IBM > Case Studies > The Patient-Centered Medical Home

The Patient-Centered Medical Home

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Customer Company Size
Large Corporate
Region
  • America
Country
  • United States
Product
  • IBM® Phytel Outreach
  • IBM® Phytel Insight
  • IBM® Phytel Coordinate
Tech Stack
  • Watson Health Cloud platform
Implementation Scale
  • Enterprise-wide Deployment
Impact Metrics
  • Cost Savings
  • Customer Satisfaction
  • Productivity Improvements
Technology Category
  • Platform as a Service (PaaS) - Data Management Platforms
Applicable Industries
  • Healthcare & Hospitals
Applicable Functions
  • Quality Assurance
Use Cases
  • Remote Patient Monitoring
  • Predictive Quality Analytics
Services
  • Data Science Services
  • System Integration
About The Customer
The five healthcare facilities include Huntsville Hospital, Orlando Health, Bon Secours Virginia Medical Group (BSVMG), Northeast Georgia Physicians Group (NGPG), and Prevea Health. Huntsville Hospital, located in Huntsville, Alabama, is the third-largest publicly owned hospital system in the nation with more than 1,800 beds and 12,000 employees. Orlando Health, based in Orlando, Florida, is one of the state’s most comprehensive private, not-for-profit healthcare networks. BSVMG is a hospital-owned multi-specialty group practice with more than 100 locations in metropolitan Richmond, Virginia. NGPG is the largest multispecialty practice in its region. Prevea Health’s 180 physicians deliver primary care and specialty care in more than 50 specialties at 20 health centers throughout Green Bay and northeast Wisconsin.
The Challenge
Five healthcare facilities were all looking to establish themselves as fully functioning Patient-Centered Medical Homes (PCMH). The National Committee for Quality Assurance (NCQA) PCMH recognition program is the most widely adopted model for transforming primary care practices in ways that mutually benefit patients and providers while improving outcomes. Organizations that achieve PCMH recognition establish the foundation to succeed as accountable care organizations and clinically integrated networks, earn reimbursements such as Medicare’s new Chronic Care Management (CCM) fee, and qualify for financial incentives from commercial and government payers. Increasingly, clients of Watson Health™ are large healthcare systems or provider organizations that have entered value-based contracts with payers and employers to deliver on explicit Triple Aim metrics. The principles, competencies, and activities of the PCMH model are widely accepted as the bedrock of provider-driven population health management, and essential for practice transformation and sustained performance.
The Solution
These five clients utilized Watson Health’s population health management solutions to integrate the key functions and attributions required to achieve PCMH recognition. The solutions include IBM® Phytel Outreach, IBM® Phytel Insight, and IBM® Phytel Coordinate. These solutions are pre-validated by NCQA to receive significant auto-credit points for specific NCQA PCMH 2014 factors when an organization activates the required Phytel Outreach protocols, Phytel Insight measures, and Phytel Coordinate workflows. The Watson Health Cloud platform was also used, which allows for information to be shared and combined with a dynamic and constantly growing aggregated view of clinical, research, and social health data.
Operational Impact
  • Improved and standardized documentation into the EMR
  • Accelerated patient compliance
  • Improved quality scores
  • Enabled healthcare staff to have more time to address their more complex patients
  • Reduced waste, improved effectiveness and proactive initiatives to increase patient compliance with care plans
Quantitative Benefit
  • All but two practices of Orlando Health have met Level 3 criteria, which is the highest recognition NCQA provides
  • BSVMG was selected as an early participant in the Medicare Shared Savings Program
  • Cigna and Anthem have offered BSVMG value-based contracts and agreed to pay BSVMG a per-member per-month adjustment for care coordination

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