# of primary care practices participating in the Blueprint
Notes on Methodology
- The number of participating practices per quarter is generated from data stored in the Blueprint portal (https://blueprintforhealthportal.vermont.gov/). The Blueprint Data Analyst manages information stored in the Blueprint portal.
- The goal figure for this measure was obtained by identifying all primary care practices in the Area Health Education Center (AHEC) survey database and immunization registry database, validating these primary care practices with our Blueprint Program Managers, and eliminating from the count practices with 1 FTE or less of a provider.
Story Behind the Curve
The data points in the above graph show the number of primary care practices who meet the NCQA standards for patient‐centered medical home (PCMH) recognition and who participate in Blueprint initiatives.
This measure is fundamental in assessing the reach of the Blueprint program. As larger numbers of practices qualify as PCMHs and are supported by Blueprint payments and field staff, high quality primary care becomes more available to Vermonters. The trend line above clearly highlights the rapid increase in practice participation in the Blueprint as NCQA‐recognized PCMHs beginning in 2011. The initial rapid increase is the result of a coordinated effort by the Blueprint team to comply with the enactment of Act 128 in May 2010 by the Vermont General Assembly. The Act mandated the statewide expansion of the Blueprint, including practice recognition as PCMHs. Evidence of this expansion required a minimum of two primary care practices in each health service area (HSA) becoming PCMHs by July 2011. The Act additionally required the involvement of all willing primary care providers in Vermont have the opportunity to participate by October 2013, thereby achieving a statewide presence. A significant achievement in 2010 that paved the way towards compliance with Act 128 was the Blueprint’s successful application for the Centers for Medicare & Medicaid Services’ Multi‐Payer Advanced Primary Care Practice (MAPCP) Demonstration Project. In mid‐July, Medicare joined all other major insurers in Vermont in contributing to the financial payments to PCMHs.
Since 2013, Blueprint Quality Improvement Facilitators and Program Managers have continued to engage providers across the State to encourage and inspire participation. Quality Improvement facilitators, highly skilled and intensively trained clinical and process coaches, work with primary care practices throughout the state to guide them as they make quality improvement changes on the path towards becoming PCMHs and after to ensure practices continue to provide high quality healthcare and well‐coordinated health services.
The Blueprint has approached a saturation point where the program has recruited most of the available primary care practices in the state, and the rate of onboarding of new practices has generally plateaued. Recent fluctuation in the number is often due to practices closing or merging. In the 10 years since the beginning of the program expansion, only 3 practices have dropped out primarily due to reporting requirements or because their patient panel was not a good fit for PCMH recognition. However, with changes to the NCQA recognition process that has made it less burdensome, the vast majority of practices have stayed in the program and additional practices have joined in recent years due to the outreach efforts of the Blueprint Quality Improvement Facilitators and Program Managers. Generally, the practices that are continuing to join the Blueprint are independent and naturopathic practices.
Narrative last updated: 3/24/2020
The Local Blueprint Transformation Network, which includes:
- Quality Improvement (QI) Facilitators
- Community Health Team leaders
- Program Managers