Coastal Pediatric Associate's PCMH Success Story

Clarify’s Anderson Wiksell spoke with Dana Wolf, Alecia Quinn and Kim Covington of Coastal Pediatric Associates located in Charleston, SC. Coastal Pediatric Associate, an incredible practice for many different reasons, is the largest private pediatric organization in the Lowcountry and one of the largest in the state. They have four locations and continue to grow. Their CEO, Amanda Pritchett, spoke about the benefits at MUSC in September. Coastal Pediatric Associate believes their purpose is to nurture and champion the health of all children and their families. They act as compassionate, relentless advocates for every patient and family, and they do it very well. As part of being an advocate for their patients, Coastal Pediatrics achieved NCQA Patient-Centered Medical Home (PCMH) Level III Recognition.

We feel lucky because we got to talk to them about how this impacts their organization.

WHY PCMH?

Coastal Pediatrics was the first privately owned pediatric practice in the Lowcountry to obtain  Level III PCMH Recognition.

When asked why they chose to get PCMH Recognition, Kim Covington, the Senior Director of Clinical Operations (SDCO) responded, “we like to be cutting edge and stay on the forefront of pediatric medicine. At first, we were not sure what it (PCMH) entailed, but after some researching we realized it would help us remain a front-runner. Many of the PCMH initiatives were things we were already doing, but it just wasn’t well documented. PCMH fit in well with what we are all about.” Dana Wolf, Quality Programs Manager added that PCMH improved their attention to detail and processes on care coordination and transitional care management (TCM) for when their patients are seen by other providers or facilities by saying, “we saw that our patients were getting excellent care from us, but we cannot provide all the care that they needed, so this is one area where PCMH works well for us. PCMH provided an updated way to care for our patients, and we gained new reimbursements.”

Change - this word brings excitement to some and fear to others. Coastal Pediatric Associate is one of those organizations that embraces change and they attribute their openness to change to part of their success. Coastal Pediatrics has seen great change in their technology, finances, and data. These three categories were improving before they implemented PCMH, but PCMH helped them focus on their progress and meet certain quality guidelines.

TECHNOLOGY- FINANCES- DATA

Efficient and effective technology and data collection plays an important role in achieving PCMH Recognition. Using current, advanced technology is important to Coastal Pediatric Associate. They use Athena as their electronic health record (EHR). Dana says they like the structure it provides to the practice. She loves collecting data and using data to help make important decisions. So far in 2015, Coastal Pediatric Associate has had 83,700 patient encounters. That is an impressive number. Utilizing technology and data-driven decision-making have enabled them to make all of these encounters possible without sacrificing quality or patient satisfaction. One statistic in particular that Coastal Pediatrics is proud of is their 48% HPV vaccination series completion rate. The national average is approximately 25%. Their childhood immunization completion is also high. They attribute this success to great communication and PCMH.

Financially, Coastal Pediatric Associates has reaped the benefits of being a PCMH. [DW1] Achieving NCQA PCMH Level III Recognition was a savvy business move and well worth the effort. They expect their reimbursement profits to continue to grow, and feel excited about the financial potential. Though the PCMH application cost for a practice their size is about $16,000, Coastal Pediatric Associates says that the money and time spent completing the application are worth it.

Alecia Quinn, LPN, Quality Programs Coordinator, says Coastal Pediatric Associates’ next challenge is Renewing under the 2014 PCMH Standards. Alecia is the one making sure they meet all the PCMH Standards and Guidelines, which will be no easy task. Dana and Alecia explained that understanding the new requirements, will be the most difficult part of the process for them. “Our minds often go straight to the hardest standards, then we catch ourselves, and have to take a step back to look at what is really important (on the application). We are lucky because we have the people and the resources to make this happen because we are a large organization.”

OVERCOMING OBSTACLES

While PCMH Recognition is beneficial for patients and the practice, Coastal Pediatric Associates does have some criticism for certain PCMH Standards. “For some (Standards), the return on investment is not enough,” says Dana, “and there is sometimes hesitation from the providers about new initiatives.” Alecia added, “We’re a business, and we have to be careful to make good financial choices. But most importantly, our patients are our number one priority and that’s why PCMH is good for us.” Dana also finds it discouraging at times to receive data from the patient surveys when she knows they’ve spent so much time and effort on improving and advocating for patients. They know constructive feedback, both positive and negative, are the only ways to continue to get better. Dana and Alecia also mentioned patients must also commit and engage in their health in order to achieve the best health outcomes. “Sometimes hard because there is only so much we can do. There is responsibility on both sides.”

“We’ve seen across the board that our staff is proud of the PCMH initiatives we are completing,” Dana says. “They might not always know the direct connection from their work to PCMH, but they are excited about the outcomes.” A good PCMH success story can help their staff remember why it is important, too. Recently Coastal Pediatric Associate had a patient come to their asthma clinic, and the patient needed care from another provider. Alecia explained that because Coastal Pediatrics is a medical home that they were able to coordinate all of her care and make sure she received the care she needed. It was a much less confusing, scary time for this patient and her family. It’s stories like this that make all of the time and effort worth it.

Dana and Alecia are excited about seeing more positive impacts in their practice as a result of PCMH Recognition. Alecia is looking forward to implementing new asthma clinics and diving into the mental health side of care. Dana is excited about continuing to collect and use data, and discovering additional ways PCMH can help Coastal Pediatrics remain front-runners in pediatric care.

A note from Clarify: We loved the chance to talk with the Dana, Alecia and Kim at Coastal Pediatric Associate. Congratulations on your NCQA PCMH Level III Recognition and all the great work you’re doing. It’s exciting to hear about an organization and people who are so excited and driven by their work. Coastal Pediatric Associate is doing well in every area - quality, revenue, process, data, research, and they always maintain focus on taking care of their patients and families.

 

To learn more or become a patient at Coastal Pediatric Associate, click here.