Session 11b: Linking PopulationHealth and MedicalManagement   CDR James Ellzy, MD, CMQ   Teaching Faculty, DeWitt Army Fam...
Outline • MTF Utilization of Population Health • MTF Utilization of Medical Management • TMA Resources                    ...
11-311b - 3
Population Health - Outcomes    Where we were...                Where we are moving…   FOCUS ON DISEASE                   ...
Why do we care?  • Because leadership is tracking it…  • Gaps exist in quality of care…  • Persons with disease/risk cost ...
11-6
Population Identificationand Assessment     Identification              Assessment                       Data resources•  ...
11-8
Demand Forecasting •   Requires:      • Accurate population identification (size, gender, age)      • Knowledge of:       ...
11-10
Demand Management•   A collection of proactive interventions focused on reducing unnecessary    health care utilization wh...
11-12
Capacity ManagementMatching the quantity and  quality of healthcare services • Provider availability  provided at the MTF ...
11-14
Evidence-Based Careand Prevention• The provision of healthcare using a  systematically developed, research-based  approach...
Evidence-BasedHealthcare Goals• Improved Quality of Life                  SCENARIO:                                       ...
11-17
Program Evaluation & Feedback • Implementing Clinical Practice Guideline (CPG) is   NOT enough • Measure outcomes to evalu...
Medical Management Model                           11-19
Case Management (CM)• Definition:  • A collaborative process under the Population Health    continuum that assesses, plans...
Case Management (CM)• Goals:  • Promote quality, safe, and cost-effective care.  • Promote utilization of available resour...
Case Management (CM)The MHS has three primary goals for CM:• Improve the care, management, and transition of recovering Se...
Utilization Management (UM)• Definition:  • An organization-wide, interdisciplinary approach to    balancing cost, quality...
Utilization Management (UM)• Goals:  • Maintain the quality and efficiency of healthcare    delivery by:     • Providing p...
Disease Management (DM)•   Definition:    • An organized effort to achieve desired health outcomes in      populations wit...
Disease Management (DM)• Goals:  • Improve clinical outcomes  • Increase patient and provider satisfaction,  • Promote app...
Medical ManagementGuidance • Department of Defense Instruction (DoDI) 6025.20   (dated Jan 2006) • Population Health/Medic...
Milliman Inpatient& Outpatient Guidelines• Enterprise-wide license for evidence based guidelines that  supports outpatient...
Milliman Inpatient& Outpatient Guidelines   Ambulatory Care:     Imaging & Diagnostic Testing     DME & Injectables       ...
Military Health System Toolsand Resources• MHS Population Health Portal (MHSPHP) on  CarePoint  • Highlights importance of...
Questions?             11-31
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Session 11B - Increasing MTF Effectiveness & Efficiency

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  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 This DOD model looks very linear – depicts in one graph: Population Health and Medical Management. This spans the entire spectrum/continuum. New model (as shown) replaces the Broad Spectrum Case Management Model in Medical Management Guide. Emphasize spectrum/continuum of health and care. As the focus moves toward illness/impairment, a more individualized approach is required (i.e. CM) Recently added: color shift, Prevention, and Palliative Care – many WII SM have chronic pain & issues requiring palliative care. It includes a health continuum which emphasizes the role of Case Management, Primary, Secondary, and Tertiary Prevention, and Outcome Measures in Broad-spectrum Case Management. It includes a health continuum which emphasizes the role of Case Management, Primary, Secondary, and Tertiary Prevention, and Outcome Measures in Broad-spectrum Case Management.
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 This is an illustration of the Population Health focus on Health and Prevention and a shift from focusing on episodic care and focus on disease. Note elements listed under the focus on Health (CPGs, demand mgmt, referral mgmt, and CM) Emphasis on prevention = decreased costs associated with disease prevented.
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 Because it’s the right thing to do……. Because our leadership is tracking it………
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 This is the DoD framework/model – the “Population Health Improvement Model” Population Health: is a systematic way of delivering proactive, effective, and efficient evidence-based healthcare in partnership with the community and out beneficiary population. Through PH strategies, you increase quality of care, lower costs, and improve health. This model is made up of 6 clinical and business process elements. The Department of Defense (DoD) PHI Plan provides guidance in support of a uniform health care system based on systematic business and clinical decision processes. This plan is a framework based on four main assumptions: 1. The delivery of “user-friendly,” quality patient care is critical for the MHS success. 2. Assimilation of best available evidence, judgment and experience are necessary to stay competitive. 3. The best allocation of scarce resources will be achieved through the systematic application of continuously improving standards of care, and is paramount for survival. 4. Ideal delivery of health care within the MHS depends on leveraging the capacity of contract partners with the direct care system. This Figure shows the overall process involved with PHI. It demonstrates the relationship of the various process elements associated with PHI to the completion of the MHS mission. There are two factors to the equation: the demand on the system and the capacity of the system to complete the mission. Basic laws of economics state that there is a gap that will exist between these two factors. Doctrine or management paradigms exist to minimize this gap. Detail regarding each component of this model will be presented to you in future sections of this Population Health Module
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 The first question to be answered in identifying the population is “ Who is the population?” - Look at age, gender, ben cat, risk factors, disease burden Assessment: do you have tobacco users? Heavy alcohol users? Depression diagnosis – could benefit from CM?, High utilizers - 10 or more outpatient visits, an ER visit or inpatient admissions? Sub-questions include …… who is an eligible beneficiary? NOT JUST WHO SHOWS UP FOR APPTS IN THE CLINIC! WHAT ABOUT THOSE YOU DO NOT SEE? They may have undiagnosed, or poorly managed chronic illnesses! Tools to help identify the population : DEERS M2: MHSPHP Dental Navy - DENCAS: Dental Common Access System Army - CDA: Corporate Dental Application Air Force - DDSW: Dental Data System-Web
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 * Demand forecasting is an estimate the volume of care required by a given population. It requires accurate identification of the population in terms of size, age, gender, location and ID Health care needs of the population (including immunizations & other clinical preventive services) - How many women greater than 42yo? – will need mammos - How many children? Will be able to forecast the needs for immunizations and well child check ups Prevalence of condition/disease within the population & clinical practices used to treat a given condition/disease Operationally defined & system-required demands (includes pre-deployment requirements, physical exams, overseas screening, etc.) Demand forecasting lets the medical management team determine the staffing and budgets required to provide acute care, chronic care, clinical preventive services, and health promotion programs for the population Demand forecasts help the disease manager determine : Prioritize programs Collaborate with leadership, medical management staff, and stakeholders on staffing and resource needs. Proactively prepare to meet needs of beneficiary population Establish budgetary requirements
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 Refers to proactive interventions aimed at reducing unnecessary healthcare utilization while encouraging the use of appropriate healthcare resources Demand Management strategies include…… Consider tracking who is calling for what types of appts, and when do they want them (pm clinics?), and possibly with which provider Evaluate PCM assignments to assess the right patient mix for the provider role and patient distribution among providers Encourage the use o f effective decision support (CPGs) and self management tools , thus enabling beneficiaries to use healthcare resources appropriately. Use of demand management strategies will decrease the need for urgent episodic care. Focus is on prevention of illness and injury. Manage Demand through UM/UR
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 * *THINK CLINIC MANAGEMENT MTF capacity must be linked to best clinical and business practices Capacity management includes : Implementing proactive vs. reactive strategies Managing the clinical processes—\\clarify staff roles & responsibilities Controlling leakage to the network Optimizing supply and demand Reducing excess needs if possible Increasing throughput of the system by improving processes (i.e., do things right) Using evidence-based practices (i.e., do the right things) TOOLS : Template analysis tool (TAT) available in the TOC CPGs or decision support tools Coordination of referrals and utilization (UM and RM) Clinic Managers (trained – courses available) Clinic support staff to optimize clinicians time with patients Shared Appointments:
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 The Foundation of Quality Care = Evidence-based Care Evidence-based prevention is provided at three levels. Primary : *** *patient education , Health Promotion and Protection (e.g. PHA, immunizations) Example of diabetic: exercise and diet can help prevent secondary diabetes for those who have a family history or are otherwise predisposed Secondary : *** Screening, Early Detection and Case Finding (e.g. Hypertension, Caries, Cancer Screening) Example: predisposed, family history of diabetes – test blood sugars periodically Tertiary : Treatment, Keeping the disease/condition from worsening, and Rehabilitation (e.g. Diabetes, Asthma) CPGs are used here Diabetes: keep A1Cs under 9 CPGs – the foundation of a successful DM program.
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 These are the GOALS of evidence-based healthcare
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 it is imperative to measure the effects of your interventions . We live in a world that is data and outcomes driven. You must measure your data in order to evaluate your program. PHP is the tool that will be used by Services to measure the required clinical quality metrics . It is the same for all MTFs, and the plans are that these metrics will be pulled OUTSIDE of identify and manage high-risk the MTF (e.g., HSO or NEHC) ·        Are the interventions having a positive impact on utilization trends, health outcomes, and medical costs? (es: have ED visits decreased? Are CPS increasing?) ·        What is the MTF doing to proactively improve the health of beneficiaries? ·        What variance analyses are used to measure a program’s success (i.e., ascertain if interventions, such as if CPGs are improving care)? Healthy People 2010 Leading Health Indicators Physical Activity Overweight and Obesity Tobacco Use Substance Abuse Responsible Sexual Behavior Mental Health Injury and Violence Environmental Quality Immunization Access to Care
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 This model has been in place for a few years now – this model looks at the administrative or practical application approach rather than a spectrum of disease approach. Depicts both the direct care and purchased care service. It is a bi-directional responsibility. UM, CM, and DM are the 3 components of Medical Management - all intertwined. THE OUTCOMES of a MM program: quality is at the center , Appropriate, efficient cost And satisfactory access…… readiness makes us (military) unique.
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 Focus is on meeting the care needs of individuals with catastrophic, complex cases/conditions (vice the population/groups) – Should be accomplished in a collaborative fashion with all involved in the case (the entire team: social workers, behavioral health, personnel etc) 6 steps of CM Process (inbedded in the definition): Assess Plan Implement Coordinate Monitor evaluate
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 Focus is on meeting the care needs of individuals with catastrophic, complex cases/conditions (vice the population/groups) – Should be accomplished in a collaborative fashion with all involved in the case (the entire team: social workers, behavioral health, personnel etc) 6 steps of CM Process (inbedded in the definition): Assess Plan Implement Coordinate Monitor evaluate
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 THE 6 RIGHTS : The right patient The right care The right provider the right time the right place The right cost The ultimate goal of UM is: quality healthcare provided efficiently, and at the appropriate level of care. ******* Resource Mgmt meets Quality The 12 step UM process is the quality improvement process used to gather info through data analysis. UM looks at the cost of services and how people access them along with the utilization rates.
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 THE 6 RIGHTS : The right patient The right care The right provider the right time the right place The right cost The ultimate goal of UM is: quality healthcare provided efficiently, and at the appropriate level of care. ******* Resource Mgmt meets Quality The 12 step UM process is the quality improvement process used to gather info through data analysis. UM looks at the cost of services and how people access them along with the utilization rates.
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 DM programs use interventions that are evidence-based to direct the patient’s plan of care. DM programs also equip the patient with information and a self-care plan to manage one’s own wellness and prevent complications. Self management is the 4 th step in DM. MTFs see decrease service demand and increased medication adherence. Self talk principle: you believe what you hear yourself say. Disease Management Goals - Standardize care - Empower patients to live healthier lifestyles through patient education and self management strategies - Decrease costly emergency visits and inpatient stays - Improve appropriate medication and treatment usage DM in the MHS: CHF and Asthma started in 2006, Diabetes added 2007. Planning the implementation of COPD (Jun), Depression/anxiety (Oct), and cancer screening.
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 DM programs use interventions that are evidence-based to direct the patient’s plan of care. DM programs also equip the patient with information and a self-care plan to manage one’s own wellness and prevent complications. Self management is the 4 th step in DM. MTFs see decrease service demand and increased medication adherence. Self talk principle: you believe what you hear yourself say. Disease Management Goals - Standardize care - Empower patients to live healthier lifestyles through patient education and self management strategies - Decrease costly emergency visits and inpatient stays - Improve appropriate medication and treatment usage DM in the MHS: CHF and Asthma started in 2006, Diabetes added 2007. Planning the implementation of COPD (Jun), Depression/anxiety (Oct), and cancer screening.
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 Useful in primary care setting to ensure care is given there before referring up to specialty care can be used for imaging, diagnostic testing, rehab services, ambulatory surgery, immunizations, injectables, referrals Onsite training: instructor led onsite training sessions in the North, South, and West regions. Each Region will host 2 training sessions/year. And Virtual Classroom training available.
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010 MHSPHP – population identification, tracking outcomes, compliance with evidence-based practice New system update/revision expected in Oct 09 Changing the provider interface to make it faster and increase capabilities Working to have Excel in the website (vice opening Excel separately) Labs, Xrays, and Mammograms will be updated/refreshed every 72 hrs vice monthly PHP data is the source for reporting an MTFs clinical performance in the Business planning tool. CPGs help standardize DM (and other PH/MM processes) and may be used as a framework for evaluating interventions.
  • Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery January 2010
  • Session 11B - Increasing MTF Effectiveness & Efficiency

    1. 1. Session 11b: Linking PopulationHealth and MedicalManagement CDR James Ellzy, MD, CMQ Teaching Faculty, DeWitt Army Family Medicine Residency & Immediate Past Director of MHS Clinical Quality james.ellzy@amedd.army.mil 11-1
    2. 2. Outline • MTF Utilization of Population Health • MTF Utilization of Medical Management • TMA Resources 11-2
    3. 3. 11-311b - 3
    4. 4. Population Health - Outcomes Where we were... Where we are moving… FOCUS ON DISEASE FOCUS ON HEALTH • Sub optimal satisfaction • Enrollment • Increase appropriate access • Appointment system • Improve population health • Claims processing • Enroll and assess needs • Sub optimal points of access • Primary disease/injury prevention • Advice/Triage/E.R. • Clinical practice guidelines • Highly episodic utilization • Demand management • Many unplanned visits • Referral management • Lack of continuity • Case management • Decreased “health status” • Ensure continuity of care • Increased satisfaction & loyalty INTERVENTION PREVENTION 11-4
    5. 5. Why do we care? • Because leadership is tracking it… • Gaps exist in quality of care… • Persons with disease/risk cost more… • We work in a financially constrained environment • Improves outcomes, productivity, satisfaction 11-5
    6. 6. 11-6
    7. 7. Population Identificationand Assessment Identification Assessment Data resources• Who are… • What is the health • Medical record reviews • The eligible status? • Health risk assessment beneficiaries? • What are the lifestyle • Health related behavior• Who is… risk factors (behaviors)? survey • Enrolled to the MTF? • Who needs clinical • MHS Population Health• Who is… preventive services? Portal • Enrolled to your • What is the prevalence clinic? of chronic disease?• Who is… • Who are the high SCENARIO: utilizers of services? Who is the • Being seen in your clinic? population at each of your three MTFs? 11-7
    8. 8. 11-8
    9. 9. Demand Forecasting • Requires: • Accurate population identification (size, gender, age) • Knowledge of: • Health care needs of the population (imms & other CPS) • Prevalence of disease/conditions within the population • Clinical practice guidelines (including VA/DoD CPGs) • Operationally defined & system-required demands (pre- deployment requirements, physical exams, overseas screening, etc.) • Resources: • Utilization Reviews (historical data such as chart reviews and M2 queries) • Demand Forecasting models 11-9
    10. 10. 11-10
    11. 11. Demand Management• A collection of proactive interventions focused on reducing unnecessary health care utilization while encouraging the appropriate use of health care resources.• Strategies: • Increasing SELF-CARE Strategies & Patient Education • PCM Assignments (Right patient mix & distribution) • Nurse Triage • Message Center SCENARIO: • Making the most of every visit How could • Immunizations at acute visits Colonel Smith’s • Oral prophylaxis at dental exam appointment utilization have • Medication refills at every visit been better • Optimizing ALL team members managed? 11-11
    12. 12. 11-12
    13. 13. Capacity ManagementMatching the quantity and quality of healthcare services • Provider availability provided at the MTF with the • Provider type needed needs of the population. • Support staff • Ancillary supportFactors affecting capacity requirements Management: • Readiness requirements• Patient demand • Physical space• Appointment types • Equipment needs • Open Access • Group Appointments SCENARIO: Any pertinent issues discussed yesterday afternoon? 11-13
    14. 14. 11-14
    15. 15. Evidence-Based Careand Prevention• The provision of healthcare using a systematically developed, research-based approach • Identifies people with or at risk for chronic disease• Provides patients & families: • Evidence-based information & tools (e.g. CPGs) • Multidisciplinary team to follow plan of care • Referral to resources, as needed (e.g., case management, disease management) • Health promotion and/or patient self-management education 11-15
    16. 16. Evidence-BasedHealthcare Goals• Improved Quality of Life SCENARIO: What 3 chronic • Higher Functional Status diseases of Col • Self-Management Smith do we have VA/DoD CPGs? • Fewer Hospitalizations/Acute Visits• Improved Quality of Care • Reduced variation• Decreased Costs  More Resources Available for Prevention Strategies 11-16
    17. 17. 11-17
    18. 18. Program Evaluation & Feedback • Implementing Clinical Practice Guideline (CPG) is NOT enough • Measure outcomes to evaluate your program’s processes and performance • Service required clinical metrics • Use the Population Health Portal on CarePoint • National benchmarks (examples) • Healthcare Effectiveness Data and Information Set (HEDIS®) • Healthy People 2020 • Joint Commission-ORYX 11-18
    19. 19. Medical Management Model 11-19
    20. 20. Case Management (CM)• Definition: • A collaborative process under the Population Health continuum that assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual’s health needs through communication and available resources to promote quality, cost-effective outcomes. • DoD Medical Management Guide 2009 11-20
    21. 21. Case Management (CM)• Goals: • Promote quality, safe, and cost-effective care. • Promote utilization of available resources to achieve clinical and financial outcomes. • Facilitate appropriate access to care. • Collaborate with the patient/family, physician, healthcare providers, and others to develop and implement a plan that meets the needs and goals of the patient. • Develop individualized patient plans of care. • Offer objectivity, healthcare choices, and self-management solutions. SCENARIO: • DoD Medical Management Guide 2009 How could Col Smith have benefitted from Case Management? 11-21
    22. 22. Case Management (CM)The MHS has three primary goals for CM:• Improve the care, management, and transition of recovering Service members.• Broaden the application of CM to include beneficiaries with complex needs and at-risk beneficiaries before they require complex care.• Evaluate the impact of CM on the quality and efficiency of military health care.Additional goals applicable to caring for wounded warriors are to:• Assist the recovering Service member in receiving quality medical and behavioral health (BH), which may include lengthy inpatient stays and transistions between facilities or between outpatient medical and BH services.• Assist the recovering Service member and his/ her family in understanding the recommended treatment (including BH services) and in receiving timely access to that treatment. 11-22
    23. 23. Utilization Management (UM)• Definition: • An organization-wide, interdisciplinary approach to balancing cost, quality, and risk concerns in the provision of patient care. UM is an expansion of traditional Utilization Review (UR) activities to encompass the management of all available healthcare resources, including Referral Management (RM). -DoD Medical Management Guide 2009 11-23
    24. 24. Utilization Management (UM)• Goals: • Maintain the quality and efficiency of healthcare delivery by: • Providing patients with the appropriate level of care. • Coordinating healthcare benefits. • Promoting the least costly, most effective treatment benefit. • Determining the presence of medical necessity -DoD Medical Management Guide 2009 SCENARIO: How could Col Smith have benefitted from a working Utilization Management Program in this Multi-Service Market? 11-24
    25. 25. Disease Management (DM)• Definition: • An organized effort to achieve desired health outcomes in populations with prevalent, often chronic diseases for which care practices may be subject to considerable variation. DM programs use evidence-based interventions to direct patient care. DM programs also equip the patient with information and a self-care plan to manage his/her own health and prevent complications that may result from poor control of the disease process. The term “condition management” includes non-disease states (e.g., pregnancy). -DoD Medical Management Guide 2009 11-25
    26. 26. Disease Management (DM)• Goals: • Improve clinical outcomes • Increase patient and provider satisfaction, • Promote appropriate utilization of resources throughout the MHS• Purpose: • Improve the quality of life for individuals by preventing or minimizing the impact of a disease or chronic condition. -DoD Medical Management Guide 2009 SCENARIO: What diseases of Col Smith’s should be part of a Disease Management program? 11-26
    27. 27. Medical ManagementGuidance • Department of Defense Instruction (DoDI) 6025.20 (dated Jan 2006) • Population Health/Medical Management Guides • Available: www.tricare.mil/OCMO/publications.aspx • Medical Management Webinars available. Schedule at www.tricare.mil/tma/ocmo/webinars.aspx 11-27
    28. 28. Milliman Inpatient& Outpatient Guidelines• Enterprise-wide license for evidence based guidelines that supports outpatient and inpatient care (replaced McKesson’s Interqual on the inpatient side). • Clinical judgment still needs to be used • As a commercial product, it doesn’t always match up with the TRICARE benefit. TRICARE rules must be followed in their application and use!• Other details • Updated annually • Requires an account/password, • Free for MTF personnel use (paid by TMA) • Username: mhs • Password: referral • Access link via: http://careweb.careguidelines.com 11-28
    29. 29. Milliman Inpatient& Outpatient Guidelines Ambulatory Care: Imaging & Diagnostic Testing DME & Injectables Inpatient and Surgical Care: Referrals & Rehab Services Actionable Criteria Detailed Care Pathways General Recovery Guidelines: Observation care guidelines Expanded decision support Integrated Quality Measures Long-term acute care Easy evidence access Evidence-based complex Patient Information Package treatments Problem oriented guidelines Behavioral Health Guidelines: End-of-life guidance Clinical indications & alternatives for admission Recovery Facility Care: Detailed discharge criteria Clinical indications Partial hospital care planning Problem-oriented guidelines Flexible recovery courses Detailed treatment plans Alternative care planning Multiple length of stay measures Care management tools 11-29
    30. 30. Military Health System Toolsand Resources• MHS Population Health Portal (MHSPHP) on CarePoint • Highlights importance of accurate documentation and coding = improving data quality https://carepoint.afms.mil• VA/DoD CPGs & toolkits: • www.qmo.amedd.army.mil 11-30
    31. 31. Questions? 11-31

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