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February 14, 2014 

The Patient-Centered Medical Home at Jacobi Medical Center has met the criteria for the highest level recertification

All Facilities Achieve High Standards of Care

Bronx, NY ― Continuing the New York City Health and Hospitals Corporation’s commitment to provide the highest level of primary care at all its locations, William P. Walsh, Senior Vice President of Jacobi Medical Center (Jacobi), North Central Bronx Hospital (NCBH) and their two health centers, announced today that all four facilities have achieved top-level recertification from the National Committee for Quality Assurance (NCQA) as “Level 3” Patient-Centered Medical Homes, the highest accreditation possible. The NCQA is a private non-profit organization that accredits and certifies a wide range of healthcare organizations in their effort to become a certified Patient-Centered Medical Home (PCMH).

Patient-Centered Medical Homes are not a place but instead are a partnership that allows the patient and his or her doctor and care team to get to know each other and work together to improve the patient’s health. A personalized care plan is developed, and the patient’s care team will review the plan regularly to ensure that it is working to keep the patient healthy. The team keeps up with the patient’s health progress, tracks test results and health screenings, and makes sure the patient receives the right care at the right time.

PCMHs are particularly effective at promoting routine and preventive primary care, and have been found to reduce emergency room visits among their patients. All of HHC’s 11 hospitals plus its six large community health centers have qualified as PCMHs at Level 3, making them eligible for the highest level of Medicaid reimbursement.

Read more about Patient-Centered Medical Homes on the website of the New York City Health and Hospitals Corporation here.

Among the facilities reviewed by the NCQA, North Central Bronx Hospital and the Health Center at Tremont received overall scores of 97.25 out of 100, while Jacobi and the Health Center at Gun Hill scored 96.25. The facilities first achieved Patient-Centered Medical Home certification in 2010, and have since been working to strengthen coordination of patient care in order to achieve even better outcomes.

The NCQA found that all four facilities have also integrated the best elements of private practice in coordinating care and making care accessible including: implementing an on-call system where patients reach their doctor if situations arise that could affect their care; new care-management procedures to identify high-risk patients; referral tracking and follow-up; and supporting safe-care, and the ability to document and measure performance in meeting these goals. Other significant Patient-Centered Medical Home benchmarks to achieve the highest level of certification include:

  • Extended hours of operation beyond a 9-to-5 schedule, so patients can juggle appointments along with their real-life obligations. Jacobi and NCBH are also experimenting with early-morning access so patients can see a provider before their workday. Providing expanded hours around patients’ schedules is enabling Jacobi and NCBH to keep unscheduled visits to the Emergency Room to a minimum.
  • Greater availability for outpatient appointments, including same day appointments, so that if a patient has an urgent condition he or she can be seen promptly. This produces better service for patients as it is more likely they will receive treatment by a provider they know, and who is familiar with the details of their medical condition. Rapid access also reduces the need for emergency room visits.
  • Developing a care team for each patient, which offers patients the reassuring experience of interacting with the same doctor or nurse at each appointment. This continuity of care enables patients to develop a relationship with providers who know their situation firsthand.
  • Tracking of patients during each step of their care by a team of care managers who provide proactive intervention, not merely reactive treatment. If a patient is in need of a refill of their prescription, that can be handled through direct communication to their pharmacy, without an appointment, making it far easier and more convenient for the patient to adhere to their medication plan. Care managers also make pre-visit calls to ensure that a patient’s test or screening results have been received so the patient and their care providers can take action immediately on any medical issues, rather than wait until an office visit. By keeping track of patients who suffer from chronic conditions, managers are able to identify triggers and catch ailments before they spiral out of control.
  • Collaborating with patients on their self-management plans ensures that a personal connection is made between providers and their patients, so that care providers become familiar not only with a patients’ ailments, but with any barriers that may exist to successful healthcare outcomes. From medication reconciliation to education and guidance to nutritional counseling, a patient’s care team becomes the first line of defense for any condition.

“As a Patient-Centered Medical Home, we are providing meaningful health care that revolves around the patient,” said Mr. Walsh. “This model of care lets a patient be seen by the right doctor at the right time, while also allowing us to keep our emergency room clear for those who need it.”

“The Patient-Centered Medical Home model is more satisfying for patients and more satisfying for those providing care,” said Dr. Lisa Rucker, M.D., Co-Director of Ambulatory Medical Practices at Jacobi Medical Center.


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