| Weekly Thursday Call Agenda 10/27/11
Thursday, October 27th at 11:00am ET we will hold a call for the Patient-Centered Primary Care Collaborative.
Call in number is 712.432.0900
Passcode is 868853
Please press *6 on your phone to mute and *6 to unmute.
Please mute your telephone unless you are speaking.
If you have not registered to receive this newsletter, follow this link and there is an easy registration process on our website. Additionally, the previous national Thursday call agendas are listed on this page.
Collaborative Announcements
1. Presentations available on-line: Five Years Making Healthy Connections: Collaborating to Improve Care in the PCMH
A huge thank you to all of our participants, volunteers, speakers, exhibitors and sponsors! You all helped make this one of our very best conferences!
SAVE THE DATE - Spring Stakeholder Conference, April 23-24, 2012, Washington, DC Wardman Park Marriott
Exhibiting/Sponsorship Opportunities - Click HERE
Upcoming PCPCC Webinars
On Tuesday, November 1st from 4-5 p.m. ET, hear from our two speakers as they discuss the how community collaboration, partnerships and engagement are promoting patient-centered medical home and continuous transformation in care delivery in New Jersey.
Kevin Maher Director, Clinical Innovation from Horizon Healthcare Innovation, a subsidiary of Horizon Blue Cross Blue Shield of New Jersey whose mission is to change and improve the health care system. Mr. Maher is responsible for the creation and launch of the various pilots with our providers, consumers and hospital.
Dr. Bob Eidus, a board certified family physician. His practice, Cranford Family Practice was one of 35 practices which participated in the TransforMed national demonstration project. It has also received NCQA recognition in Patient-Centered Medical Home and Diabetes. He speaks frequently on the topics of practice transformation and the Medical Home.
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PCMH Happenings
1. New Care Coordination Guide from the PCPCC
This report begins by firmly placing the patient at the center of the patient-centered medical home. Christine Bechtel, vice president, National Partnership for Women & Families captures this perfectly in the foreword with this succinct thought: “I just want my doctors to talk to each other.” The expert articles offer insight into what is known and tested about care coordination, and are designed to offer a roadmap for new and emerging programs. The case examples in this report represent a range of programs at various stages in the journey. Care coordination is not a cookie-cutter exercise for the patient; its implementation in programs across practice types, sizes, and even practice sites within the sameorganization may be similarly varied. There is much to learn from what is being tried, tested and applied bythose on the care coordination journey.
The report features three core elements:
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Expert-authored articles on the definition, role and function of care coordination, as well as tools forimplementation, and measurement and monitoring of its effectiveness.
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Case examples.
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Summary of survey responses from select practices.
We hope you find this report to be thought-provoking, informative and inspiring. We encourage you to reach out to both the sites that were profiled and those with selected examples listed as they can offer valuable insight as you begin your own journey. Click HERE to download this publication.
2. Conversation with CMS Innovation Center on new Comprehensive Primary Care Initiative
Join us next Thursday for a discussion of the new Comprehensive Primary Care Initiative with Christa Shively, who will review the Letter of Intent process and how purchasers can play a key role in this program. We encourage all organizations interested in this program to stay for a follow-up conversation with PCPCC leaders to share ideas on how to engage stakeholders in your community through this program.
The Comprehensive Primary Care (CPC) initiative is a new CMS-led, multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care for all Americans. Primary care is critical to promoting health, improving care, and reducing overall system costs, but it has been historically under-funded and under-valued in the United States. Without a significant enough investment across multiple payers, independent health plans-- covering only their own members and offering support only for their segment of the total practice population-- cannot provide enough resources to transform entire primary care practices and make expanded services available to all patients served by those practices. The CPC initiative offers a way to break through this historical impasse by inviting payers to join with Medicare in investing in primary care in 5-7 selected localities across the country.
For more information, please send your questions to CPCi@cms.hhs.gov.
3. THINC announces new white paper - Building ACOs and Outcome-Based Contracting in the Commercial Market: Provider and Payer Perspectives
New value-based payment models and accountable care opportunities pose fresh challenges for health plans and health care providers needing contracting and business intelligence to move forward. A new white paper produced by a workgroup of the Taconic Health Information Network and Community provides a window into the concerns of both groups of stakeholders while offering insights into the issues they must tackle in this largely uncharted territory.
“Building ACOs and Outcome-Based Contracting in the Commercial Market: Provider and Payor Perspectives” reveals the willingness and necessity for health plans and providers to collaborate in implementing value-based payment models such as commercial accountable care organizations. Over a period of months, a THINC Workgroup held a number of facilitated discussions, bringing together health plans and providers for the express purpose of developing an understanding of one another’s concerns and priorities. The work of the group sheds light on these stakeholder concerns in the Hudson Valley, and has application for health care leaders across the nation.
“The THINC Workgroup white paper sheds light on the issues providers should consider before they start the contracting conversation with commercial health plans about accountable care, and reveals health plan concerns about these trends in the marketplace,” said Susan Stuard, THINC’s executive director. “The discussions provided a truly collaborative environment and contributed to a framework for better understanding the expectations of all parties, as well as contributing to a clearer understanding of the path to move forward to deliver high quality, cost-effective care.”
The white paper is part of THINC’s ACO Insights program, an effort to provide training and technical assistance to physician practices, health plans, hospitals and other health facilities in the Hudson Valley. ACO Insights, supported by a grant from the New York State Health Foundation, also includes a daylong meeting and a series of webinars on relevant ACO topicsbased on a framework of ACO model components: financial and legal, leadership and operations, quality measures and improvement, and engagement.
The white paper, “Building ACOs and Outcome-Based Contracting in the Commercial Market: Provider and Payor Perspectives,” is available as a free download at www.THINC.org.
About the Taconic Health Information Network and Community (THINC)
THINC is dedicated to improving the quality, safety and efficiency of health care for the benefit of the people of the Hudson Valley region of New York. The primary purpose of THINC is to advance the use of health IT through the sponsorship of a secure health information exchange network, the adoption and use of interoperable EHRs and the implementation of population health improvement activities. These activities include public health surveillance and reporting, pay for performance, patient-centered medical home practice transformation, care coordination activities, public reporting, and other quality improvement initiatives. For more information, go to www.THINC.org. THINC is part of the Hudson Valley Initiative, an effort to revolutionize health care delivery through a shared vision to improve the quality, safety and efficiency of health care in the community. To learn more, go to http://www.hudsonvalleyinitiative.com
4. Aetna and Emory Healthcare Partner to Form Patient-Centered Medical Home
Aetna and Atlanta-based Emory Healthcare have announced a collaborative agreement that will launch a Patient-Centered Primary Care program, which includes a medical home. Aetna Medicare Advantage plan members and Emory's employees and family members covered by the Emory employee health plan (administered by Aetna) can participating in the program. The collaboration also includes more than 60 Emory-affiliated primary care physicians.
The collaborative program will focus on specific quality metrics and incentives, such as encouraging office visits every six months for patients with chronic heart failure or diabetes and confirming that members schedule follow-up visits within 30 days of being discharged. Click HERE for more information.
5. Medical Homes lower out-of-pocket costs for families
Parents of children with special healthcare needs pay less in out-of-pocket expenses if the children are cared for in a medical home setting, according to a report published online October 17 in Pediatrics.
Researchers from the schools of social work at the University of Missouri–St. Louis and Florida Atlantic University in Boca Raton analyzed data from the 2005 to 2006 National Survey of Children with Special Health Care Needs, including information about 31,808 children from birth to 17 years old, 73% of whom had private insurance and 27% of whom had public insurance. The results of their study indicated that the care coordination component of the medical home helped to lower out-of-pocket medical costs per $1000 of household income.
The type of health insurance also made a difference. Parents of special-needs children with public health insurance paid on average $317 per year (1.8% of household income) compared with parents of special-needs children with private health insurance, who paid an average of $1298 per year (2.1% of household income). In addition, out-of-pocket medical expenses exceeded 5% of household income for more than 12% of families with private insurance and 10% of household income for more than 3% of those families. That compared with almost 7% and about 4% for families with public insurance.
Families with private insurance in a medical home setting spent $1088 per year (1.6% of household income), and families with public insurance spent $215 (1% of household income). However, more than 20% of families with public insurance reported that their expenses led to family financial problems, and 17% said they needed to make extra income to pay the expenses. Severity of condition led to higher costs for all survey participants.
Also, regardless of insurance type, families reported that mental healthcare, occupational or speech therapy, and dental healthcare were the highest levels of unmet needs. Families reported that cost of care was the biggest reason for delayed care and unmet needs. Click HERE for more information.
Upcoming Conferences and
Webinars
1. Embedded Case Management in the Primary Care Practice: Program Design and Results
Presenter: Robert Fortini, vice president and chief clinical officer
Modeled after Geisinger Health System's Patient Care Navigator program, Bon Secours Health System launched an embedded case management program in 2009. Adapting the Geisinger model to fit its unique needs, Bon Secours' embedded case managers have been placed in eight physician practices and will be expanded system-wide over the next two years. Join this webinar as Robert Fortini, vice president and chief clinical officer at Bon Secours Health System, shares the program's development and roll-out strategy.This webinar will unveil the National Health Care Transition Center’s Six Core Elements of Health Care Transition and mark the general availability of a package of tools for their implementation in primary care and specialty practice settings. Experience with the Six Core Elements and tool set in a multi-practice learning collaborative will be described.
Click HERE for the archived presentation.
2. Webinar- Common Strategy for Health Care Transition Improvement in Practice Settings November 16th from 2-3 p.m. ET
This webinar will unveil the National Health Care Transition Center’s Six Core Elements of Health Care Transition and mark the general availability of a package of tools for their implementation in primary care and specialty practice settings. Experience with the Six Core Elements and tool set in a multi-practice learning collaborative will be described.
3. 2012 Accountable Care and Health IT Strategies Summit January 17-19, 2012, Intercontinental, Doral, Miami, Florida
The 2012 Accountable Care and Health IT Strategies Summit delivers critical insights into the information powered health system that will lay the foundations for clinical improvement, operational and financial efficiencies in Era of Accountable Care.
Healthcare providers, payers and ACO Pilots are rapidly determining their organization's strategy to succeed in an Accountable Care setting, a critical part of establishing a successful ACO is to plan and implement the IT systems that will enable the improved workflow, care coordination and support new incentive and payment models.
The 2012 Accountable Care and Health IT Strategies Summit is produced in close collaboration with Co-Sponsors The Care Continuum Alliance, Patient-Centered Primary Care Collaborative (PCPCC) and The Advisory Board Company.
Click HERE to learn more.
4. Special Registration Discount for the 2nd National ACO Congress Featuring PCPCC Vice Chairman David Nace, MD
Patient-Centered Primary Care Collaborative Vice Chairman David Nace, MD will be featured in a session on The Medical Home: The Foundation of Accountable Care at the upcoming National ACO Congress, November 1-3, 2011, at the Hyatt Regency Century Plaza in Los Angeles. Sponsored by the Integrated Healthcare Association (IHA) and the California Association of Physician Groups (CAPG), this year’s Congress has a special emphasis on the burgeoning commercial ACOs that are springing up all over the country and, according to some experts, defining the future of the ACO movement.
Patient-Centered Primary Care Collaborative members and friends can register for the Congress at the deeply discounted price of $995. The regular Congress price is $1,695. In addition, PCPCC members and friends can choose to attend one of the Congress Pre-Conference sessions at no additional charge (regular cost is $495). To receive the discounted rate, enter PCPCC in the discount code box on the Congress registration form athttp://acocongress.com/registration.php. The $995 rate is good anytime up to the Congress date but we encourage you to register early. For more information and complete agenda go towww.acocongress.com.
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FEATURED SESSION |
The Medical Home: The Foundation of Accountable Care |
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David Nace, MD
Vice President & Medical Director, McKesson Corporation / Relay Health
Vice Chairman, Patient-Centered Primary Care Collaborative (PCPCC)
Malvern, PA |
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Kevin Grumbach, MD
Professor and Chair, UCSF Department of Family and Community Medicine
Chief, Family and Community Medicine, SF General Hospital
San Francisco, CA |
This pre-conference session will be dedicated to participants who need to receive the latest information related to the Primary Care Medical Home Initiative. Taught directly by Joint Commission faculty with primary knowledge of this new option, you will learn about the additional standards, integration into the on-site survey process, and other related accreditation activities. Get your questions answered and learn the latest updates to the Primary Care Medical Home option.
5. American College of Physicians Free Webinar on Medical Home Builder 2.0
Dates
Tuesday, October 18, 2011; 6:30 pm, ET
Thursday, November 3, 2011; 8:00 am, ET
Thursday, November 17, 2011; 6:30 pm, ET
Tuesday, November 29, 2011; 5:00 pm, ET
Thursday, December 15, 2011; 8:00 am, ET
Thursday, December 29, 2011; 7:00 pm, ET
Do you want to see how the Medical Home Builder works? Participate in a free, 30 minute live/interactive demonstration webinar and learn how to improve patient care and office efficiency!
Medical Home Builder 2.0 is an online practice support tool from the American College of Physicians (ACP) that provides primary care practices with an affordable, self-paced means to improve office operations, quality, and/or transition to a Patient-Centered Medical Home model. Medical Home Builder 2.0 features 13 modules, an online community and hundreds of online resources in a virtual library.
The newly updated version features new elements and functions to help clinicians improve patient care, office efficiency, and move toward PCMH recognition and accreditation. Included in Medical Home Builder 2.0 are expanded patient-centered care modules, a new scoring methodology, module-specific resource libraries and a searchable master resource library.
Additionally, a robust reporting function is particularly suited for large practices, groups, institutions and regional programs.
Sign up today and see how Medical Home Builder 2.0 can help you provide quality patient care and achieve a well-managed practice.
To register, visit the ACP web site at: http://www.acponline.org/running_practice/pcmh/help.htm or contact Ayanna Wells at awells@acponline.org
6. Webinar featuring Dr Paul Grundy: Increase your understanding of Patient-Centered Medical Home (PCMH) and the possibilities for your organization.
Thursday, October 27, 2011 at 3:30 p.m. ET
Increase your understanding of Patient-Centered Medical Home (PCMH) and the possibilities for your organization. Health care costs are now a business issue and PCMH provides an opportunity to lower hospitalization rates, overall health care costs, as well as improve patient health. At its core, PCMH is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Dr. Paul Grundy, Director Health Care Transformation at IBM, drove transformation via broad coalition with other large employers to form the Patient-Centered Medical Home movement. Dr. Grundy's work has been covered by theNew York Times, Business Week, Health Affairs, The Economist, and The New England Journal of Medicine. Dr. Grundy will share his experiences at IBM and cover:
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The Principles of Patient-Centered Medical Home
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Statistics showing the impact of PCMH
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Defining how care is centered on the patient
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Steps to value based purchasing
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Tools used to collaborate with patients
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Health care trends in the U.S.
Webcast Registration Fee:
$195—International Foundation/ISCEBS Members
$255—Nonmembers
Click HERE for more information on how to register.
Collaborative Centers
To receive Center emails, please signup here.
For more information please contact Amy Gibson at agibson@pcpcc.net .
A. Center for Multi-Stakeholder Demonstration
The primary objective of the Center for Multi-Stakeholder Demonstrations (CMD) is to serve as a clearing house for information on Patient-Centered Medical Home (PCMH) pilot efforts around the country that include multiple private sector payers. The CMD will aim to recruit payers to devote covered lives to demonstration projects, while assisting them with demonstrations efforts through sharing of lessons learned and best practices from existing PCMH demonstrations. This will be accomplished by the CMD serving as an information exchange where Plans can discuss innovative reimbursement models to test in pilots as well as program design. The CMD will also be responsible for working with local convening entities to support regional pilots.
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Care Coordination Taskforce -The Care Coordination Taskforce has reconvened their calls and will be discussing future activities and strategies for addressing care coordination in the PCMH. They have received input from PCPCC stakeholders toward the development of an outline for a PCPCC publication on care coordination.
B. Center for Public Payer Implementation
CPPI is tasked with a very broad mandate encompassing over 50% of all payors in the US Healthcare System. Growing out of the work that the Collaborative had undertaken within the Medicaid environment the CPPI is charged with promoting the Patient-Centered Medical Home (PCMH) concept in all facets of the public payer system.
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Task Force on Education and Training - Participants continue to work with co-chairs Cynthia Belar and Libby Baxley to define the goals and activities of this new Task Force. They are focusing on the training and educational needs around PCMH of both the incoming and current workforce, and that of academic faculty across multiple disciplines.The next call will be held on October 19th at 4 p.m. ET
C. Center for Employer Engagement
The Center for Employer Engagement (CEE) promotes large and small employer interest in - and implementation of - the patient-centered medical home (PCMH) model through educational resources, sharing employer best practices, implementation tools, and evaluation measures to demonstrate the value of this strategy and build market demand. Their next call will be held on Wednesday, November 9th at 3 p.m. ET.
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Task Force on Behavioral Health - This Taskforce is collecting best practices and behavioral health screening tools for use in primary care. They are looking for resources to publish a more comprehensive guide to Behavioral Health in PCMH and possibly an on-line database of resources.
D. Center for eHealth
On Wednesday, September 22nd, from 1:00-2:30pm ET, the Center for eHealth co-hosted a presentation with the Center for Public Payer Initiatives entitled: “Health Information Technology and the Indian Health Service ‘Improving Patient Care’ Program." This presentation is available for viewing on the PCPCC web site at: www.pcpcc.net/media
E. Center for Consumer Engagement
The primary objective of the Center for Consumer Engagement (CCE) is to ensure the medical home model is truly patient-centered by: facilitating consumer involvement and leadership in the design and evaluation of the PCMH, strengthening the consumer voice in the PCPCC, and by developing a set of "Best Practices" for consumer engagement in PCMH. The CCE partners with large consumer groups to capitalize on their visibility and existing efforts.
F. Center for Accountable Care (CAC)
The CAC works to ensure that the Patient-Centered Medical Home (PCMH) serves as the foundation for all ACO’s, and that ACO’s thrive as a result of strong robust PCMH support. The center is tasked with strengthening the collaboration between the PCPCC and evolving ACO stakeholders, as well as espousing strategies and positions that strengthen the notion of a strong PCMH foundation for evolving ACO guidelines and practices. The next call of the CAC will be held on Monday, November 14th at 2 p ET.
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