Call Agenda- Thursday, November 18th, 11:00 AM EDT

(Moderators/Speakers use #0 to mute all participant lines and #1 to unmute.)
A. CMS Introduces New Center for Medicare and Medicaid Innovation, Initiatives to Better Coordinate Health Care
The Centers for Medicare & Medicaid Services (CMS) today formally established the new Center for Medicare and Medicaid Innovation (Innovation Center). Created by the Affordable Care Act, the Innovation Center will examine new ways of delivering health care and paying health care providers that can save money for Medicare and Medicaid while improving the quality of care. CMS also announced the launch of new demonstration projects that will support efforts to better coordinate care and improve health outcomes for patients.
The Innovation Center will consult stakeholders across the health care sector including hospitals, doctors, consumers, payers, states, employers, advocates, relevant federal agencies and others to obtain direct input on its operations and to build partnerships with those that interested in its work. The organization will also test models that include establishing an “open innovation community” that serves as an information clearinghouse of best practices in health care innovation. The Center will also work with stakeholders to create learning communities that help other providers rapidly implement these new care models. As part of this engagement, today, Administrator Berwick and Acting Director Gilfillan, met with stakeholders representing the health care industry, as well as consumers, states, and employers, to discuss the Innovation Center and its planned activities.
CMS also announced several new initiatives to strengthen primary care and better coordinate care for patients.
Eight states have been selected to participate in a demonstration project to evaluate the effectiveness of doctors and other health professionals across the care system working in a more integrated fashion and receiving more coordinated payment from Medicare, Medicaid, and private health plans. Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan, and Minnesota will participate in the Multi-Payer Advanced Primary Care Practice Demonstration that will ultimately include up to approximately 1,200 medical homes serving up to one million Medicare beneficiaries.
To learn more, please click here.
B. University of Michigan Health System Study: PCMH Model Will Demand More Primary Care Physicians
Provisions of new federal healthcare reforms will move the country toward a patient-centered medical home (PCMH) model, but the nation may not have enough primary care doctors to handle the workload, according to a study by the University of Michigan Health System published online ahead of print in the journal Medical Care.
Shifting patients to a medical home care model could save time and money and allow specialists to focus on complex patient care, according to the study, in which researchers examined the implications of redistributing the chronic disease care workload between specialists and primary care physicians under a PCMH model of care.
According to the study, specialists spend a significant amount of time each year—more than 650,000 work weeks collectively—on routine follow-up care for patients with common chronic conditions, such as asthma, diabetes or low back pain. Delegating a proportion of this care could create systemwide efficiencies by freeing up specialists to concentrate on new patients and those with complex conditions.
To learn more, please click here.
C. State Initiatives in Patient-Centered Medical Homes
The majority of state Medicaid programs are testing models of coordinated medical care to improve quality and reduce costs, particularly for patients with multiple chronic illnesses. Known as patient-centered medical homes, the models assure that:
- Each patient has an ongoing relationship with a personal physician who directs all care. The physician is responsible for all the patient’s health care needs, provided by all health care professionals in all stages of the patient’s life.
- Each patient’s care is coordinated and integrated across all parts of the health care system. The physician’s office monitors the quality of care and patient safety for all patients. Patients have expanded access to care through extended hours and new ways to communicate with physicians and other office staff.
- Physicians receive additional payment to support expanded staff and recognize the added value provided to patients.
State Medicaid programs, which provide health insurance for the poor using state and federal funds, constantly strive to cut costs and achieve savings. That’s because Medicaid’s share of total state spending has more than doubled in the past 20 years, reaching nearly 22 percent of all state budget funds.1 States are pursuing patient-centered medical home initiatives as one approach to improving the way health care is delivered while controlling rising health care costs. Based on the premise of rewarding doctors to keep their patients healthy—rather than paying exclusively for treating them when they’re sick, this approach has many supporters, including policymakers, employers, physicians, patients and insurers.
Descriptions of eleven states’ pilot programs or authorizing legislation are included in a breifing from The Council of State Governments. To learn more and to download this report, please click here.
D. Podcast from the Commonwealth Fund - Transforming Safety Net Clinics into Medical Homes
Sandy Hausman reports on the Safety Net Medical Home Initiative, a Commonwealth Fund-support demonstration project designed to help clinics that serve low-income patients become medical homes. To download this podcast, please click here.
E. CareFirst BlueCross BlueShield Now Includes NPs as Independent Primary Care Providers
The Maryland Coalition of Nurse Practitioners (MCNP) and the Nurse Practitioner Association of Maryland (NPAM) have been working with CareFirst to expand quality health care coverage to Maryland citizens. The newly announced expansion of the CareFirst Medical Home to include nurse practitioners as leaders, and/or team members is a serious commitment towards moving Maryland's health care programs forward. Credentialing Nurse Practitioners (NPs) as primary care providers for Blue Choice further shows CareFirst's commitment to providing improved access to high quality health care for their subscribers.
There are over 3500 nationally board certified, state licensed NPs in Maryland who will now be better able to provide both primary and specialty care to people throughout Maryland. For nearly half a century NPs have been providing care and millions of Americans have been selecting NPs for their primary, acute and chronic care needs. This decision by Blue Cross Blue shield will aid in direct access to care and enhance the transparency of the health insurance system.
To learn more, please click here.
F. Health Affairs Article - How Geisinger’s Advanced Medical Home Model Argues the Case for Rapid-Cycle Innovation
The Patient Protection and Affordable Care Act of 2010 provides for a number of major payment and delivery system initiatives. These potential changes need to be tested, scaled, and adapted with an urgency not evident in previous demonstration projects of the Centers for Medicare and Medicaid Services Geisinger Health Plan discusses lessons they have learned through care redesign, specifically from their advanced medical home model, ProvenHealth NavigatorSM. Geisinger has been continuously modifying the model to improve quality and value. They suggest that the most important component in their medical home model has been embedding nurse case managers into community practices and using real-time feedback from their patients on the use of health services. To read the full article, please click here.
I. Job Opening at American Academy of Family Physicians (AAFP)
The American Academy of Family Physicians is recruiting for a new position to take organizational lead for its patient-centered medical home activities. A qualified candidate will have excellent project management, communication and leadership skills and a passion for helping family physicians transform their practices in anticipation of a more value-driven future. Those interested in this exciting opportunity can learn more about the position and apply on line at: http://www.aafp.org/online/en/home/careers/staff/job22-10.html.
- Outline how health care reform rewards the PCMH model of care
- Evaluate pros and cons of the PCMH
- Debate payment reform and impacts on the PCMH
- Understand how to align incentives for collaboration and success
- Learn the importance of assessment and identifying gaps to see ways to eliminate waste using LEAN
II. Important Links
October 22 Annual Summit Materials - click here
- PCPCC Stakeholders' Working Group Meeting - Tuesday, March 30, 2010
- PCPCC Stakeholders' Working Group Meeting - Thursday, July 22, 2010
-
PCPCC Annual Summit - Thursday, October 21, 2010
The Collaborative would like to welcome the following groups as the newest signing members of the PCPCC:
- Astra HR
- Cine Learning Productions
- Ernst & Young
- Family Medical Center of Torrance
- South East Texas Health Access Network
V. PCMH in the Press
- Center for Multi-Stakeholder Demonstration: Identify community-based sites to test and evaluate the concept; share information and best practices about pilots within a collaborative community; and serve as the connector to technical, quality improvement and education resources to facilitate ongoing demonstrations.
- Center to Promote Public Payer Implementation: Assist public payers as they implement and refine programs to embed the Patient-Centered Medical Home model by offering technical assistance; sharing best practices and giving guidance on the development of successful funding models.
- Center for Employer Engagement: Create standards and buying criteria to serve as a guide and tool for large and small employers/purchasers in order to build the market demand for adoption of the Medical Home model.
- Center for eHealth Information Adoption and Exchange: Evaluate use and application of information technology to support and enable the development and broad adoption of information technology in private practice and among community practitioners.
- Center for Consumer Engagement: Engage the consumer in awareness activities through three ways: day-to-day operations, messaging and pilots. The center will continue the use of “Patient-Centered Medical Home”, but focus on how the concept and its components are communicated to the public and partner with large consumer groups to capitalize on their visibility and existing efforts.
B. Center to Promote Public Payer Implementation
I. Introductions
C. Center for Employer Engagement
Introductions
Co-Chairs: Duane Putnam, Pfizer, Inc.; Bruce Sherman, MD, The Goodyear Tire & Rubber Company; Robert Dribbon, Merck & Co., Inc.
I. Introductions
Co-Chairs: Duane Putnam, Pfizer, Inc.; Bruce Sherman, MD, Whirlpool Corporation; Robert Dribbon, Merck & Co., Inc.
II. Update on PCMH Metrics work for employers and other purchasers (Measuring the impact of PCMH on healthcare utilization, cost, quality, absenteeism, presenteeism and employee health status.)
III. General Mills MyMedsManagement Outcomes Victoria Losinski, Pharm.D., Ph.D. Candidate Director of Implementation Medication Management Systems, Inc. (Presentation Attached)
The Center for eHealth Information Adoption and Exchange will serve a number of related functions. The first will be to act as a clearinghouse for information concerning the national development of various Health Technology system platforms and electronic delivery platforms for medical records. The second task is to coordinate national education concerning the importance of HIT/EMR developments to both providers and consumers of health care. The final task of the Center will be to elucidate the integral role of HIT/EMR development within the specific context of the Patient-Centered Medical Home model and expand upon the provision with the Joint Principles of the Patient-Centered Medical Home as agreed to by the ACP, AAFP, AOA, and AAP.
On November 11th, the Center held a webinar featuring:
- Health Information Technology Framework for Population Health Management
On the Center's recent call, on October 29th, the following occured.
ssessing Patient-Centered Medical Homes from the Patient’s Perspective: Developing the CAHPS® PCMH Survey [12:10-12:30]
Speaker
Patricia M. Gallagher- Senior Research Fellow, Center for Survey Research, University of Massachusetts Boston
Trish Gallagher, a medical sociologist, is a Senior Research Fellow at the Center for Survey Research at UMass Boston and a member of the Yale CAHPS Team. She is a long-time contributor to the CAHPS project, serving on the Instrument Development Team. Trish talked about both the development of the CAHPS Patient-Centered Medical Home survey instruments and the focus group she conducted with parents whose children are patients at MGH’s Coordinated Care Clinic.
Below please find the dates for the various weekly Collaborative phone calls.
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> PCPCC National Thursday Calls Phone Number: 712.432.3900 Pass Code: 471334– Thursday, 11 AM EST: 2010 - 11/4, 11/18, 12/2, 12/9, 12/16; 2011 - 1/6, 1/13, 1/20, 1/27, 2/3, 2/10, 2/17, 2/24, 3/3, 3/10, 3/17, 3/24, 3/31, 4/7, 4/14, 4/21, 4/21, 4/28, 5/5, 5/12, 5/19, 5/26, 6/2, 6/9, 6/16, 6/23, 6/30, 7/7, 7/14, 7/21, 7/28, (no August calls) 9/1, 9/8, 9/15, 9/22, 9/29, 10/6, 10/13, 10/20, 10/27, 11/3, 11/10, 11/17, 12/1, 12/8, 12/15.
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> General PCPCC Briefings Phone Number: 712.432.3900 Pass Code: 471334 – Monthly - Tuesday, 11 AM EST: 2010 - 11/5, (no December call); 2011 - Monthly – Tuesday, 11 AM EST: (no January call) 2/1, 3/1, 4/5, 5/3, 6/7, 7/5, (no August call) 9/6, 10/4, 11/1 (no December call).
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> Center for Multi-Stakeholder Demonstration Phone Number: 712.432.3900 Pass Code: 471334 – Bi-weekly - Tuesday, 2 PM EST: 2010: 12/7; 2011 - Quarterly - Tuesday, 2 PM EST: 3/1, 6/7, 9/6, and 12/6.
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> Center for Public Payer Implementation Phone Number: 712.432.3900 Pass Code: 471334 – Monthly - Tuesday, 3 PM EST:2010 - 11/16, 12/21; 2011 - Tuesday, 3 PM EST: 1/18, 2/15, 3/15, 4/19, 5/17, 6/14, 7/19, (no August calls) 9/20, 10/18, 11/15, 12/20.
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; ">
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> Center for Employer Engagement Phone Number: 712.432.3900 Pass Code: 471334 – Bi-weekly - Wednesday, 3 PM EST:2010 - 11/10, 12/15; 2011, Monthly- Wednesday, 3 PM EST – 2nd Wednesday of the Month: 1/12, 2/9, 3/9, 4/13, 4/27, 5/11, 5/25, 6/8, 7/13, (no August calls) 9/14, 10/12, 11/9, 12/14.
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> Center for eHealth Information Adoption and Exchange Phone Number: 712.432.3900 Pass Code: 471334 – Monthly - Thursday, 1 PM EST – 2nd and 4th Thursday of the Month: 2010 - 5/13, 5/27, 6/10, 6/24, 7/8, 9/9, 9/23, 10/14, 10/28, 11/11, 12/9, 12/23; 2011 - Thursday, 1 PM EST – 2nd Thursday of the Month: 1/13, , 2/10, 3/10, 4/14, 5/12, 6/9, 7/14, 9/8, 10/13, 11/10, 12/8.
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> Center for Consumer Engagement Phone Number: 712.432.3900 Pass Code: 471334 – Last Friday of the month, 12pm EST: 12/3; 2011, Monthly - Friday 12pm EST: 1/28, 2/25, 3/25, 4/29, 5/27, 6/24, 7/29, (no August calls) 9/30, 10/28, 11/18, 12/16.
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> Taskforce Activity Calls
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> Training the Workforce and the PCMH - Bi-weekly - Wednesday, 4pm EST:
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> Care Coordination and the PCMH (to include Transitions in Care, Home Health, Hospice, and Long Term Care) -
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> Integrating Behavioral Health into the PCMH - Bi-weekly - Thursday 10am EST:
- http://www.pcpcc.net/sites/all/themes/pcpcctheme/images/raquo.png); background-attachment: initial; background-origin: initial; background-clip: initial; background-color: initial; list-style-image: none; list-style-type: none; background-position: 0% 0.833em; background-repeat: no-repeat no-repeat; "> Medication Management and the PCMH - Calls are scheduled as
There are 61 members of the Executive Committee:
Abbott; Aetna, Inc; Alliance for Home Health Quality and Innovations; AllScripts; American Academy of Family Physicians; American Academy of Nurse Practitioners; American Academy of Pediatrics; American College of Physicians; American Osteopathic Association; AMERIGROUP Community Care; Amgen; BlueCross BlueShield; Boehringer Ingelheim; Bon Secours Medical Group; Bristol-Myers Squibb; CIGNA HealthCare; CVS Caremark; DMAA: Care Continuum Alliance; EHE International; Geisinger Health Plan; GlaxoSmithKline; Healthcare Facilities Accreditation Program; Healthways; Hooper Holmes; Humana, Inc.; IBM; Interim HealthCare, Inc; Intuit Health Group; Johnson & Johnson; The Joint Commission; Kaiser Permanente; King Pharmaceuticals, Inc; Lilly USA; Living Well for Coca-Cola North America; McKesson Corporation; MedAssurant, Inc.; Medco; Merck & Company; Microsoft; MidMichigan Health; MVP Health Care; National Changing Diabetes Program (Novo Nordisk); NextGen Healthcare Information Systems; American College of Nurse Practitioners; National Association of Pediatric Nurse Practitioners; Pfizer; Philips Healthcare; PhRMA; Phytel; Priority Health; PRISM; Robert Bosch Healthcare; Sanofi-Aventis; Taconic IPA, Inc.; Thomson Reuters; TransforMED; The TriZetto Group; UnitedHealthcare; Universal American Corp.; UPMC Health Plan; Walgreens; and Wellpoint, Inc.
Co-Chairs: Dr. David Nace, McKesson Health Solutions (David.Nace@mckesson.com), William Rollow, IBM (wrollow@us.ibm.com), Dr. James Crawford, North Shore-Long Island Jewish Health System (JCrawford1@NSHS.edu), and Jeff Hanson, Thomson Reuters (jeffrey.hanson@thomsonreuters.com)
Executive Director - Chris Nohrden (cnohrden@hughes.net)
Four New Center Task Groups:
- Participatory Engagement - Lead: Steve Adams (sadams@rmdnetworks.com)
- HIT Resource Center - Lead: Jim Crawford (JCrawford1@NSHS.edu)
- Meaningful Use - Lead: William Rollow (jmarchibroda@us.ibm.com)
- Decision Support - Lead: Pete Martinez (pmartinez@quantummd.com)
- Christine Bechtel - National Partnership for Women & Families
- Julie J. Martin, MS - Stoeckle Center for Primary Care Innovation
- Warwick Charlton, MD - Medfusion
There are 20 member organizations of the advisory board and they are: AARP, American Academy of Communication in Healthcare, American Board of Internal Medicine, American Department of Family Medicine, American Society of Consultant Pharmacists, Association of Medical Education and Research in Substance Abuse, Brian Klepper, Bridges to Excellence, The Center for Excellence In Primary Care, The Center for the Advancement of Health, The Commonwealth Fund, eHealth Initiative, HR Policy Association, the John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital, the Massachusetts Health Data Consortium, Medication Management Systems, National Association of County and City Health Officials, National Business Coalition on Health, National Business Group on Health, the National Council for Community Behavioral Healthcare. We are considering additional advisory board representatives from state based groups and labor organizations.
Edwina Rogers
Executive Director
Relja Ugrinic
Director of Operations and External Affairs
Patient-Centered Primary Care Collaborative
The Homer Building
601 Thirteenth Street, NW, Suite 400 North
Washington, DC 20005
Edwina Direct: (202) 417-2081
Edwina Cell: (202) 674-7800
Relja Direct: (202) 724-3332
Relja Cell: (703) 585-9165
Fax: (202) 393-6148
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