What is patient-centered primary care?
Just as it sounds, patient-centered care is all about you — the patient. Your primary care provider will work with you to improve care coordination that results in higher quality care to you and your family.
If needed, you will be connected with other health professionals to help you get the care you need. For example, your primary care provider can connect you with a pharmacist, mental health specialist, or a nutritionist — whatever your health needs call for. This is called your "health team" and your primary care home is at the center, making sure you have all the information you need.
What is a Patient-Centered Primary Care Home?Press enter to show.
A Patient-Centered Primary Care Home is a health care clinic that has been recognized for their commitment to patient-centered care.
Your primary care home will:
- Better coordinate your care to help get you the services you need, when you need them
- Listen to your concerns and answer your questions
- Offer after-hours help and alternatives to the emergency room
- Help you play an active role in your health
I received a letter about my health care clinic being a recognized primary care home. What does this mean?Press enter to show.
If you are a member of the Oregon Health Plan (Medicaid), and your primary care clinic has been recognized as a Patient-Centered Primary Care Home, you will receive a letter notifying you of this.
Your benefits will stay the same. And in addition to providing your benefits, your primary care home will focus on better coordinating the care you need. This is better for you and your primary care provider.
The letter you received, lets you know what a Patient-Centered Primary Care Home is and what it means for your health care. You are given the option to opt-out, or change your health care provider, or primary care provider, if you don’t wish to receive care in a recognized primary care home.
What can I expect from my primary care home?Press enter to show.
Across Oregon, health care clinics are finding new and better ways to care for you. As a member of your primary care home, you and your health team will work together so that you get all the care and information you need. You will have more time to address the things that are important to you and your family.
- Your primary care provider can answer questions and help you better understand your health needs
- If you need to get help from other doctors or health care providers in the community, your primary care provider can support you every step of the way
- When you have concerns about your health, your health care team will work with you to decide the best way to deal with them
How can I get involved? Press enter to show.
Find a recognized Patient-Centered Primary Care Home- Be an active team player:
- Talk with your primary care provider about your health questions
- Share your past health care successes and challenges
- Tell your primary care provider about other health care professionals who care for you
- Tell your primary care provider how you feel about the care you are receiving
- Take care of your health:
- Follow the health care plan you and your primary care provider have created. Make sure you understand how to follow the plan.
- Set goals you can reach. Once you begin to see results, you and your team can discuss adding new goals.
- Talk openly with your primary care provider:
- Tell your primary care provider if you are having trouble sticking to your care plan
- Speak up if your care plan is not working. Tell your primary care provider what is not working so together you can make changes if needed.
How is a primary care home recognized? Press enter to show.
To be a recognized Patient-Centered Primary Care Home, a clinic must meet certain quality standards. Being a recognized primary care home lets you know that a clinic is dedicated to providing you with the best possible care.
There are different standards, or criteria, a clinic must meet to gain recognition. Overall, clinics are dedicated to these quality standards:
- Accessible: Care is available when you need it.
- Accountable: Clinics take responsibility for the community they serve and provide the best possible care.
- Comprehensive: You get the care, information and services you need.
- Continuity: Your primary care provider knows you and works with you to improve your care over time.
- Coordinated: Your primary care provider helps you find the care you need, when you need it — even from other types of health care providers, like mental health providers.
- Patient & Family Centered: You and your family are the most important part of your health care. Your primary care provider will make sure you understand your care and follow-up care.
Depending on the level of criteria a clinic meets, they can achieve a higher "tier" of recognition. Tier 1, tier 2 and tier 3 being the highest. For example, a tier 3 primary care home meets the highest level of standards.
What is patient-centered care?Press enter to show.
Patient-centered care is a team-based approach to care focused on prevention and managing health conditions. By coordinating the needs of patients through a team of health professionals, more focus can be on prevention and delivering needed care.
Patients who receive care in a recognized primary care home enjoy access to the care they need, when they need it. Care is comprehensive and coordinated across all aspects of care including physical, mental and specialty care — which is especially important for patients who receive multiple types of care from a variety of health care providers.s
What is a Patient-Centered Primary Care Home and what does it mean to be "recognized"? Press enter to show.
A Patient-Centered Primary Care Home is a clinic that has been recognized by the state of Oregon for providing personal, continuous and coordinated care for their patients. Recognized primary care homes evaluate the needs of the population they serve and work to improve care to meet those needs.
Recognized primary care homes demonstrate the ability to meet the key standards set by the state. Recognized clinics can now apply to receive additional Medicaid funding to support the comprehensive, coordinated and patient-centered care they offer Medicaid patients with chronic conditions such as diabetes and asthma. The program is also working to secure supplemental funds for recognized clinics from other Oregon Health Authority programs as well as private payers.
Who is eligible and what type of clinics can become recognized? Press enter to show.
Any health care clinic that can demonstrate the ability to meet the standards will be considered for recognition. Recognition is given at the clinic level and not the individual provider level. Solo practitioners who are the only provider in a clinic may apply for that clinic.
As long as they provide the services described in the standards, eligible practices may include physical health providers, behavioral, addictions and mental health care providers, solo practitioners, group practices, community mental health centers, tribal clinics, rural health clinics (RHCs), federally qualified health centers (FQHCs), and school-based health centers.
How do I become recognized; what data is necessary? Press enter to show.
In order to become recognized, a health care practice must apply. The application process guides practices on how to find out if they meet Oregon's standards for the program and how to report necessary data.
Visit the
Become recognized page for further details and instruction on what's needed to apply for recognition.
How long is the application process? Press enter to show.
Practices applying for recognition should gather all relevant information as laid out in the
Self-assessment tool 
. Once this information is gathered, the application process takes about one hour to complete. After the application is submitted with all required data, the Oregon Health Authority will review the application and notify the practice in writing within 60 days.
To qualify for recognition, does my practice need to provide all the services described by the standards on-site or within my practice? Press enter to show.
No. A Patient-Centered Primary Care Home does not necessarily need to provide all of the services described by the standards on-site, but must be responsible for coordinating or offering those services through partnerships within the area and population they serve. Primary care homes are encouraged to partner with local public health agencies and community organizations to educate patients, identify community health priorities, and develop plans to improve the overall health of their communities.
How are Patient-Centered Primary Care Homes different from a Coordinated Care Organization? Press enter to show.
Coordinated Care Organizations are required to include recognized primary care homes in their networks of care to the maximum extent feasible. Both will aim to achieve the goals of wellness and prevention, coordination of care, behavioral health integration, and a patient-centered approach to care. Expanding the availability of recognized primary care homes will provide access to better care now, and strengthen the primary care networks as
Coordinated Care Organizations emerge.
When will recognized practices be able to apply for enhanced Medicaid funding? Press enter to show.
Right now, the Oregon Health Authority is pursuing innovative payment methods that reward efficiency and improve health outcomes. Such innovations in primary care would reimburse clinics for activities that aren't typically reimbursed such as care coordination, allowing providers to take a more patient-centered approach to care, instead of a visit-based approach.
Recognized primary care homes can now apply for supplemental Medicaid payments to support the care they provide their Medicaid patients with certain chronic conditions. These payments are for the enhanced services that patients receive at primary care homes, helping providers focus on keeping patients healthy. To apply for payments, please complete the requirements outlined in the
Supplemental Payment Option Packet . The packet explains the program requirements and what recognized clinics must to do to begin receiving payments.
Will there be an audit process? And how do I demonstrate or attest to the services we offer? Press enter to show.
The Oregon Health Authority will conduct a random verification process on a select percentage of recognized practices. The practice will be notified no less than 30 days prior to the scheduled verification date.
The Oregon Health Authority will conduct a random verification process, or audit, on a select percentage of recognized clinics. When a clinic is selected for random on-site verification, the
Technical Assistance and Reporting Guidelines let you know what information your clinic must demonstrate to support its attestation. The guidelines also describe how clinics should collect and calculate any data that may be required.
Do I need to renew my recognition status? Press enter to show.
Yes. Recognized practices must renew their status annually, along with all required data.
What type of written agreement is needed between primary care homes and hospitals? Press enter to show.
An important part of coordinated care is making sure you know when and where patients receive other types of care outside the primary care home setting (e.g. emergencies). Staying actively involved and helping them recover or get the proper follow-up care can help patients stay healthy. Therefore, to meet the standards for recognition, practices should form partnerships with hospitals or other health clinics that include:
- Notification when patients visit the emergency room or other hospitalizations
- Expectations around notification of post-emergency room care
If a primary care home refers many patients to specialists within a hospital system, the written agreement should address those roles and communications. More information on this standard can be found in the
implementation guide .
What if my clinic is already pursuing recognition as a Patient-Centered "Medical" Home? Press enter to show.
Many practices have already, or are in the process of, pursuing Patient Centered Medical Home recognition by the National Committee for Quality Assurance. While this model is not identical to the Oregon Patient-Centered Primary Care Home model, there are many areas of similarity. The health authority will recognize "medical" home sites at the level that the national committee has recognized the site, with submission of additional information.
What is the Consumer Assessment of Healthcare Providers and Systems, and are clinics required to use it to gain recognition? Press enter to show.
The consumer assessment is a survey that asks patients to report on and evaluate their experiences with health care. Clinics do not need to field the survey as long as it meets enough of the standards. Clinics can however receive points toward primary care home status if they field either independent surveys (5 points) or one of the four available Consumer Assessment of Healthcare Provider Systems survey (10-15 points).
How are children's needs being met through primary care homes? Press enter to show.
The standards set by the program outlines several guiding principles to be considered during development and implementation of primary care homes, a selection of which are specific to pediatric care.