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STATE OF TENNESSEE PCM WEBINAR: Population Health Management Brief Action Planning (BAP) /Goalkeeping Presented by: Rick Walker, Coach Lead, PCM CCE 5/23/1812:001:00 pm Introduction to today's topic
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How to fill out pcmh population health management

01
Start by gathering all relevant patient data, such as medical history, demographics, and health behaviors.
02
Identify the target population for your population health management efforts.
03
Assess the health needs and risks of the identified population.
04
Develop a care plan that includes interventions and goals tailored to the population's needs.
05
Implement the care plan and monitor progress regularly.
06
Use technology and analytics tools to track population health indicators and outcomes.
07
Engage patients and empower them to actively participate in their own healthcare.
08
Collaborate with other healthcare providers and community resources.
09
Continuously evaluate and improve your population health management strategies.
10
Document and communicate the impact and results of your population health management efforts.

Who needs pcmh population health management?

01
PCMH population health management is beneficial for healthcare providers, accountable care organizations (ACOs), and healthcare systems.
02
It is particularly useful for managing and improving the health of patient populations with chronic conditions, high-risk individuals, and those with complex medical needs.
03
Employers and payers can also benefit from PCMH population health management, as it can help reduce healthcare costs and improve the health outcomes of their employees or members.
04
Overall, anyone looking to optimize healthcare delivery, enhance patient outcomes, and promote preventive care can benefit from implementing PCM population health management.
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PCMH (Patient-Centered Medical Home) population health management is a healthcare delivery model that emphasizes coordinated care and improved health outcomes for patient populations through comprehensive management of chronic diseases and preventive care.
Healthcare providers and organizations that participate in the PCMH model, including primary care practices, must file PCMHPHM reports to ensure compliance with quality measures and reimbursement requirements.
To fill out PCMHPHM, providers should gather relevant patient data, assess health outcomes based on established metrics, and report on the population's health status by completing the required forms and submitting them to the appropriate authority.
The purpose of PCMHPHM is to improve patient care quality, enhance health outcomes, reduce healthcare costs, and ensure that patients receive necessary preventive and chronic care services.
Reports must include patient demographics, health outcomes, utilization of services, care management activities, and evidence of adherence to quality measures and best practices.
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