AFMC’s Practice Transformation team has been making significant strides in transforming patient care, particularly through initiatives focused on preventive screenings and effective healthcare navigation. Rhelinda McFadden and Stacey George, manager and supervisor of the Practice Transformation department at AFMC, have seen its positive impact on health outcomes within our state.
IN THIS BLOG:
1. What is the main focus of AFMC's Practice Transformation team?
The Practice Transformation team primarily focuses on enhancing patient care through initiatives aimed at increasing preventive screenings and improving healthcare navigation, particularly in partnership with programs like the Arkansas Department of Health Division of Medical Services (DMS) Patient-Centered Medical Home (PCMH) program.
2. What notable improvements have been made in breast cancer screening rates?
After facing a significant decrease in their screening rates, the quality team led by Connie Ash improved their breast cancer screening rate among Medicaid patients from 10% to 50% by the end of the 2023 performance period, achieving a further increase to 53% as of August 29, 2024.
3. How does the Partnerships in Colorectal Cancer Screening for Arkansas (PiCS-AR) program contribute to preventive screenings?
The PiCS-AR program assists clinics by providing technical support, data cleanup for accurate screening records, and the introduction of patient navigators who help patients understand the healthcare system and access necessary screenings, ultimately enhancing screening rates.
4. What strategies does the PiCS-AR program employ to encourage clinics to improve their screening numbers?
The program employs innovative strategies such as reimbursement measures that track the number of screenings scheduled and engaging campaigns to foster healthy competition among providers. This includes developing provider scorecards to motivate clinics to prioritize and improve their screening rates.
5. What challenges does the PCMH program face in its implementation?
The PCMH program encounters challenges such as staff turnover and downsizing in some clinics, leading to added stress as teams balance their PCMH responsibilities with existing workloads. This makes it difficult to manage the various metrics and obligations associated with the program effectively.
A Focus on Preventive Screenings
One of the team’s standout efforts has been collaborating with the Arkansas Department of Health Division of Medical Services (DMS) Patient-Centered Medical Home (PCMH) program and various stakeholders to enhance screening rates for colorectal, cervical, and breast cancers. “With funding from private sources and targeted grants, the program aims to eliminate factors that prevent patients from receiving crucial screenings,” Rhelinda says.
Connie Ash, an APRN and PCMH lead for Family Medicine Associates of Blytheville, has been involved with the PCMH program since its inception. She and her quality team were surprised when they ended the 2022 performance period with a 15% breast cancer screening rate among their Medicaid patients. They became even more distraught when they learned in April 2023 that their rate had dropped to 10%.
“Motivated to improve these low rates, she and her team ended the 2023 performance period with a screening rate of 50%,” Stacey says. “As of August 29, 2024, their current screening rate was at 53%.”
Another major component of the PT team’s work is their work with Partnerships in Colorectal Cancer Screening for Arkansas (PiCS-AR), now in its fifth year. Through a subcontract with the University of Arkansas for Medical Sciences (UAMS), AFMC provides technical assistance and coaching to clinics across three health systems, including 1st Choice, Mid Delta Health Systems, and Mississippi County Hospital System.
“This screening began simply as a data cleanup project for providers’ electronic health records to identify completed screenings that had not been accurately recorded,” Stacey says.
This work eventually paved the way for the introduction of patient navigators—historically non-nursing roles designed to assist patients in navigating the healthcare system, finding financial resources, and ensuring they receive the necessary screenings.
“Clinics chose to hire nurses and others with healthcare experience for these patient navigator roles due to their previous knowledge of the healthcare landscape,” Stacey explains. “This allowed for deeper patient connection and accurate recommendations.”
To foster a culture of accountability and competition among providers, the PiCS-AR program employed several innovative strategies for enhancing screening numbers. Reimbursement measures in value-based care systems track the number of screenings providers schedule with their patients, so Stacey and her team used fun and engaging campaigns to help raise the number of colorectal screenings.
“We also developed provider scorecards to encourage clinics to always strive for excellence,” Stacey says. “This helped ensure they understand the importance of scheduling screenings rather than simply talking about them.”
Nobody wants to see low numbers on their scorecard, so this was a great way to foster healthy competition and increase preventive care for patients. A win-win.
Garnering a Sense of Responsibility and Follow-Up
Another success for the AFMC PT team is their work with DMS on the PCMH program focusing on tracking follow-ups with high-priority patients. Some patients may have chronic conditions that require close management and check-ins to ensure they are meeting their health goals. This program encourages providers to follow up with patients on preventing screenings and ensure they get the care they need when they need it.
“If we didn’t track some of these things, such as follow-ups and preventive screenings, some underlying conditions, such as heart disease, may get overlooked,” Stacey says. “This program ensures providers go beyond ‘checking the box.’ They work to ensure patients receive the comprehensive and timely treatment they need.”
Recent expansions in the program have also led to improvements in screening for chlamydia, for example. Initially met with resistance, many physicians have learned that standardizing the questions around sexual health can uncover surprising health issues, even among patients who may not appear at risk.
Enhancing Program Success
Despite these advancements, however, the PCMH program is not without its challenges. Staff turnover and downsizing have hindered progress in some clinics, especially in those who have been part of the program for over 10 years.
“Some teams are balancing their PCMH responsibilities alongside their existing workload, which can create additional stress,” Rhelinda adds. “So, it can be difficult to navigate everything with all these different metrics being thrown at you all at once.”
Arkansas primary care practices’ engagement and participation in value-based programs such as the PCMH program improve significantly when they have a clear understanding of what is required to gain financial incentives. Annual presentations review the financial benefits of participating, and providers see the opportunities for tangible gains. The AFMC Practice Transformation team motivates providers by identifying revenue opportunities, risks, and potential financial rewards. They have found that when there is a strategic approach to success in the program, providers demonstrate a greater commitment and are more meaningful participants.
Final Thoughts
The AFMC Practice Transformation team continues to evolve, showcasing how a patient-centered approach to healthcare can drive significant change and improve health outcomes. By implementing innovative strategies and fostering a culture of accountability, the program is making a tangible difference in the lives of patients and providers alike. As we reflect on these successes, it’s clear that the future of healthcare can be bright when we prioritize patient needs and empower our healthcare teams.
For more important healthcare topics, follow AFMC on Facebook, Instagram, LinkedIn, X, and YouTube.
Subscribe to our newsletter for the latest news and updates, including the most recent episode of AFMC TV.
