No Weekly Call - Thursday, October 7th, 11:00 AM EDT

(Moderators/Speakers use #0 to mute all participant lines and #1 to unmute.)
A. Register Now! October 21st PCPCC Annual Summit - Exhibiting the Evidence: Advance of the Patient-Centered Medical Home
- PCMH and Accountable Care Organizations
- Standards-Setting and Recognition of the PCMH
- The PCMH Abroad
- Success stories and "lessons learned" from PCMH initiatives in the field
To register, please click here.
B. Richard Gilfillan, MD To Head CMS Innovation Center
Richard Gilfillan, MD, will be the new Acting Director of the new Center for Medicare and Medicaid Innovation (“CMI,” or “Innovation Center”) at the Centers for Medicare and Medicaid Services (CMS), CMS Administrator Don Berwick announced today. Gilfillan currently directs CMS’ performance-based payment policy staff.
The Affordable Care Act gives the Innovation Center the crucial mission of testing “innovative payment and service delivery models to reduce program expenditures…while preserving or enhancing quality of care.” A CMS spokesperson said that Gilfillan was named in an acting capacity to quickly fill a role vital to the implementation of health reform; the spokesperson said he could not at this point provide a timetable for filling the position on a permanent basis.
“As the Acting Director of CMI, Rick will be working closely with the CMS Deputy group and me to develop and implement innovative programs that will help improve and update the nation’s health care delivery systems under the provisions of the Affordable Care Act,” Berwick wrote in an email message to CMS staffers.
Gilfillan accepted the job directing CMS’ performance-based payment policy staff in August. Before joining CMS, Gilfillan was a consultant for Geisinger Consulting Services, where, Berwick wrote, “he provided consulting services to health care systems and payer organizations regarding the design and implementation of innovative care delivery and financing programs including accountable care organizations, patient-centered medical homes and bundled payment systems.”
For more information, please click here.
C. New Deloitte Report Outlines Future of the Medical Home
The Deloitte Center for Health Solutions has released a new issue brief, "Medical Home 2.0: The Present, The Future," outlining the current state of the patient–centered medical home (PCMH) under the new health reform legislation. The report reviews several PCMH pilots and provides insights on the future evolution of the medical home. It highlights the expansion of medical home pilots as part of the Patient Protection and Affordable Care Act of 2010 (PPACA) to help reduce costs and improve population-based health by leveraging clinical information technologies, care teams and evidence-based medical guidelines.
The report states that the medical home model's clinical and economic potential is promising; however, the precise features of an optimally successful program are somewhat elusive. Deloitte's research further indicates the following:
- With significant investment, the PCMH yields results.
- Physician adoption is a major challenge.
- Health Care information technology (HIT) is the essential front-end investment.
- One size does not fit all.
- Access to an adequate supply of primary care service providers is an issue.
- Incentives must be aligned and realistic.
To learn more, please click here.
D. New NASHP Publication - Making Connections: Medicaid, CHIP, and Title V Working Together on State Medical Home Initiatives
The medical home model–an approach to offering excellent primary care–is gaining momentum. A wide range of stakeholders are now embracing medical homes, and the Affordable Care Act has dedicated resources to developing and spreading the model. In this context, states have been leaders in building medical homes – especially for vulnerable populations. Several of the most promising state medical home initiatives have entailed interagency collaboration. This report details best practices and policy considerations for collaborative medical home building in four areas: laying foundations for partnership, and then working together to engage patients and families, engage health care providers and practices, and build strong systems of care. To download the report, please click here.
E. New NASHP Publication - Evaluating the Patient-Centered Medical Home: Potential and Limitations of Claims-Based Data
This State Health Policy Briefing summarizes the advantages and disadvantages of using claims-based data to evaluate patient-centered medical home initiatives. A Medicaid-based medical home initiative in Oklahoma and a multi-payer medical home pilot in Rhode Island are highlighted. Both states are using a mixture of claims-based data and supplementary resources like patient or provider surveys and data collected from electronic medical records to evaluate their medical home programs. Understanding the potential uses and limitations of both claims data and other data sources that can aid evaluators will help states to design appropriate evaluative criteria for their medical home programs. To download the report, please click here.
F. Medicaid Health Plans of America White Paper: Role of Medicaid Health Plans in Patient-Centered Medical Homes
Medicaid Health Plans of America (MHPA) released a policy statement and white paper highlighting the common ground between Medicaid health plans and the patient-centered medical home (PCMH) model. According to MHPA, the capabilities of Medicaid plans are closely aligned with the principles of PCMHs and therefore plans should be included in states' PCMH implementation strategies. MHPA's Policy Statement notes that collaboration between states, medical home providers and health plans is essential for coordinating complex inpatient and outpatient needs of Medicaid beneficiaries.
In Role of Medicaid Health Plans in Patient-Centered Medical Homes, MHPA maintains that Medicaid health plans are well-positioned to support development of a PCMH system for Medicaid beneficiaries. The white paper highlights evidence showing that coordinated, comprehensive primary care as offered in a PCMH can reduce preventable hospitalizations and improve health outcomes. But, the transformation of medical practices into medical homes is time and resource intensive and most medical home demonstrations are in the pilot testing phase. Along with a solid track record of ensuring access to high quality care for Medicaid beneficiaries, health plans have the data, the analytic capability and care management infrastructure to support medical home implementation and aid in physician practice transformation. In partnership with State Medicaid programs, health plans also have the flexibility to adopt payment innovations to reward value.
"The scope of Medicaid health plans - their experience in care coordination, financial management, and quality improvement, as well as their mature data infrastructures for quality and cost reporting in all care settings - makes Medicaid health plans a natural and essential partner with states as they begin to roll out medical homes for the complex and vulnerable populations in their communities," explained Thomas L. Johnson, President and CEO of MHPA. "Medicaid health plans have the capability to link members to primary care physicians, coordinate access to specialists, even facilitate access to care by providing language interpretation services and transportation, a benefit that's especially useful given the unique characteristics of the people they serve."
MHPA encourages states to draw on the valuable experience of Medicaid health plans and include health plans in PCMH implementation strategies. "The Medicaid health plan industry has much to offer and we're looking forward to collaborating with both states and providers to make the PCMH model work to provide better care to Medicaid enrollees," said Mr. Johnson.
To download the paper, please click here.
I. Blue Cross Blue Shield Of Texas Setting Up PCMH Program
Blue Cross Blue Shield of Texas, a state’s largest illness insurer, pronounced Monday it is implementing a module in 5 North Texas counties to improved stress wellness as well as conduct diseases.
The insurer has combined a supposed medical home module with dual disinfectant groups, Medical Clinic of North Texas as well as Village Health Partners, which yield caring for some-more than 20,000 members in Dallas, Denton, Tarrant, Collin as well as Johnson counties.
The tenure medical home refers to a concurrent complement of initial caring physicians, specialists as well as pharmacists pity a patient’s report electronically. Today, a illness caring complement in Texas as well as a republic is mostly fragmented. Patients with ongoing conditions mostly have been treated with colour for any medical sign rsther than than handling a underlying disease, such as diabetes.
Blue Cross is not a initial illness insurer to introduce such a program. In August, Cigna HealthCare voiced a state’s initial commercially sponsored medical home module with Medical Clinic of North Texas to offer 10,000 patients. An estimated 10 percent of those patients have ongoing conditions as well as have a aloft risk of being certified to an puncture room, Cigna said.
Although insurers have been only embracing a medical home concept, hospitals as well as physicians prolonged have pushed for medical homes. Children’s Medical Center in Dallas invested $2 million to begin Physicians for Children as a nonprofit medical-home hospital complement in Aug 2000.
For more information, please click here.
- 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:
- BNY Mellon
- Joslyn Levy & Associates, LLC
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 July 22nd Stakeholder's Working Group Meeting (Boeing and Whirlpool Presentations)
III. Update on September 1st Executive Strategic Planning Working Group Meeting
V. AHIP Link: Model For Primary Care May Cut Diagnostic Errors
A study from the Baylor College of Medicine finds that clinics that adopt the still-evolving patient-centered medical home model for primary care are less likely to perform diagnostic errors. [ RedOrbit | Aug 18, Medical Home, Clinical Affairs, Health & Wellness ]
VI. From AMA News Thursday August 12th - Use of "medical homes" saved Illinois $140 million in FY 2009.
To view the agenda for the CEE call, please click here.
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 July 8th, the Center co-sponsored a webinar with the CMD featuring:
- Joslyn Levy and Dana Stephenson of the NYC Dept. of Health presented on the innovative Primary Care Information Project. The webinar is now posted on the Collaborative's website. There were over 150 participants on the presentation.
On the Center's recent call, on September 24th, the following occured.
Bringing a Consumer Voice to the Work of the PCPCC
Speakers
Center for Employer Engagement [12:10-12:20]
- 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; "> Robert Dribbon- Merck and Co., Inc.
Center for eHealth Information Adoption and Exchange [12:20-12:30]
- 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; "> Jim Crawford- North Shore-Long Island Jewish Health
Center to Promote Public Payer Implementation [12:30-12:40]
- 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; "> Lesley Reeder- Colorado Department of Health Care Policy and Financing
Center for Multi-Stakeholder Demonstration [12:40-12:50]
- 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; "> Shari Erickson- American College of Physicians
Below please find the dates for the various weekly Collaborative phone calls.
- PCPCC National Thursday Calls Phone Number: 712.432.3900 Pass Code: 471334– Thursday, 11 AM EST: 2010 - 7/8, 7/15, 7/29, (no August calls) 9/9, 9/16, 9/23, 9/30, 10/7, 10/14, 10/28, 11/4, 11/18, 12/2, 12/9, 12/16
- General PCPCC Briefings Phone Number: 712.432.3900 Pass Code: 471334 – Monthly - Tuesday, 11 AM EST: 2010 - 5/4, 6/1, 7/13, (no August call) 9/14, 10/5, 11/2, (no December call)
- Center for Multi-Stakeholder Demonstration Phone Number: 712.432.3900 Pass Code: 471334 – Bi-weekly - Tuesday, 2 PM EST: 2010: 5/4, 6/15, (no August calls) 10/5, 11/6, 12/7
- Center for Public Payer Implementation Phone Number: 712.432.3900 Pass Code: 471334 – Monthly - Tuesday, 3 PM EST: 2010 - 5/18,6/15, 7/20, (no August calls) 9/21, 10/19, 11/16, 12/21
- Center for Employer Engagement Phone Number: 712.432.3900 Pass Code: 471334 – Bi-weekly - Wednesday, 3 PM EST: 2010 - 5/12, 6/9, 6/23, 7/14, 7/28, (no August calls) 9/15, 9/29, 10/13, 10/27, 11/10, 12/15
- 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.
- Center for Consumer Engagement Phone Number: 712.432.3900 Pass Code: 471334 – Last Friday of the month, 12pm EST: 4/30, 5/28, 6/25, 7/30, 9/24, 10/29, 12/3
- Taskforce Activity Calls
- Mobile Health Communication and Technology in the PCMH Taskforce - Bi-weekly - Thursday, 2pm EST: 5/6, 5/20, 6/3, 6/17
- Training the Workforce and the PCMH - Bi-weekly - Wednesday, 4pm EST: 5/5, 5/19, 6/16, 6/30, 7/14, 7/28, 9/8, 9/22, 10/6, 10/20, 11/3, 11/17, 12/8
- Care Coordination and the PCMH (to include Transitions in Care, Home Health, Hospice, and Long Term Care) - Bi-weekly - Wednesday 4pm EST: 5/12, 5/26, 6/9, 6/23, 7/21, 9/15, 9/29, 10/13, 10/27, 11/10, 12/1, 12/15
- Integrating Behavioral Health into the PCMH - Bi-weekly - Thursday 10am EST:5/6, 5/20, 6/3, 6/17
-
Medication Management and the PCMH - Calls are scheduled as needed
There are 52 members of the Executive Committee: Aetna; Alere; American Academy of Family Physicians; American Academy of Nurse Practitioners, American Academy of Pediatrics; American College of Physicians; American Osteopathic Association; BlueCross BlueShield; Boehringer Ingelheim; CIGNA HealthCare; CVS Caremark; DMAA: Care Continuum Alliance; Community Health Collaborative;EHE International; Geisinger Health System; GlaxoSmithKline; Health Care Services Corporation; Humana, Inc.; IBM; Interim HealthCare; Johnson & Johnson; Kaiser Permanente; McKesson Health Solutions; MedAssurant; Medco; Medfusion; Merck; Microsoft; MVP Health Care; National Changing Diabetes Program; NextGen Healthcare Information Systems; Novartis; Nurse Practitioners Roundtable; Pfizer; PhRMA; Phytel; Priority Health; PRISM; The Quantum Group; Robert Bosch Healthcare; Robert Wood Johnson Medical School; Sanofi-Aventis; Taconic IPA, Inc.; Thomas Group; Thomson Reuters; TransforMED; UnitedHealthcare; Universal American Corp.; UPMC Health Plan; Walgreens; WellCentive, LLC and Wellpoint.
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)
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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