These are practices who meet the NCQA standard of a patient-centered medical home (PCMH) and participate in Blueprint initiatives. This measure is fundamental in assessing the reach of the Blueprint program. As larger numbers of practices are qualified as PCMHs and supported by Blueprint payments, increasing numbers of Vermonters should have access to high quality primary care.
The trend line above clearly highlights the rapid increase in practice participation in the Blueprint as NCQA-recognized Patient-Centered Medical Homes (PCMHs) in 2011. This rapid increase is the result of a coordinated effort by the Blueprint team to comply with the enactment of Act 128 in May 2010 by the Vermont General Assembly. The Act mandated the statewide expansion of the Blueprint, including practice recognition as PCMHs. Evidence of this expansion required a minimum of two primary care practices in each health service area (HSA) becoming PCMHs by July 2011. The Act additionally required the involvement of all willing primary care providers in Vermont by October 2013 (full statewide spread). A significant achievement in 2010 that paved the way towards compliance with Act 128 was the Blueprint’s successful application for the Centers for Medicare & Medicaid Services’ Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration Project. In mid-July, Medicare joined all other major insurers in Vermont in contributing to the financial payments to PCMHs.
Since the mandate that all willing primary care providers in Vermont be involved as a PCMH in the Blueprint by October 2013, Blueprint QI Facilitators have continued to engage providers across the State to encourage and inspire participation. QI Facilitators, highly skilled and intensively trained clinical and process coaches, work with primary care practices throughout the state and guide them as they make quality improvement changes on the path towards becoming PCMHs. When practices achieve NCQA certification as a PCMH with the assistance of the Blueprint QI Facilitators, they demonstrate adherence with important characteristics of high-quality healthcare and well-coordinated health services. The practices find the NCQA PCMH standards and Blueprint program as value-adds to their practice, as since the inception of the Blueprint program, only one PCMH has dropped out of the Blueprint (pending an upcoming move out of state).
The Blueprint has approached a saturation point where the program has recruited most of the available primary care practices in the state, and the rate of onboarding of new practices has generally plateaued. Program expansion is continuing due to the outreach efforts of the Blueprint QI Facilitators, who are making a coordinated effort to reach primary care practices in their communities that have not participated in the Blueprint as a patient-centered medical home in the past. Generally, the practices that are continuing to join the Blueprint are independent and naturopathic practices.
Last updated: 06/19/2020