Our Services


Patient Centered Solutions

Our team of consultants are focused not just on helping clients achieve NCQA Patient Centered Medical Home (PCMH) and Patient Centered Specialty Practice (PCSP) recognition, we also deliver solutions to help you meet patient education needs, help you reach pay-for-performance targets, and improve the patient experience at your practice.

We work with each client individually to determine where your practice stands today. We’ll identify the work to be done to help you meet your goals, put a project plan in place, keep you on track, and get you to the finish line. Single site or multiple sites, primary care or multi-specialty, we help you to navigate the process from application through submission.


Patient Centered Medical Home Assist (PCMH)

Patient Centered Medical Home Assist (PCMH)

Understanding and navigating the process to achieve recognition as a Patient Centered Medical Home (PCMH) can be complex, requiring changes in staff roles, and healthcare policies and procedures.  Quality First Healthcare Consulting will work collaboratively as a member of your project team to help you achieve Patient Centered Medical Home (PCMH) recognition from the National Committee for Quality Assurance (NCQA). We provide:

  • On-site and/or web-based staff training and technical assistance in interpretation of the NCQA Patient Centered Medical Home (PCMH) Standards.
  • Completion of a gap analysis to identify areas of deficiency in meeting NCQA Patient Centered Medical Home (PCMH) elements and factors.
  • Development of a customized project plan to achieve Patient Centered Medical Home (PCMH) recognition.
  • Project management oversight through regular communication and project facilitation.
  • Assistance with redesign of staffing models to maximize clinical and non-clinical resources to support Patient Centered Medical Home (PCMH) transformation.
  • Document preparation readiness for NCQA's survey tool upload from the NCQA Patient Centered Medical Home (PCMH) surveyor perspective.
  • Mock review prior to survey submission.
  • Support for random audit response requests.

PCMH Assist Delivers Patient Centered Medical Home Solutions:

  • Enhanced Systems Performance
  • Improved Patient Outcomes
  • Efficient Care Coordination
  • Achievement of NCQA Patient Centered Medical Home (PCMH) Recognition.


Effective Patient Centered Leadership Characteristics

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Patient Centered Specialty Practice Assist

PCSPAssist

Understanding the changes in provider reimbursement methods to value-based designs with incentives offered for Patient Centered Specialty Practice (PCSP) recognitions we offer the perfect solution to transforming into a patient centered specialty practice.  We focus with you to create workflow processes that successfully coordinate care with primary-care colleagues and other specialty providers, and meets established targets for timely access to care and continuous quality improvement.

We provide:

  • On-site and/or web-based staff training and technical assistance in interpretation of the NCQA Patient Centered Specialty Practice (PCSP) Standards.
  • Assistance in coordinating Patient Centered Specialty Practice (PCSP) quality improvement standards to MACRA (MIPS/APM)
  • Completion of a gap analysis to identify areas of deficiency in meeting NCQA Patient Centered Specialty Practice (PCSP) elements and factors.
  • Development of a customized project plan to achieve Patient Centered Specialty Practice (PCSP) recognition.
  • Project management oversight through regular communication and project facilitation.
  • Assistance with redesign of staffing models to maximize clinical and non-clinical resources to support Patient Centered Specialty Practice (PCSP) transformation.
  • Document preparation readiness for NCQA's survey tool upload from the NCQA Patient Centered Specialty Practice (PCSP) reviewer perspective.
  • Mock review prior to survey submission.
  •  Support for random audit response requests.

PCSP Assist Delivers Patient Centered Specialty Practice (PCSP) Solutions:

  • Enhanced Systems Performance
  • Improved Patient Outcomes
  • Efficient Care Coordination and Transitions between settings
  • Achievement of NCQA Patient Centered Specialty Practice (PCSP) Recognition

 
Population Health Management

Care Spectrum Plus™Care Spectrum Plus™ is a build-and-run, evidence-based population health management model — scalable, replicable, and relevant to all populations and payers.

Care Spectrum Plus™ is agile by design

Build your population health management program components using our tested design as the foundation. Tools are intuitive and support end users of different skill sets andbackgrounds.

Care Spectrum Plus™

Run! Get up and running quickly using our prototype workflows forms, and process & outcome measurements that are sharable with design tools that facilitate collaboration.

Adapt quickly to effectively manage the needs of different populations, payers, providers, and other collaborators. Design components are service oriented, adaptable, scalable, and easily replicated.

Care Spectrum Plus™ offers:

  • Population health management program solutions
  • Policies and procedures
  • Staffing models, including behavioral health integration
  • Program descriptions, work plans, and evaluations
  • Business Planning
  • Marketing strategies
  • Collaborative clinically integrated network development
  • Staff recruitment
  • Job descriptions
  • On-site staff training
  • IT Software solution advisory support
  • Value-based contract reviews
  • Performance measure and outcome analysis
  • ROI strategies
  • Clinical oversight

Program Components Include:

  • Case Finding
  • Health Impact Assessment and Risk Segmentation
  • Population Engagement
  • Health Promotion and Early Detection
  • Care Coordination and Service Navigation
  • Chronic Condition Management
  • Complex Case Management Care Transitions
  • Health Information Technology Leverage
  • Performance Measurement & Continuous Quality Improvement


Population Health Management Program Policy & Procedure Table of Contents

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Population Health Management Training Description & Outline

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Quality & Risk Assist (Community Health Center Focused)

Quality & Risk Assist (Community Health Center Focused)QFHC's Quality and Risk Assistance program, called Q&R Assist, delivers a unique combination of expert management solutions specifically designed to address needs of community health centers.  Q&R Assist focuses on sustainable solutions that enhance organizational performance, assures compliance to PHS 330 grantee program requirements, promotes continuous quality improvement, and supports clinical risk prevention. Quality and Risk management solutions include:

  • Health Care Plan management and reporting
  • Maximizing efficiencies (making your systems work for you)
  • Patient-centered medical home development
  • Policy and procedure development and management
  • Provider Credentialing and Privileging management
  • QA/QI Plan oversight and/or management
  • Data analytics and statistical testing
  • Data processing services
  • Clinical Risk Management oversight

 
Health Care System Redesign

QFHC is redesigning health care communities through transformation of health care delivery into patient-centered and value-driven integrated systems of care.  QFHC focuses on eight key transformation principles throughout the health care system redesign process:

  1. Organizational culture and leadership
  2. Service delivery capacity and organizational cooperation across the care continuum
  3. Physician integration
  4. Patient-focused philosophies
  5. Geographic coverage of network
  6. Standardized care delivery
  7. Performance management
  8. Information systems


Financial and Medical/Clinical Operations Management

Efficient, natural workflow is essential to cost-effective operations.  QFHC has the ability to effectively assess and redesign core operational processes to meet your business requirements and maintain compliance with regulatory and/or accrediting standards:

  • Work Flow Analysis (From "As is" to "To be").
  • Change management facilitation.
  • Policies and procedures, program descriptions, work plans, outcomes/ROI measurement design.
  • Systems software conceptual design to effectively and efficiently manage new business requirements.
  • Operational testing of reorganized processes to prevent inefficient manual processes from becoming inefficient automated ones.


Performance Management

QFHC addresses the challenge of today's health care with its model of performance management. Performance management is the art of formulating key organization goals, developing the strategies and methods to be used, refining goals into specific measurable objectives, managing those objectives, measuring the results achieved, and modifying strategies and methods based upon the outcomes realized.

QFHC's customized programs help your organization improve services, optimize outcomes and make the most efficient use of your resources while complying with state, federal, and accreditation standards.  Performance management services provided include:

  • Identifying "critical elements" that act as base standards required to ensure all consumers receive quality care and service.
  • Facilitating a team-planning meeting to establish outcome-based performance measurements.
  • Developing processes to monitor the effectiveness of current procedures.
  • Designing customized outcome measurement projects and corresponding tools for collection and management of data.

Providing technical assistance to facilitate integration of performance management techniques into operations.

 
Quality Management

QFHC has extensive knowledge and experience in the continuous quality improvement (CQI) process. We are experts in crafting Performance and Quality Management programs that are systematic, goal-driven, relevant, meaningful, evidence-based, multi-purpose, resource efficient and highly effective.  Quality management services provided include:

  • Development/assessment of committee structures for oversight of quality of care and services.
  • Facilitation of organizational integration of quality improvement through internal coordination and communication processes.
  • Development/assessment of an organization's quality improvement monitoring system.
  • Providing of technical assistance in generating quality management reports for committee and governing board presentations

 
Care Management Program Development

We understand the challenges in implementing a care management program.  From cost to implementation to return on investment, we work with organizations to develop care management business models.  Building on our successes and lessons learned we use our experience and knowledge to significantly reduce the amount of time it takes, and risk involved, when transforming care management concepts into sustainable effective population management models of care.

 
Accreditation Management

(NCQA, Joint Commission, URAC, AAAHC)
QFHC assesses the organizations accreditation readiness using a strengths-based approach.  A baseline analysis is developed for review by the organization's management team and through this collaborative process an accreditation project plan is generated. Accreditation management services include:

  • Strengths-based survey readiness assessment and planning
  • Project plan development and implementation
  • Project management—accreditation preparation
  • Development of policies and procedures
  • Review/design of clinical and service quality improvement activities
  • Coordination and management of day-to-day project plan activities
  • Survey presentation preparation/supporting documentation
  • Post accreditation management of compliance with standards

 
New Program and Product Development

QFHC's experience in the development of startup programs and products significantly reduces the amount of time it takes and risk involved in moving a concept into reality.  Program development services provided include:

  • Developing policies and procedures.
  • Designing program models.
  • Developing program descriptions, work plans, and evaluations.
  • Developing and complete a business plan.
  • Developing marketing strategies.
  • Writing job descriptions.
  • Conducting on-site staff training.

 
Process & Operations Workflow Analysis

Efficient, natural workflow is essential to cost-effective operations while maintaining quality care and services. QFHC helps organizations reorganize around core processes.  Work-flow studies are conducted through interviews, document review, and observation to identify opportunities for improvement.  A gap analysis is developed and reviewed with the organization's management team, then in collaboration with management and staff, new processes are developed.  Operational testing is completed around reorganized processes to prevent inefficient manual processes from becoming inefficient automated ones.

 
Regulatory Compliance

QFHC uses the expertise of a licensed health care risk manager to assist in the assessment of an organization's compliance with state and federal regulations.  Regulatory compliance services provided include:

  • Conducting comprehensive assessment of the organization's policies and procedures to applicable state and federal regulations.
  • Assisting in survey/review preparation.
  • Providing technical assistance in the development and monitoring of improvement activities associated with corrective action plans imposed by state and federal agencies.
  • Preparing case summaries for state/federal consumer complaint hearings/reviews.