Percentage of Visits for MTF Prime with their Assigned PCM:
This measure reflects the percentage of appointments in Primary Care clinics that enrollees have with their assigned PCM. To determine the rate, an extract from the Patient Appointment and NED Provider Group files is run against all CHCS hosts
each week. The adhoc report indicates if the PCM was the assigned provider for each appointment based on their current enrollment status.
Click here to access the PCM by Name Medical Home Report.
Click here to access the PCM by Name Medical Home Report (weekly).
Click here to access the PCM by Name Medical Home Report (BENCAT).
This measure reflects how frequently an MTF enrolled Prime beneficiary
seeking care at a primary care site, gets that appointment with his/her
assigned PCM. To determine the rate, an extract from the Patient Appointment
and NED Provider Group files is ran against all CHCS hosts. The data is then
filtered according to the following methodology:
1.) MTF Prime enrollee seeking care at enrollment site treatment DMIS. Non enrollees and enrollees with a DMIS other than the treatment DMIS are dropped.
2.) Primary care is defined by: Family Practice Clinic (BGA, BGZ, and BDZA ,excludes BGAZ ); Flight Medicine Clinic (BJA); Internal Medicine Clinic (BAA); Pediatric Clinic (BDAA, BDAN and BDZ); Primary Care Clinic (BHA), Primary Care not elsewhere classified (BAZ); TRICARE Clinic (BHH) and Underseas Medicine Clinic (BKA). It excludes any of those MEPRS ending in: 0,1,2, 5, 6, 7.
3.) Includes these appointment statuses: Pending, Kept, Walk-In, Sick Call, and LWOBS.
4.) Includes these appointment types (includes "$" appts): ACUT, OPAC,WELL, EST, ROUT, and PCM
5.) PCM has to be flagged in CHCS as "PCM" and "provider."
6.) Non-PCMs have to be flagged as "provider" in CHCS (excludesnon-credentialed providers)
7.) Does not matter if PCM is seeing patients the day of the appointment or not.
8.) Match enrolled PCM on day of appointment not current enrolled PCM.
The above reflects the HA/TMA approved methodology to include HA Policy 11-002, "Memorandum Directing the Use of a Unique Fourth-Level Medical Expense and Performance Reporting Code for Each Patient Centered Medical Home Team". Previous extracts should be used with caution since the methodology differes. Please direct all questions to , Government TOC Director or , TOC Project Manager.
