AHRQ Posts a Tool Kit for Yesterday's Care Advances

The Disease Management Care Blog found this on-line AHRQ "Tool Kit" that provides a detailed tailored step-by-step guide for primary care practices' switch to a 'Chronic Care Model.' The roadmap has decision points that account for prevalent payment streams (fee for service versus capitation) and the ability to bill for ancillary services. It focuses on how to create your leadership team, establish data streams, set performance targets, engineer the necessary measurement infrastructure, redesign the practice with clinical teams, understand which patients 'belong' to the practice and address the patients' needs with care plans, self management support and continuous improvement. It provides links to multiple other sites with additional information.

While the AHRQ deserves credit for working with the MacColl Insitutute to put this resource out there, it doesn't provide the details necessary to successful switch to a Patient Centered Medical Home (PCMH) or to what Medicare will use in its upcoming Medical Home Demo. Coming out with a similar document that supports either would be a timely public service.

Don't hold your breath.

Given the government's hidebound speed in getting these kinds of things done, the DMCB predicts that by the time THAT happens, NCQA PCC-PCMH Ver 2.0 will be long established or - more likely - the CCM and/or PCMH will be supplanted by even newer versions of care that combine disease management, consumerism, health information technology and new reimbursement models. At least it hopes so.