Primary care clinics apply for accreditation or recognition and are required to demonstrate that they meet performance standards set by the accreditation or recognition body. Accreditation and recognition typically involve definitions of required services and performance metrics to demonstrate the primary care site actually provides the defined services with acceptable quality.
As a behavioral health provider, you will contribute to accreditation and recognition by developing, delivering and evaluating integrated behavioral healthcare interventions that contribute to meeting performance targets. What kind of targets? Look at the CMS Quality Metrics and the HEDIS 2016 Measures in the links below. How is the Patient Centered Medical Home (a key new model of how to organize and deliver primary care) defined? See the NCQA PCMH definitions, the AHRQ PCMH definitions, the Joint Commission definition (see the PowerPoint slides in the section “Previous Teleconferences” “Slides for March 8th Teleconference”). You will notice that many of these organizations share common definitions.
Describe your evaluation of the CMS Quality Metrics and/or the HEDIS measures. Are they relevant to primary care? Are they comprehensive? How are the CMS and HEDIS measures similar? How are they different?
Provide a critical review of one set of metrics. Are the measures meaningful? Are there areas that you think are important for quality in primary care that are missing? Is behavioral health well-represented? If not, what do you think should be added?
Describe what you notice in terms of areas of overlap between the PCMH definitions for recognition and the performance measures as well as any unique features for each measurement set.
What has been your experience working with national PCMH recognition or accreditation quality measures? If you are currently working in a healthcare setting what national quality measures are used? Have you had experience working on projects to measure quality? If you are not currently working in a healthcare setting, describe your experience in the past with national accreditation quality measures.