Wood Johnson Foundation, and the Office of the National Coordinator Meaningful Use program. In addition, Physician Care Alliance personnel have the following experience and expertise: EHR and population health software implementation; care management and case management program development and implementation; health plan, shared savings and at-risk contracting; and clinical and business analytics.
The PCA team will work with your provider organization to evaluate software data entry, reporting, and validation, workflow review and design, quality improvement tools and processes, and data-driven population and chronic care management. PCA will provide training and tools to facilitate your organizational change process, team-based learning opportunities, information sharing processes, and provider organization support systems. In addition, PCA will incorporate team engagement and patient self-management tools for long term sustainability in value-based healthcare.
The PCA Quality Matrix is based on research, evidence based guidelines, and best practices validated through national medical and quality associations.