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Learn The Lingo

Learn the Lingo: Key Terms for Navigating the Value Based Care World

With the shift toward value-based payment models, pharmacists are seizing new opportunities to improve patient care in medical homes, accountable care organizations, and other innovative care models. This resource includes acronyms and terminology commonly used when practicing in or discussing innovative practice models. Each term includes a short description and references so you can further your practice in a value based care world. This is the first of multiple volumes that will be published by the Medical Home/ACO SIG.

Annette Jones
/ Categories: Learn the Lingo

Empanelment

Definition: Empanelment is the process of assigning patients to primary care providers (PCPs) and care teams within a value-based payment model such as a Patient Centered Medical Homes (PCMH) or Accountable Care Organization (ACO).1 Patient and family preference may be considered during the assignment as patients continue to visit their PCP or care team for wellness visits.1 The PCP leads the team and works collaboratively with all members.1

Empanelment is the basis of population health management because it removes the focus from those who attend office visits. The PCMH accepts responsibility for the entire panel of patients and works to improve outcomes for all.

How it relates to ACO/PCMH: Empanelment helps determine the practice’s average visits per patient per year (AVPY) and sets the number of patients a provider will take (panel size). It helps determine the number of visit slots needed to accommodate the patients and if additional providers are required. Appropriate panel size for a provider will improve the continuity measures for the PCMH. Empaneling patients also enhances the quality of the subjective component of risk stratification by increasing interaction a patient has with the same primary care team.

Involved organizations/oversight: Centers for Medicare and Medicaid Services; Agency for Healthcare Research and Quality; National Committee for Quality Assurance (NCQA)

Resources:

  1. Brownlee B, Van Borkulo N. Empanelment: How to form patient panels in primary care. AHQR: Agency for Healthcare Research and Quality. https://www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/tools-and-materials/executive-summary-empanelment.pdf

Contributing author:

Courtney Doyle-Campbell, PharmD, BCACP, AHSCP-CHC

Clinical Associate Professor, Western New England University

 

 

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