Download - MiPCT Webinar 6/20/2012
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MEDICAL NETWORK ONE
PRIMARY CARE PHYSICIAN
AND PRACTICE TEAM WEBINAR
JUNE 20, 2012
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Welcome and Acknowledgements
Online Introductions
Current PCP membership
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Welcome and Acknowledgements
Dedicated PCMH Implementation Team
BCBSM PCMH Designations
Behavior Health recruitment
Provider and Health Plan Outreach
Organized Systems of Care
Specialist Contracts
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Congratulations: 2012 BCBSM PCMH Designations
• Everett Campbell • Douglas Hames, MD • Elzbieta Rozmiej, MD • Pam Cox, MD • Al Juocys, DO • Shalija Rastogi, MD • Elena Stephan, MD • Namir Stephan, MD • Rick Poston, DO • Michelle Pavlik, DO
• James Miller, DO • Tedd March, DO • Solon L. Alimario, MD • Anthony Clarke, MD • Alfred Newton, MD • Roy Elrod, MD • Katrice Herndon, MD • Nichole Massie, MD • Lennox Pike, MD • Ralph E. Williams II, MD
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Congratulations: 2012 BCBSM PCMH Designations
• Richard Fici, DO • Polly Schmidt, DO • Kevin Klein, DO • Thomas Mianecki, DO • Karl Emerick, DO • David Ginnenbaugh, MD • Thomas Horrigan, MD • Ashraf Barry, MD • Anna Fraymovich, MD • Antoun Oska, MD
• James Miller, DO • Ia Y. Kue, MD • Bruce Johnson, DO • Susan Tam, DO • Abdul Kabir, MD • John Pradko, MD • Curtis LaJoie, DO • Taras Lisovsky, DO • John Floreno, DO • Robert Moretzky, DO
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Congratulations: 2012 BCBSM PCMH Designations
• David Everingham, DO • Craig Everingham, DO • Gregory Henk, DO • Vesna Evkoska, DO • Ricardo Cabrera, MD • Fayes Shukairy, MD • Jeetender Matharu, MD • Ronald Williamson, MD • Stephen Bell, DO • Samar El-Achkar, MD
• Stephanie Lucas, MD • Logan Oney, MD • Maan Askar, MD • Steven Zalla, DO • James Kohlenberg, MD • WSU FP • WSU IM-5B • WSU IM-4C
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Goals and Purpose of Webinars Restated
Provide information about ongoing company
endeavors both internal and external
Describe to your colleagues and practice teams
what we do and what we are striving for
Identify 3rd quarter goals
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Goals and Purpose of This Webinar
Present an overview of the following:
• CMS Demonstration Project (MiPCT)
• Diabetes Cell Phone Project
• Behavior Health Initiative
• Organized System of Care Activities
• Care Manager and Population Manager Training
Draw comments and input regarding:
• Communication efforts
• Collaborative efforts
• Initiatives
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Current Activities – Care Teams
Adult
Adolescent/Pediatric
R-Team (Pediatric Healthy Lifestyle)
Behavior Health
DSME
Worksite Wellness Programs
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Collaborative Activities
Mackinac Learning Collaborative III
Preparation for MLC IV
Practice Coaching
LEAN Coaching
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Enterprise Wide Activities
Dedicated PCMH Implementation “A” Team
Organized Systems of Care
Specialist Agreements
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Enterprise Wide Activities
IMPACT Model co-training with WSUPG Team
Monthly Specialist Focus Group Meetings
Quarterly Cluster Meetings
Complex Care Manager Training
Moderate Care Manager training
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Internal Activities
Medical Management
Physician Recruitment, Contracting and Retention
Quality Improvement
IT revamping
AADE audit
Staff training and education
HAP Contract
OMNICARE Contract
Blue Complete Contract
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Current Activities - Ongoing
MiPCT
CDSMP - PATH
Diabetes Crossover
Matter of Balance
Mindful Eating
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Clinical Activities
Patient Registry
ePrescribing
Generic Use Rate
QI Activities to Improve Quality Scores
MUSIC: WSUPG Committee Member
Cardiology: WSUPG Committee Member
Transitions of Care
Organized Systems of Care
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MiPCT: CMS Demonstration Project
PCMH designated practices for 2 years
Practice transformation payments
Participating health plans contribute $3.00 PMPM
to the incentive program pool
Performance incentive metrics in place
PO scores will be ranked from high to low and
placed into payment deciles, ranging from 82% to
118% of the mean payment
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MiPCT: MNO
Clinical leadership support
Care Manager Support
Implementation of tools and care processes that
enable the primary care practices to achieve
practice transformation
Analytical support with generation of reports to
measure transformation progress
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MiPCT: MNO and PCP
RN, MSW, PA-C and APRN care managers within
primary care practice settings
• Geisinger
• University of Massachusetts
• PTI
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MiPCT: MNO and PCP
Develop processes that enable primary care
practice teams to engage patients and their
caregivers and/or families, as appropriate, in their
own care through:
Care management
Self-management support
Navigation and coordination of care
Effective transitions of care
Linkage with community resources
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MiPCT: PCP
Develop processes that enable collaborative team
care
Enhance access to quality care through:
Same day appointments
After hours care
Electronic access to care: email, e-visits
Patient portal
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MiPCT: Deliverables
Year One: Develop primary care practice
infrastructure including enhanced access, all
patient registry system and embedding care
managers within the primary care practices
Year Two: Optimize care management, improve
quality metrics and avoid high cost care
Year Three: Achieve the “Triple Aim” of improved
quality of care, improved patient and primary
healthcare team experience of care and reduced
/stabilized costs of care
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MNO Engagement
Travel Team
• Behavior health
• RN
• Dietitians
• Exercise specialists
Medical Management
Care Management
Quality Improvement
IT
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Our Enterprise… It’s Up To You Now
What do we need to move forward effectively?
What evidence do we have to prove that our work
is making a difference?
What evidence do we have to prove that our work
made a difference?
Have we shared the results of our work beyond
our organization?
How can we share the results of our work beyond
our organization?
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Vision… Revision Required
To be recognized and respected as the premier
independent healthcare organization in Michigan
that offers community-based inter-professional
patient-centered/family-centered quality care.
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Ask Yourself This Question…
I know what action steps our organization is taking
next as a result of today’s meeting.
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