Patient Centered Medical Home Model

Sunshine Health is committed to supporting its network providers in achieving recognition as a Patient Centered Medical Home (PCMH) or a Patient Centered Specialty Practice (PCSP).  As part of our quest to help you provide value-based care and achieve the Quadruple Aim: Better Care, Better Outcomes, Lower Cost, and Greater Physician and Patient Satisfaction, we can support you in achieving and maintaining PCMH with NCQA, AAAHC, TJC or URAC; the NCQA Distinction in Behavioral Health (BH) Integration; and the NCQA Patient Centered Specialty Practice (PCSP) certification.

The purpose of the PCMH, BH Distinction and PCSP certifications is to promote and facilitate a whole person model of care that aims to help you organize your practice to achieve better healthcare quality, improve member self-management and reduce avoidable costs over time. The Medical Home concepts, properly implemented and measured, can lead to a more efficient practice, a focus on population health, measurable quality improvement and resources to address social determinants of health.

Sunshine Health will actively partner with our providers, with community organizations and other groups representing our members to increase the number of providers who are recognized as PCMH and PCSP. 

Sunshine Health’s technical support model includes:

• Readiness survey and medical home standards gap analysis
• Education on the history of the medical home and the process of becoming certified
• Resource tools and best practices

Our secure Provider Portal and related technologies offer tools that provide data and information to support PCMH and PCSP practices. These tools include:

• Online Care Gap Notification
• Member Panel Roster including member detail information
• PCP ENS system 

For more information on PCMH and best practice models, visit the following websites: 

• NCQA Patient Centered Medical Home Recognition Program
• Accreditation Association for Ambulatory Health Care, Inc.
• The Joint Commission
• URAC
• National Center for Medical Home Implementation
• Understanding and Running a Patient-Centered Medical Home
• Patient-Centered Primary Care Collaborative

For more information on Sunshine Health’s PCMH and PCSP program, please call Provider Services at 1-844-477-8313 to be connected with our Provider Engagement Quality Director.