A goal of the Affordable Care Act (ACA) is to support innovation in health care delivery and payment. The Center for Medicare & Medicaid Innovation (CMMI), established by the ACA, awarded the State of Connecticut a SIM grant in support of this goal and to develop multi-payer health care payment and service delivery models to improve health system performance, increase quality of care, and decrease costs. Through the support from CT SIM Program Management Office, the AMH program seeks to improve the quality of primary care services provided by physician practices in CT.
Qualidigm leverages practice transformation interventions to assist practices in achieving the National Committee for Quality Assurance (NCQA) PCMH 2014 and 2017 recognition and meeting AMH Must Pass requirements. Qualidigm provides hands-on support to guide participating practices through customized approaches to enhance workflows, policies and procedures, and reporting capabilities. Practices are encouraged to align PCMH activities with their current performance and quality improvement efforts. Qualidigm convenes an interactive learning collaborative with in-office technical assistance, virtual group webinars, individualized hands-on support, and documentation review. The goal of the AMH program is for all participating practices to successfully implement NCQA PCMH recognition that advances clinical efficiencies and promotes sustainability.
In the PCMH model, a primary care clinician or care team serves as the hub of patient care, coordinating the comprehensive needs of its patients. Studies have shown that PCMHs improve quality, patient experience, and health outcomes, while reducing costs.1 Becoming a PCMH promotes a supportive team-based culture for patients and staff and better positions practices for quality-based incentive programs and payment models. The SIM AMH Program supports the transformation of primary care practices throughout CT to the PCMH model.