Primary Care and Prevention Focused Care Model (PCPFCM)
What is the PCPFCM?
Relationships with your patients and our members is crucial to their overall health. Our new PCPFCM creates a “dynamic duo” between you and your patient in their quest to be a Health Hero. Regular consultations with your patients will assure they are receiving the care they need. The more you get to you know your patients, their family, and their medical circumstances, it will enhance their overall health.
The PCPFCM includes 6 key elements:
- Annual wellness visits
- Patient-Focused Health Risk Assessments (PDF)
- Lifestyle Counseling
- Preventive Services (U.S. Preventive Services Task Force (USPSTF) A+B recommendations)
- Care Management and Coordination
- Comprehensive Medication Review
Collaboration is key to fostering strong relationships within healthcare teams, and it all starts with the support and engagement of the Provider Engagement Administrator. Their role is crucial in facilitating communication, ensuring resources are available, and supporting providers in delivering the best care possible.
Provider-Driven Care Coordination
The PCPFCM encourages our members to see their PCP regularly even when not sick. This approach will support the member as a whole person, assist with coordinating care, and make available appropriate screening test and visits designed to keep members healthy, address barriers to staying healthy, such as housing or food challenges, and support a high quality of life.
What is a Health Hero and What's in It for Your NH Healthy Families Patients?
- A Health Hero is a NH Healthy Families member of any age who takes charge of their own health and wellness.
- A Health Hero chooses a Primary Care Provider (PCP) as their partner in their health journey.
- A Health Hero communicates by completing all forms, a Welcome Call, and alerting us to any changes like address changes, PCP changes, pregnancies and more!
- A Health Hero visits their PCP for annual wellness visits, follows their PCP’s advice for prevention appointments like vaccinations, screenings, specialist visits and follow-up visits.
- A Health Hero receives My Health Pays® dollar rewards* automatically, just for participating in healthy activities like Welcome calls, annual Wellness visits, screenings and more!
- A Health Hero uses their My Health Pays® dollar rewards* to shop at Walmart.
Your NH Healthy Families Patients Can Earn Dollar Rewards* for Preventive Activities with My Health Pays®
My Health Pays® is a wellness program that awards dollars* to Health Heroes. Completing their Welcome Call, their forms, PCP Wellness Visits, screenings, and activities for both physical and behavioral health can earn them up to $250* every year. They can start earning today! If they have questions? Contact us at 1-866-769-3085.
*Some restrictions and limitations apply. Each member can earn up to $250 in cash and non-cash goods and services through June 30 each year.
Resources
- Primary Care and Prevention Focused Model of Care Guide (PDF)
- Primary Care and Prevention Focused Model of Care Fee Schedule
- PCPFCM All NH MCO Training Presentation (PDF)
- PCP Change Form (PDF)
- Health Risk Assessment (HRA) (PDF)
- Health Risk Assessment (HRA) - Spanish (PDF)
- USPSTF A+B screenings
- My Health Pays® Rewards for Members
- Comprehensive Medication Review Medication List and Patient Takeaway Template (PDF)