Enrollment

Enrolment is how a practice joins the patient centered medical home programme and becomes eligible for its care coordination and shared savings payments. The programme has run enrolment through the provider portal, using a defined window so that applications can be processed together and the terms of participation confirmed.

Enrolling through the portal

To enrol, a practice logs in to the provider portal and follows the steps set out for the enrolment process. The portal is the single point of entry, which keeps the application, the practice's data and the reports that follow in one place.

Enrolment has been organised into a defined period rather than left open indefinitely. The programme announced a window beginning September 1 and ending October 31, so that practices knew when to prepare and the programme could handle the applications in a single cycle.

What a practice should have ready

Enrolling is easier when a practice has already reviewed the programme's requirements. The eligibility requirements and the PCMH manual set out what a practice needs to demonstrate, and reading them first means the application can be completed without a second pass.

The programme's questions section and the manual are the two references for points that come up during enrolment. Where those do not answer a question, the programme's contact channels take the query directly.

After an application is submitted

Once a practice has submitted its enrolment, the programme reviews the application and the practice moves towards participation. Enrolled practices become eligible for the support the programme offers, including transformation assistance and access to the reporting that tracks performance.

Participation brings obligations as well as benefits. A practice is expected to meet the programme requirements, submit the data the portal requests and review the reports the programme publishes, because those reports determine whether incentive payments apply.

Planning around the cycle

Because enrolment has opened and closed on specific dates, a practice that misses a window needs to know what happens next. The programme's updates, the PCMH manual and the questions section are the places to check for the current position and any future window.

A practice that plans for the next cycle can use the time to review the requirements, prepare its data and get its team ready, so that enrolment is a confirmation of readiness rather than the beginning of preparation.

Because enrolment can involve more than one payer, a practice should think about which programmes it is joining and how the applications relate to each other. The medical home programme and the episodes of care programme are distinct, even though they share a payment philosophy, and a practice may take part in one, the other or both. Reading the programme material before starting means the practice knows which sets of requirements apply to it, which reduces the chance of preparing the wrong documents.

Timing is worth planning around as well. Because enrolment has run in defined windows, a practice that decides to join late in a cycle may need to wait for the next one, so it is sensible to review the requirements, prepare the data and settle the internal responsibilities in advance. A practice that has done that work will be able to submit as soon as a window opens, rather than using the window itself to read the requirements for the first time.

The enrolment path

• Review the eligibility requirements and the PCMH manual.
• Log in to the provider portal.
• Complete the enrolment steps set out in the portal.
• Submit the application within the announced enrolment window.
• Wait for the programme to process and confirm participation.
• Begin participation, reporting and access to programme support.

Enrolment essentials

Enrolment windows, requirements and procedures are updated by the programme from time to time. Practices should confirm the current dates and steps in the official programme materials and on the provider portal before applying.