PCMH: Care Coordination and Care Transitions (CC)

About this On Demand Training

A Look Inside PCMH Concept: Care Coordination and Care Transitions (CC)

NCQA’s PCMH Recognition program has evolved to feature a set of six concepts that make up a medial home. Underlying these concepts are criteria (activities for which a practice must demonstrate adequate performance to obtain NCQA PCMH Recognition) developed from evidence-based guidelines and best practices.

This self-paced module focuses on Care Coordination & Care Transitions (CC). The intent of the CC concept is to ensure that there are processes and connections in place to ensure proper tracking of patient orders and referrals. It also focuses on the exchange of information between providers and between the practice and other settings of care. It’s essential to coordinate care transitions for patient safety and to ensure clear communication processes are in place so that patient needs are addressed promptly and efficiently. Avoiding duplication of services with comprehensive, coordinated patient care moves the practice in the direction of the high quality, cost effective outcomes sought by patients and payers alike.

For an overview of all 6 PCMH Concepts, please refer to the “A Look Inside the 6 PCMH Concepts: A Comprehensive Overview” course.

What You Will Learn

At the conclusion of the module, participants will have the knowledge they need to:

1. Discuss the format of PCMH requirements, the virtual check-in process and the transformation journey.
2. Outline core and elective criteria for Care Coordination and Care Transition (CC).
3. Explain how CC is scored using scoring criteria within the standards and guidelines.
4. Discuss examples that meet core criteria and electives.

Who Should Attend

This program is designed for any health care professional, health care decision maker or consultant who needs a detailed explanation of the Care Coordination & Care Transition concept of the PCMH Medical Home Recognition standards and guidelines. It is intended for, but not limited to: 

• CCE’s
• Consultants
• Practice care teams
• Practice managers
• Payers

Faculty

Planning Committee

Cathy Beckner, MS (Instructional Designer)
eLearning Program Manager, Education
NCQA
Washington, DC 

Christina Borden, PCMH CCE
Assistant Director, Recognition Programs Policy & Resources
NCQA
Washington, DC 

Johann Chanin, RN, MSN, PCMH CCE
Consultant
Denver, CO

Vashon Coehins, MA
Assistant Director, Education
NCQA
Washington, DC 

Mina L. Harkins, MBA, MT (ASCP), PCMH CCE
Assistant Vice President, Recognition Programs Policy
NCQA
Washington, DC 

Jacquelyn Lombos, MS, PCMH CCE
Assistant Director, Education 
NCQA
Washington, DC

Continuing Education

In support of improving patient care, the National Committee for Quality Assurance is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC), the American Academy of Physician Assistants (AAPA), the American Psychological Association (APA), and the Association of Social Work Boards (ASWB) to provide Interprofessional Continuing Education for the healthcare team. 

This activity was planned by and for the healthcare team, and learners will receive 1 Interprofessional Continuing Education (IPCE) credit for learning and change. 

This educational activity is approved for: 1 AMA PRA Category 1 Credit^TM, ANA CNE,  ACPE. 

The assigned universal program number(s): JA0004597-0000-18-008-H04-P. Upon successful completion of this program (attending the full session and completing a program evaluation), participants will access CPE Monitor on the ACPE website to locate and track their CPE statement of credit. 

This on-demand webinar provides maintenance of certification credit (1 point) under “other continuing education” for PCMH CCEs.

* Please note – You must attend the entire program to be eligible for total number of contact hours. 

Event Type

1. Self Paced