District of Columbia

Due to its location, primary care practices in the District of Columbia are significantly impacted by medical home programs in neighboring states and federal programs (VA, Military, OPM, etc.). The DC Primary Care Association (DCPCA) is helping federally qualified health centers (FQHC's) in DC move to a PCMH model of care. The DCPCA Quality and Improvement and Operations Program utilizes models from HRSA-BPHC’s Health Disparities Collaboratives and the National Committee for Quality Assurance (NCQA) including the Planned Care and Improvement Models, to guide training and support activities. The Planned Care Model is a population-based model incorporating evidence-based medicine to develop and sustain system changes, while the Improvement Model is a quality methodology for small-scale, rapid-cycle improvements. Through the strategic integration of these models, DCPCA’s Quality Improvement (QI) team is able to support a variety of initiatives focused on issues of high volume, high risk and/or problem-prone areas for the District’s FQHCs and Community Health Centers.

Additionally, DCPCA helps member health centers leverage health information technology to improve the delivery of primary care by following the patient-centered medical home (PCMH) principles and guidelines, which aim to increase quality, improve health outcomes, and manage costs. The principles of PCMH call for a team approach to primary care and aim for systems change through the coordinated implementation of both the Care and Improvement Models for quality methodology. 

Currently there are no formal medical home programs in the DC Medicaid program, although they have been awarded a CMS health homes planning grant.

CHIPRA: 
No
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
No
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
No
Private Payer Program: 
Yes
State Facts: 
Population:
650,700
Uninsured Population:
8%
Total Medicaid Spending FY 2012: 
$2.1 Billion 
Overweight/Obese Adults:
51.9%
Poor Mental Health among Adults: 
38.3%
2014 Medicaid Expansion: 
Yes 

Doctors are a naturally competitive bunch. CareFirst has tapped into that to tackle health costs.

on Tue, 2016-05-17 00:00   amanda

What's one of the most effective ways to get doctors to change their referral and drug-prescribing habits, two of best-known drivers of health care costs? Tap into their competitive sides.

That's what CareFirst BlueCross BlueShield CEO Chet Burrell told attendees at the recent Health Datapalooza conference in D.C. as he discussed how data has become a secret weapon for the Owings Mills-based insurer, the region's largest.

Story Date: 
May 17, 2016
Source Link: 
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Mary's Center - Georgia Ave

Practice Type: 
FQHC
Multispecialty practice
Not-for-profit practice
Practice Setting: 
Urban
Practice Address: 
3912 Georgia Ave, NW
Washington, DC 20011

Executive Member Annual Meeting & Luncheon

2015-11-11 08:00 to 12:30

The PCPCC Executive Member Meeting provides an opportunity to engage with health care leaders from across the country who are working to develop innovative strategies and partnerships to transform how we are delivering primary care services in partnerships with patients and families. During this meeting, we hope to engage our members in a meaningful dialogue with representatives from federal agencies on how to strengthen programs supporting primary care and identify possible solutions to ongoing challenges to patient and clinician engagement in new models of care.

Register Here
Announcement Type: 
PCPCC

CMS State Innovation Model (SIM) Design Award - DC

The District of Columbia will engage a diverse group of stakeholders, including public and commercial payers, providers and consumers, to develop a State Health Care Innovation Plan. The overall goal of the Plan will be to bolster primary health care and to better coordinate the care of the District’s most vulnerable residents. States receiving Model Design awards under the State Innovation Models initiative will have twelve months to submit their State Health Care Innovation Plans to CMS.

Small practices key to CareFirst's medical home success

on Fri, 2014-07-11 14:46   staci

By combining forces, solo and small-group medical practices helped generate $237 million in savings over three years in CareFirst's Patient-Centered Medical Home Program, the insurer revealed Thursday.

Story Date: 
July 11, 2014
News Author: 
Andis Robeznieks
Source Link: 
Read More

New form of U.S. healthcare saves money, improves quality, one insurer finds

on Thu, 2014-07-10 00:00   staci

In one of the largest tests of a novel way to deliver and pay for healthcare, insurer CareFirst BlueCross BlueShield announced on Thursday that 1.1 million people receiving care through its "patient-centered medical homes" last year were hospitalized less often and stayed for fewer days compared to patients in traditional fee-for-service care.

Story Date: 
July 10, 2014
News Author: 
Sharon Begley
Source Link: 
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Will Health Reform Bring New Role, Respect To Primary Care Physicians?

on Thu, 2014-07-10 00:00   lisabeth

A few years ago it struck the D.C. region’s biggest medical insurer that the doctors who saw its members most often and knew them best got the smallest piece of the healthcare dollar. CareFirst BlueCross BlueShield spent billions on hospital procedures, drugs and specialty physicians to treat sick patients. Only one dollar in 20 went to the family-care doctors and other primary caregivers trained to keep people healthy.

The company’s move to shift that balance tells a lesser-known story of the Affordable Care Act and efforts to change the health system.

Story Date: 
July 10, 2014
News Author: 
Jay Hancock
Source Link: 
Read More

CareFirst Patient-Centered Medical Home - DC

CareFirst’s PCMH program is designed to provide primary care providers with a more complete view of their patients' needs and of the services they receive from other providers so that they can better manage their individual risks, keep them in better health and produce better outcomes. The program requires greater provider-patient engagement and it meaningfully compensates providers for that engagement.

2014 PCPCC Annual Fall Conference

2014-11-12 08:00 to 2014-11-14 12:00

Join us for the PCPCC 2014 Annual Fall Conference on Wednesday, November 12 – Friday, November 14, 2014 at the Grand Hyatt in Washington, DC. Our theme this year Patient-Centered Primary Care: At the Heart of Value and Quality offers the opportunity for you and your colleagues to participate in dozens of panel discussions and workshops that will focus on the critical role of patient-centered primary care in achieving health care delivery system reform. 

Register Here
Announcement Type: 
PCPCC

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