Health Care Reform

Recognizing that our national and local healthcare system is transforming from a care delivery model in which hospitals, physicians and providers are rewarded individually based on volume of services provided to one in which providers will be collectively reimbursed and rewarded by patients, employers and payers based on performance outcomes and the value they bring to defined populations.  Western Connecticut health Network (WCHN) has embarked on creating a clinically integrated network to meet these new demands and to meet the tenants of the Triple Aim (improving the health of a population, delivering better care and lowering overall medical costs).

Current initiatives under the PHO include:

  • Support for community practices to meet National Committee for Quality Assurance (NCQA) level III patient centered medical home (PCMH) certification.
  • Community-based primary care practices  that are recognized as level three PCMH  have demonstrated  the ability to  provide high quality care that is planned, patient and family-centered which can deliver health promotion, acute illness care, and chronic condition management.
  • Integrating behavioral health into primary care practices.
  • Across the US, Connecticut and throughout WCHN communities we are seeing increasing difficulty accessing behavioral health care. Primary care physicians have thus become the default providers, prescribing 79% of the antidepressants and seeing 60% of those being treated for depression. Having social worker trained resources embedded in the primary care practices have shown great outcomes in managing vulnerable populations.
  • Providing assistance with value-based care delivery competencies
  • In order to meet the challenges of a changing healthcare environment physicians and providers will need to rely more heavily on technology, data and care management resources. The PHO offers help with electronic medical records (EMR), population health software, care management resources, and data analytics.