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Paul D. Spiro, M.D.
David E. DiPietro, M.D.
Louis C Marino, M.D.
Tina H. Degnan, M.D.
Louis C. Cimorelli, D.O.
Michelle Horn, D.O.
Angad K. Khalsa, PA-C
Colleen C. MacClay, PA-C
Scott Griffith, PA-C
Jennifer C. Steele, CRNP
BUCKINGHAM FAMILY MEDICINE is active in Quality Improvement
Over the past 10 years, Buckingham Family Medicine has been participating in several organized efforts to improve the quality of care in America. These have been the collaborative efforts of physicians and health insurers, along with state and federal government, and have enabled us to transform our practice and become recognized by the NCQA as a Patient Centered Medical Home. This has allowed us to change the way we organize our practice; interface with patients and colleagues; monitor and track chronic diseases; and reach out to patients after hospital or emergency care. Much of this is enabled by the use of an Electronic Medical Record, which is used to record clinical data and communicate with hospitals, consultants, pharmacies, labs, and patients. The computerized records also allow us to measure quality metrics which are used for quality improvement. See below for some of the initiatives are practice has participated with:
- National Committee on Quality Assurance (NCQA): In 2008, Buckingham Family Medicine became one of the first practices in the country to be recognized by the National Committee on Quality Assurance as a Patient-Centered Medical Home. This new way of structuring primary care medical practice to best meet the needs of patients and families includes the following principles:
- A long term relationship between the patient and their individual primary care provider in conjunction with a team of professionals that provide continuous and comprehensive care.
- A whole person orientation taking responsibility for providing or arranging care for all stages of life: acute care, chronic care, preventive services, and end of life care.
- Coordination of care across the complex health care system including subspecialists, hospitals, home health agencies, and community resources. Information technology is used to track patients to help them get the indicated care when and where they want and need it.
- Enhanced access to care is promoted through open scheduling facilitated by triage nurses for acute visits, and extended hours including evenings and Saturdays.
- Continuous quality improvement using data generated from many aspects of our practice including chronic disease registries, reports from our electronic health record, and feedback from patients and their families.
- Renaissance Health Network is a physician directed organization that has helped our practice get started with population monitoring of our chronically ill patients, in addition to providing telephonic nursing support to our seriously ill patients under contract with Independence Blue Cross. The network has over 200 physicians and is now in contract with Medicare as a Pioneer ACO (see below).
- The Chronic Care Initiative was started by the Pennsylvania Department of Health Care Reform in 2008, as a consortium of health plans, including Independence Blue Cross, Aetna, Cigna and Keystone Mercy. Buckingham Family Medicine was one of 32 practices enrolled in the analytic and educational program run by a faculty of national experts. We have been able to improve critical health metrics such as Blood Pressure, Cholesterol, and Glucose control to be among the best in the nation. In 2012 we were selected to enter the second phase of the initiative now part of a federal program, referred to as the Multi-payer Demonstration Project. We are now focusing on providing telephonic care management nursing for our most seriously ill patients in addition to improving the rate of cancer screening in our practice.
- The Accountable Care Organization was formed in 2010, as thirty groups were selected by the federal government to contract with Medicare as a Pioneer Accountable Care Organization (ACO.). The ACO is an alliance for healthcare providers who work together to provide superior, coordinated care in an effort to reduce illness and stem the rise in healthcare expenditures. Renaissance Health Network was selected due to a proven track record of helping improve health outcomes by assisting in health and prevention programs and by caring for those with chronic illness. Most of our Medicare patients have been assigned to the ACO which provides our practice with additional resources to help care for our patients. This program imposes no restraint on our patients who may continue to use any Medicare participating physicians or facilities. It will be invisible to patients, unless a condition requires extra attention, such as care coordination, which will be offered without additional expense. Patients in the ACO have received notification and may opt out of the information sharing which would be used to coordinate care.
- Health Quality Partners is part of an ongoing Medicare Demonstration project which we have participated for over 10 years. A study published in 2009 (JAMA. 2009;301 (6);603-618), has shown that additional nursing care to assist our chronically ill Medicare patients who volunteered for this program achieved improved health outcomes with reduced need for hospital care.