Your SlideShare is downloading. ×
0
PAGE 1 KAREO | CONFIDENTIAL
The Patient-Centered Practice
Meeting the Demands of Health Reform
PAGE 2 KAREO | CONFIDENTIAL
Your Hosts Today…
Judy Capko
Capko & Company
Lea Chatham
Content Marketing Manager, Kareo
PAGE 3 KAREO | CONFIDENTIAL
How to Participate Today…
Follow us on Twitter
@GoKareo
We’ll be tweeting live using
the hasht...
PAGE 4 KAREO | CONFIDENTIAL
Our Schedule for Today…
1 Introduction & Welcome Judy
2 The Patient-Centered Practice
3 Discov...
PAGE 5 KAREO | CONFIDENTIAL
Judy Capko
 Founder of Capko & Company
 Nationally-recognized practice
management and health...
PAGE 6 KAREO | CONFIDENTIAL
Our Schedule for Today…
1 Introduction & Welcome Judy
2 The Patient-Centered Practice
3 Discov...
PAGE 7 KAREO | CONFIDENTIAL
Course Objectives
1. Learn the basics of the patient-centered
movement and the motivation behi...
PAGE 8 KAREO | CONFIDENTIAL
Patient-Centered: Historical Perspective
Institute of Medicine:
Crossing the Quality Chasm Rep...
PAGE 9 KAREO | CONFIDENTIAL
What is Patient-Centered?
Quality Chasm Report Definition:
Providing care that is respectful o...
PAGE 10 KAREO | CONFIDENTIAL
Identified Six Quality Aims
1. Safe
2. Effective
3. Patient-centered
4. Timely
5. Efficient
6...
PAGE 11 KAREO | CONFIDENTIAL
Healthcare Planners/Leaders Debate and Resolve
• Evidence-based medicine:
 Meant to improve ...
PAGE 12 KAREO | CONFIDENTIAL
Strengthening the Patient-Clinical Relationship
Strengthen
Promote
Help
Facilitate
• Patient-...
PAGE 13 KAREO | CONFIDENTIAL
CMS Pays Hospitals Based on Performance
•Hospitals scored on performance
•Medicare Value Base...
PAGE 14 KAREO | CONFIDENTIAL
Patient Experience of Care Dimensions
1. Nurse communication
2. Doctor communication
3. Hospi...
PAGE 15 KAREO | CONFIDENTIAL
CMS Physicians Quality Measures
• Physician Quality Reporting Initiative, PQRI
 Link financi...
PAGE 16 KAREO | CONFIDENTIAL
In the Beginning
• The Patient-Centered Medical Home (PCMH)
 Consortium establishes 2007 Joi...
PAGE 17 KAREO | CONFIDENTIAL
PCMH Joint Principles
1. Personal physician
2. Physician directed medical practice
3. Care co...
PAGE 18 KAREO | CONFIDENTIAL
PCMH Momentum and Strength 2008-2010
• Recognition programs emerge
Accreditation Association...
PAGE 19 KAREO | CONFIDENTIAL
NCQA Gains PCMH Traction
• 2011 program expansion of Physician Practice
Connection recognitio...
PAGE 20 KAREO | CONFIDENTIAL
2011 Revised PCMH Standards
• Guidance on developing better chronic care
management programs,...
PAGE 21 KAREO | CONFIDENTIAL
PCMH Recognition
Meeting specific elements in six standard
categories
1. Enhance access and c...
PAGE 22 KAREO | CONFIDENTIAL
Must Pass Recognition Elements
• Tiered levels of PCMH recognition
• At any level required to...
PAGE 23 KAREO | CONFIDENTIAL
2010 PCMH
• Key Health Information Technology Domains
1. Telehealth
2. Measurement of quality...
PAGE 24 KAREO | CONFIDENTIAL
Technology Rules
• Collect and report accurate data
Measures quality outcomes nationally
Re...
PAGE 25 KAREO | CONFIDENTIAL
Patient-Centered Physicians and Managers
• Messaging is critical
 Communicate and demonstrat...
PAGE 26 KAREO | CONFIDENTIAL
Actions You Can Take
1. Promote staff understanding
2. Demonstrate your commitment
3. Educate...
PAGE 27 KAREO | CONFIDENTIAL
Look Forward – Not Backward
1. Read and stay informed
 Gain objectivity
 Lower level of res...
PAGE 28 KAREO | CONFIDENTIAL
“We need to move from what’s the matter with
our patients to what matters to our patients.”
S...
PAGE 29 KAREO | CONFIDENTIAL
Our Schedule for Today…
1 Introduction & Welcome Judy
2 The Patient-Centered Practice
3 Disco...
PAGE 30 KAREO | CONFIDENTIAL
Discover Kareo’s Role
“…Make Your Practice a Best Practice!”
PAGE 31 KAREO | CONFIDENTIAL
Discover Kareo’s Role
• Cloud-based
• Medical Billing
• Patient Payment Services
• Insurance ...
PAGE 32 KAREO | CONFIDENTIAL
Discover Kareo’s Role
• Patient Education
PAGE 33 KAREO | CONFIDENTIAL
Discover Kareo’s Role
• Patient Education
• Care
Recommendations
PAGE 34 KAREO | CONFIDENTIAL
Discover Kareo’s Role
• Patient Education
• Care
Recommendations
• Patient Portal
PAGE 35 KAREO | CONFIDENTIAL
Discover Kareo’s Role
• Patient Education
• Care
Recommendations
• Patient Portal
• Meaningfu...
PAGE 36 KAREO | CONFIDENTIAL
Discover Kareo’s Role
PAGE 37 KAREO | CONFIDENTIAL
Our Schedule for Today…
1 Introduction & Welcome Judy
2 The Patient-Centered Practice
3 Disco...
PAGE 38 KAREO | CONFIDENTIAL
Let’s Answer Your Questions
888.775.2736 x1
sales@kareo.com
http://kareo.com/chat
PAGE 39 KAREO | CONFIDENTIAL
The Patient-Centered Practice
Meeting the Demands of Health Reform
Thank you for attending!
Upcoming SlideShare
Loading in...5
×

Kareo - Patient-Centered Practice And Healthcare Reform

877

Published on

Medical practices across the country are experiencing new requirements and changes in compensation based on healthcare reform. Meaningful use is already being addressed as everyone adjusts to implementing electronic health records, but more is on the horizon. There are specific standards for the Patient-Centered Medical Home (PCMH) that will affect practice revenue. This presentation will discuss the rationale behind this focus, what is required, and how to implement a successful patient-centered program that improves the patient experience. You’ll learn about:
• The seven guiding principles of the PCMH
• Key program standards and metrics used to determine and measure success
• How technology contributes to efficiency and reporting needs
• Appropriating payment based on value-added components
• And much more!

Published in: Health & Medicine, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
877
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
27
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Transcript of "Kareo - Patient-Centered Practice And Healthcare Reform"

  1. 1. PAGE 1 KAREO | CONFIDENTIAL The Patient-Centered Practice Meeting the Demands of Health Reform
  2. 2. PAGE 2 KAREO | CONFIDENTIAL Your Hosts Today… Judy Capko Capko & Company Lea Chatham Content Marketing Manager, Kareo
  3. 3. PAGE 3 KAREO | CONFIDENTIAL How to Participate Today… Follow us on Twitter @GoKareo We’ll be tweeting live using the hashtag #KareoTip Join our other social media channels for constant updates!
  4. 4. PAGE 4 KAREO | CONFIDENTIAL Our Schedule for Today… 1 Introduction & Welcome Judy 2 The Patient-Centered Practice 3 Discover Kareo’s Role 4 Answer Questions
  5. 5. PAGE 5 KAREO | CONFIDENTIAL Judy Capko  Founder of Capko & Company  Nationally-recognized practice management and healthcare consultant with over 25 years experience  Focus on patient-centered strategies, improving leadership, and valuing staff contributions  Judy authored best-selling book Secrets of the Best-Run Practices  New book The Patient-Centered Payoff due out next month Capko & Company www.capko.com/blog judy@capko.com 805-499-9203
  6. 6. PAGE 6 KAREO | CONFIDENTIAL Our Schedule for Today… 1 Introduction & Welcome Judy 2 The Patient-Centered Practice 3 Discover Kareo’s Role 4 Answer Questions
  7. 7. PAGE 7 KAREO | CONFIDENTIAL Course Objectives 1. Learn the basics of the patient-centered movement and the motivation behind it. 2. Examine financial incentives related to patient satisfaction and outcomes. 3. Discuss key program standards of Patient- Centered Medical Home. Copyright Capko & Company 2013
  8. 8. PAGE 8 KAREO | CONFIDENTIAL Patient-Centered: Historical Perspective Institute of Medicine: Crossing the Quality Chasm Report 2001 Motivation for change: “Faced with such rapid changes, the nation’s health care delivery system has fallen far short in its ability to translate knowledge into practice and to ap-ply new technology safely and appro­priately.” Copyright Capko & Company 2013
  9. 9. PAGE 9 KAREO | CONFIDENTIAL What is Patient-Centered? Quality Chasm Report Definition: Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. Copyright Capko & Company 2013
  10. 10. PAGE 10 KAREO | CONFIDENTIAL Identified Six Quality Aims 1. Safe 2. Effective 3. Patient-centered 4. Timely 5. Efficient 6. Equitable Copyright Capko & Company 2013
  11. 11. PAGE 11 KAREO | CONFIDENTIAL Healthcare Planners/Leaders Debate and Resolve • Evidence-based medicine:  Meant to improve healthcare of the population  Proponents accept: Good outcome must be defined in terms of what is meaningful and valuable to the individual patient. • Patient-centered efforts and actions must strengthen the patient-clinical relationship. Copyright Capko & Company 2013
  12. 12. PAGE 12 KAREO | CONFIDENTIAL Strengthening the Patient-Clinical Relationship Strengthen Promote Help Facilitate • Patient-Clinical Partnership • Communication: About things that matter • Patients know more about their health • Patients involvement in their care Copyright Capko & Company 2013
  13. 13. PAGE 13 KAREO | CONFIDENTIAL CMS Pays Hospitals Based on Performance •Hospitals scored on performance •Medicare Value Based Purchasing (VBP) Payment adjustments based on Hospital Consumer Assessment of Healthcare Provider Survey (HCAPS) • 30% patient experience of care domain (thru 2015) • 70% clinical process of care domain • Intention: Improve healthcare of population Control the cost of care Copyright Capko & Company 2013
  14. 14. PAGE 14 KAREO | CONFIDENTIAL Patient Experience of Care Dimensions 1. Nurse communication 2. Doctor communication 3. Hospital staff responsiveness 4. Pain management 5. Medicine communication 6. Hospital cleanliness & quietness 7. Discharge information 8. Overall hospital rating Copyright Capko & Company 2013
  15. 15. PAGE 15 KAREO | CONFIDENTIAL CMS Physicians Quality Measures • Physician Quality Reporting Initiative, PQRI  Link financial payment to quality reporting  Claims-basis, as much as 1.5% bonus • Physician Quality Reporting System, PQRS  Penalty: Eligible physician who do not collect and report data reduced payment – 2015 = 1.5% – 2016 = 2% *PQRI: SCHIP Extension Act 2007 **PQRS MIPPA Act 2007 Copyright Capko & Company 2013
  16. 16. PAGE 16 KAREO | CONFIDENTIAL In the Beginning • The Patient-Centered Medical Home (PCMH)  Consortium establishes 2007 Joint principles – American Academy of Family Physicians, AAFP – American Academy of Pediatrics – American College of Physicians – American Osteopathic Association *Consortium: Representing 333,000 physicians Copyright Capko & Company 2013
  17. 17. PAGE 17 KAREO | CONFIDENTIAL PCMH Joint Principles 1. Personal physician 2. Physician directed medical practice 3. Care coordinated and/or integrated 4. Quality and safety 5. Enhanced access 6. Appropriate payment Copyright Capko & Company 2013
  18. 18. PAGE 18 KAREO | CONFIDENTIAL PCMH Momentum and Strength 2008-2010 • Recognition programs emerge Accreditation Association for Ambulatory Health Care National Committee for Quality Assurance, NCQA • AAFP Demonstration project results released Political actions support the Medical Home • Patient Protection and Affordable Care Act, PPACA, 2010 Copyright Capko & Company 2013
  19. 19. PAGE 19 KAREO | CONFIDENTIAL NCQA Gains PCMH Traction • 2011 program expansion of Physician Practice Connection recognition program • NCQA declares its standards First and most widely used • NCQA program promotes goals Improving patient experience Recognizing clinicians’ efforts Providing confidence for purchasers Value for money spent on quality care • Payers implement bonus and payment systems based on PCMH recognition Copyright Capko & Company 2013
  20. 20. PAGE 20 KAREO | CONFIDENTIAL 2011 Revised PCMH Standards • Guidance on developing better chronic care management programs, enhancing patient engagement and improving patient outreach • Aligned with New healthcare IT Meaningful use criteria Copyright Capko & Company 2013
  21. 21. PAGE 21 KAREO | CONFIDENTIAL PCMH Recognition Meeting specific elements in six standard categories 1. Enhance access and continuity 2. Identify and manage patient populations 3. Plan and manage care 4. Provide self-care support and community resources 5. Track and coordinate care 6. Measure and improve performance Copyright Capko & Company 2013
  22. 22. PAGE 22 KAREO | CONFIDENTIAL Must Pass Recognition Elements • Tiered levels of PCMH recognition • At any level required to meet these elements: Standard 1A: Access during office hours Standard 2D: Using data for population management Standard 3C: Care management Standard 4A: Self-care process Standard 5B: referral tracking and follow-up Standards 6C: Implement continuous QI process For a free copy of the PCMH Standards and Guidelines go to: www.ncqa.org/pcmh. Copyright Capko & Company 2013
  23. 23. PAGE 23 KAREO | CONFIDENTIAL 2010 PCMH • Key Health Information Technology Domains 1. Telehealth 2. Measurement of quality and efficiency 3. Care transitions 4. Personal health records 5. Registries 6. Team care 7. Clinical decision support for chronic diseases Copyright Capko & Company 2013
  24. 24. PAGE 24 KAREO | CONFIDENTIAL Technology Rules • Collect and report accurate data Measures quality outcomes nationally Results in better payment CMS Payment bonus plans & incentive payment other payers CMS payment incentive with meaningful use • Meeting criteria for EMR implementation and reporting Copyright Capko & Company 2013
  25. 25. PAGE 25 KAREO | CONFIDENTIAL Patient-Centered Physicians and Managers • Messaging is critical  Communicate and demonstrate involvement in improving the patient experience – The staff, patients, community, payers  Collecting and reporting data is essential  Patient surveys matter  Outcomes will tell the story Copyright Capko & Company 2013
  26. 26. PAGE 26 KAREO | CONFIDENTIAL Actions You Can Take 1. Promote staff understanding 2. Demonstrate your commitment 3. Educate and support staff 4. Manage the score care 5. Coach the team 6. Attain best practices (measure and manage) Copyright Capko & Company 2013
  27. 27. PAGE 27 KAREO | CONFIDENTIAL Look Forward – Not Backward 1. Read and stay informed  Gain objectivity  Lower level of resistance 2. Explore opportunities 3. Recognize the potential gains Copyright Capko & Company 2013
  28. 28. PAGE 28 KAREO | CONFIDENTIAL “We need to move from what’s the matter with our patients to what matters to our patients.” Source: Patient-Centered Care: What it Means and How to get there; www.healthaffairs.org; blog posted January 24, 2012 Copyright Capko & Company 2013 James Rickert, MD
  29. 29. PAGE 29 KAREO | CONFIDENTIAL Our Schedule for Today… 1 Introduction & Welcome Judy 2 The Patient-Centered Practice 3 Discover Kareo’s Role 4 Answer Questions
  30. 30. PAGE 30 KAREO | CONFIDENTIAL Discover Kareo’s Role “…Make Your Practice a Best Practice!”
  31. 31. PAGE 31 KAREO | CONFIDENTIAL Discover Kareo’s Role • Cloud-based • Medical Billing • Patient Payment Services • Insurance Billing & Remittance • Scheduling & Practice Management • Electronic Health Records • Medical Billing Services 20,000 Providers Nationwide
  32. 32. PAGE 32 KAREO | CONFIDENTIAL Discover Kareo’s Role • Patient Education
  33. 33. PAGE 33 KAREO | CONFIDENTIAL Discover Kareo’s Role • Patient Education • Care Recommendations
  34. 34. PAGE 34 KAREO | CONFIDENTIAL Discover Kareo’s Role • Patient Education • Care Recommendations • Patient Portal
  35. 35. PAGE 35 KAREO | CONFIDENTIAL Discover Kareo’s Role • Patient Education • Care Recommendations • Patient Portal • Meaningful Use
  36. 36. PAGE 36 KAREO | CONFIDENTIAL Discover Kareo’s Role
  37. 37. PAGE 37 KAREO | CONFIDENTIAL Our Schedule for Today… 1 Introduction & Welcome Judy 2 The Patient-Centered Practice 3 Discover Kareo’s Role 4 Answer Questions
  38. 38. PAGE 38 KAREO | CONFIDENTIAL Let’s Answer Your Questions 888.775.2736 x1 sales@kareo.com http://kareo.com/chat
  39. 39. PAGE 39 KAREO | CONFIDENTIAL The Patient-Centered Practice Meeting the Demands of Health Reform Thank you for attending!
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×