What PCA Supports

Quality Performance Assessment and Action Plans: PCA assessments, training and tools help to both improve quality of care and reduce the total cost of care by focusing on implementing best practices in preventative care, access and utilization. Additional resources include clinical pathways and standardized workflows for disease management, care gap closures, medication reconciliation, care coordination and other clinical quality activities.

Patient Centered Care: PCA provides training for patient-centered care including pre-visit planning, shared decision-making, patient engagement and patient experience activities.

Care Management and Transition of Care: PCA provides care coordination, care management and transition of care training and implementation resources including a Care Management platform connected to the population health software. These programs reduce hospital and emergency department readmissions and complications as well as improve care gap closure, collaboration, communication and coordinated care.

Population Health: PCA provides population health software and train-the-trainer programs for data aggregation and analysis, care gap campaigns, quality program alignment and bundled disease measures. Training and education include provider panels, patient attribution, high-risk patient identification, pre-visit planning, workflow, patient outreach and engagement activities and tracking/trending chronic disease quality measures. Based on data availability, analytics may also include pharmacy utilization.

Value-Based Care Education: PCA provides physician and team education on value-based health plan contracts incorporating quality metrics, shared savings, health insurance partnerships and transitioning from fee-for-service focus. Training also includes Medicare and commercial risk coding and workflow.

Analytics and Risk Management: PCA provides data analytics support and reporting for clinical performance and quality outcomes at the provider, clinic and network level to meet health plan requirements including shared savings contracts.

Network Management: PCA negotiates commercial payor agreements and provides contract advocacy and quality metric modification to support sustainability. PCA helps improves contract performance and increases shared savings by submitting supplemental quality data on behalf of its member groups. Additionally, PCA coordinates with health plans on behalf of providers to obtain rosters, patient attribution information and updates.

Evidence-Based Committee Facilitation: PCA committees facilitate the use of evidence-based guidelines to incorporate the standard of care and best practices for clinical quality, utilization, population health, care coordination and practice transformation.