As many of you that were able to attend our first Health 3.0 Networking event observed, we had a very diverse group of health care providers that function in multiple health care roles at our event. We had pharmacists, physicians, surgeons, educators, periodontists, optometrists, heart specialists, and more. We had CFOs, CEOs, COOs, Practice Managers, directors, providers, and health care consumers. The list goes on.
Yet even with this diverse group of attendees, every discussion I encountered shared one common unifying question…How do I fit into PCMH?
And, of course, the short answer to that question was, and still is…”We are still all trying to figure it out.”
And, as part of the process, we can start by thinking of it this way…We’re trying to piece back together a puzzle that should have never become as disassembled and disconnected as it has over the past several years. After all, the puzzle shares the same unifying glue –patient health – at the very center. So, how can we effectively throw a piece here or toss a piece there (or forget where we placed a piece) and expect to reassemble it on command?
It’s tough. But just like any master puzzle assembler (is there such a word?) would tell you, you have visualize the finished piece, the end result, before you can start taking the most efficient steps toward assembly. You have to know where the blues go and the reds belong in order to find the corner pieces and build the framework.
So, how do we get the big picture and snap the pieces back into place? First we have to agree to what the finished piece is. Is it *health* as an outcome that we want to achieve? Is it accreditation so we can (hopefully) improve our margins?
Maybe we start re-connecting on various levels…We connect by re-organizing around patients at our respective organizations or the organizations we support. We then communicate what we’re doing, what we need, what we’ve learned and start learning about other organizations outside our own. And, even if we haven’t started re-organizing internally, we utilize networking to reach beyond who we currently know – not unlike the goal of the Health 3.0 Event – to create living, breathing learning organizations greater than ourselves.
With this process in mind, an incredible health care provider that I have been fortunate enough to find through networking (@DocForeman), has shared a proposed rule for Medicare programs that speaks directly to behavioral health’s role in PCMH and the importance, nay requirement, of an interdisciplinary approach.
Even for those of you that weren’t able to attend our Health 3.0 event, I can share that the PCMH model is rapidly gaining momentum in our health care industry. The pieces are coming together. And, like any change, the question is do you want to be part of creating the puzzle? Or forgoing your choice and merely receiving your assigned piece once the framework has been built?
Medicare Program; Conditions of Participation (CoPs) for Community Mental Health Centers
This proposed rule would establish, for the first time, conditions of participation (CoPs) that community mental health centers (CMHCs) would have to meet in order to participate in the Medicare program. These proposed CoPs would focus on the care provided to the client, establish requirements for staff and provider operations, and encourage clients to participate in their care plan and treatment. The new CoPs would enable CMS to survey CMHCs for compliance with health and safety requirements.
In proposed § 485.916(a), “Standard: Delivery of services,” we are proposing that the CMHC designate a physician-led interdisciplinary team for each client, which would include either a psychiatric registered nurse, clinical psychologist, or clinical social worker, who would be a coordinator responsible, with the client, for directing, coordinating and managing the care and services provided to the client. The team would be composed of individuals who would work together to meet the physical, medical, psychosocial, emotional, and therapeutic needs of CMHC clients.
The interdisciplinary team would include, but would not be limited to the following:
- A doctor of medicine, osteopathy or psychiatry.
- A psychiatric registered nurse.
- A clinical social worker.
- A clinical psychologist.
- An occupational therapist.
- Other licensed mental health professionals, as necessary.