Learn how a healthy heart message was delivered to the Choctaw Nation through a local cooking show. From the CDC, published in March of 2013.
Hear how a community diabetes education class in South Carolina is changing lives and perceptions about diabetes. From the CDC, published in March of 2013.
Hear how community partnerships help the West Indian population of Schenectady County prevent and control type 2 diabetes. From the CDC, published in March of 2013.
The National Committee for Quality Assurance (NCQA) is launching the newest iteration of their Patient Centered Medical Home (PCMH) recognition program March 31, 2017. This program differs significantly in concept and in process to the 2008, 2011, and 2014 PCMH standards previously released by NCQA.
Practices currently recognized under NCQA PCMH 2014 Standards have a few options for maintaining their recognition. Use the infographic below to inform the path your practice will choose regarding PCMH recognition. Click here for more information on the NCQA website.
Hear how local communities take action to improve the health of their residents and reduce racial and ethnic health disparities. Addressing several chronic health conditions including diabetes, cardiovascular health, asthma, cancer, and obesity, innovative programs meet local health needs and demonstrate positive impact. From the CDC, published in January of 2013.
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Population health management can be defined as the daily practice of improving health and health care for defined populations. Population health management requires new capabilities for organizations across the spectrum of clinical care. Organizations that continually improve these capabilities will be positioned to engage in new models of health care delivery and financing that reward accountability for population health. As outlined below, Community Health Solutions has identified seven core capabilities that are essential for population health management. Much of our work is focused on helping organizations strengthen these capabilities.
The 2011 Institute of Medicine (IOM) reports, Advancing Oral Health in America and Improving
Access for Oral Health for the Vulnerable and Underserved, highlighted the importance of viewing oral health as inseparable from total health. The IOM and other leading health organizations have also called for the integration of oral health and primary care to enhance access, quality, and outcomes for individuals and populations. The resources below provide ideas, insights, and promising practices for integrating oral health and primary care practice. The resources can be adapted to support improvements in community care models.
Care transitions occur when a patient moves from one health care provider or setting to another, or from a health care provider to home. Effective care transitions are important for optimizing patient health and for avoiding unnecessary utilization of hospital services and related services. As CMS has noted:
Nearly one in five Medicare patients discharged from a hospital—approximately 2.6 million seniors—is readmitted within 30 days, at a cost of over $26 billion every year. Hospitals have traditionally served as the focal point of efforts to reduce readmissions by focusing on those components that they are directly responsible for, including the quality of care during the hospitalization and […]
Chronic care models are designed to optimize the care of patients who have or are at significant risk for chronic conditions. The prevalence of chronic conditions has been increasing due to the aging of the population and rising levels of lifestyle-related risk factors. Projecting these trends forward, the growing burden of disease and costs could be crippling. Consequently, chronic care improvement is a high priority for population health management. The resources below provide ideas, insights, and promising practices for improving chronic care. These resources can be used to support collaborative learning and improvement in community models of care.
The following resources include research, tools, and insights for PCMH development.