September 6, 2018

PCMH Reflection: Altura Centers for Health

The Primary Care Development Corporation (PCDC) provides consultation and technical assistance that enhances the ability of health care providers to deliver quality primary care. Through these services, PCDC has helped nearly 770 health centers achieve Patient-Centered Medical Home (PCMH) recognition. One such provider is Altura Centers for Health, which worked closely with PCDC to provide better, more patient-centered care.

Altura has two mobile units which park outside schools and are available to anyone in the community

Altura is comprised of eight different sites located across rural expanses in central California. Its centers provide a range of health care services — primary care, pediatrics, obstetrics and gynecology, dental care, behavioral health, nutrition education, and specialty care — to broaden access to vital services in rural communities with minimal access to hospitals.

Although Altura presently holds Level 3 PCMH status — the highest certification level — its past procedures were not as developed and organized as they are now. In fact, Altura’s first PCMH recognition submission was denied for failing to meet National Committee for Quality Assurance (NCQA) standards in successfully addressing individual patients’ needs.

For example, Altura’s disorganized email and phone documentation hindered patient contact and follow-up. Altura also used sweeping generalizations in identifying patients as “high-risk,” a sign that its original health care procedures lacked direct, targeted focus.

Because of these challenges, Altura decided to partner with PCDC for PCMH consultation, marking a transition in its health center procedures. PCDC helped Altura interpret the language of NCQA’s open-ended PCMH recognition guidelines and translate them into actionable goals. With PCDC’s assistance, Altura reapplied for PCMH recognition in 2014, and received Level 2 certification for one site.

By 2016, Altura had significantly improved its care delivery, resulting in Level 3 PCMH recognition in seven of its eight sites. During the transformation process Altura staff worked closely with PCDC’s Project Manager Amy Breyer, who helped them identify their unique challenges and opportunities for improvement.

Leveraging Breyer’s background as a Licensed Clinical Social Worker, Altura was able to refresh its programs with a patient-centered mindset. For example, Altura now classifies patients as “high-risk” based on their circumstances and background, using these factors to construct individualized care. According to Eric Medina, Quality Improvement Coordinator at Altura, “everybody has a story,” and no two patients are alike, embodying PCMH’s patient-centered model. Altura’s email and phone documentation has also become more organized, further cultivating their contact with patients.

Working up to Altura’s PCMH certification required a large amount of dedication and reorganization. Today, Altura effectively delivers comprehensive, quality care to thousands of people in California. Though the process of PCMH certification is lengthy and requires significant attention to detail, Altura exemplifies how PCDC’s customized support can make the process streamlined, efficient, and approachable.

Learn more about how PCDC can work with your practice to achieve PCMH recognition and the wide range of capacity building services offered by our Performance Improvement team.

–Written by Annie Wang, intern with PCDC’s Advocacy and Communications group