How does this fit with the Medical Home and ACOs?

Healthcare Reform has already made so many changes in running a medical practice. Many of these changes may not have been pleasant or easy to accomplish. Within the next few weeks the HHS is expected to release their guidelines on Accountable Care Organizations (ACOs). They have pushed back the release date several times already and it is possible that they will again. Why? These guidelines could after many existing anti-trust laws and state regulations.
Many feel that “this to shall pass,” and go the way of so many other changes in healthcare (many remember the 1990s and healthcare reform then). Whether or not you are consider joining an ACO or other practice affiliation, creating an overall quality improvement process is a good idea. If you do not wish to sell to an ACO, it allows you to improve your overall success and profitability. If you are consider joining an ACO, it allows you to measure where you are at and improve to develop a better bargaining chip when you are negotiating your contract. One of the biggest problems is choosing which program or process to use for the change management in your organization. This has been compounded by the fact that many wish to become Patient Centered Medical Homes (PCMH) and there are choices on which program to use to become one. To assist you, we are now offering a new book on change management that takes into consideration the PCMH and ACOs.

Excerpt from PMSA's new book:

How does this fit with the Medical Home and ACOs?
Two of the hottest topics in healthcare currently are the medical home and Accountable Care Organizations (ACOs) and how they can be created. This program, while not focusing on the medical home or an ACO, can be used in the development of one. In the inner parts of the diagram are nine separate sections. The most common standard currently for certification of a Patient Centered Medical Home is offered by the National Committee for Quality Assurance (NCQA). However, the standards used by all of the certification processes are similar and these have been identified in the inner parts on the Medenneagram.

An Accountable Care Organization (ACO) is typically considered to be a hospital or other organizational based provider system with employed physicians. A Practice Affiliation may be an ACO and is a group of providers that shares responsibility for providing care to a defined population of patients that together have a goal of improving patient health, satisfaction and efficiency. The Patient-Centered Medical Home (“Medical Home”) empowers primary care to coordinate care for patients across the continuum of care and it can become the core of an ACO but lacks the financial incentives, like shared savings, to encourage providers to deliver the highest quality at the lowest cost. However, by becoming a Medical Home it aligns the practice to become a practice affiliation or and ACO and allows the practice to began to measure and increase performance. To become an ACO it is necessary to incorporate a change process in the practice. Experts agree that incorporating parts of the Medical Home into the organization aligns with becoming an ACO.


This program allows the organization to include the principles in the Medical Home and those needed for an ACO. The principles of these change processes have been identified as how they fit or tie into the Medenneagram. Even if the practice does not want to become an ACO or obtain Medical Home certification, it may simply skip these sections and still be able to fully utilize the rest of the material in creating a better practice.

How is this broken up into sections and how do they work (personalize the program for your setting)
As mentioned this program is broken into section and it is possible to focus on the sections that are needed in your practice. The program is designed to be personalized and the intent is for a program that can work for you. This program has at its heart the concept of doing what is right and this will need to be identified by you.

We often hearing of failing business in the news due to scandal and corruption. Why has the subject of ethics become so important to the field of business in the last 40 years? In the past people had a different view of what was right and wrong. If you asked someone if stealing pens from work was wrong forty years ago they would have probably said yes. Now many employees feel that it is their “right” to take office supplies and are surprised when you actually confront them with the theft. They justify the theft by saying that the company is rich and powerful and that this is actually “owed” it to them. In healthcare we are experiencing a wave of patients and employees looking for drugs that can be sold on the streets.

As we have seen powerful people that were once held in respect and admired fall, we tend to be complacent about our own ethics. If they did it, why shouldn’t we? Many people have the mindset that they won’t get caught, it happens to other people, but not to me. Since it is easy to develop this mindset, it is important for everyone to be ethical and this is especially true for employers and business people. They are the example setters and can often be the “moral compass” for the rest of the staff. People that feel their employers are ethical according to Ferrell, Fraedrich, and Ferrell in “Business Ethics-Ethical Decision Making and Cases,” employees that feel their employer is ethical are more likely to remain loyal to their employer. Medenneagram addresses this problem by putting moral and ethical behavior at the center. While there are many books on servant leadership, there is a big gap in how all the other aspects of the business should be ethical. By having ethics at the core and having all the other aspects of the business around the core, it allows the reader to use that part and still find ways to “do the right thing”. While this is not a religious book or faith book, it encourages the reader to run a business in a profitable and ethical manner for long-term growth and sustainability.

In the center is Ethical Behavior that ties everything together

I. Ethics in the Practice
II. What is needed from leadership?
III. Management Fundamentals
IV. Patient/Customer Issues
V. Employee Development (professional and personal)
VI. Financial Accounting
VII. Clinical and Business Systems
VIII. Team Development
IX. Legal and Regulatory Aspects
X. Change and Strategic Decision Process
Each of the different aspects is as important as the others. If you do not have a strong leadership, then how can the employers follow? Without good customer service, why would your patients keep coming back? Without financial growth, how can the practice thrive? That is why each of the different aspects is as important as the others and they are all connected. As you will see in the final chapters, not only do they form a star, but they are all inter-related. By making each part of the diagram strong, you are building a star practice. The program is divided into sections with the understanding that your practice may be stronger in one area than another one. It is possible to review all the different areas and then go back and work on the areas that need improvement. In some cases, you may wish to just go through the entire program and focus on each section as you work through the process.

To assist you in the process, in the addendum is a test. Please take the test and then save the results. Later after you complete the program, go back in a few months and retake the test to see how you have improved. Maybe after the second test it will reveal a different area that needs to be focused on for success. The test can be taken as many times as you wish.

If you wish to receive additional information on this new book, please contact jenniferzarate37@yahoo.com