Kareo - Patient-Centered Practice And Healthcare Reform
 

Kareo - Patient-Centered Practice And Healthcare Reform

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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 ...

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!

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Kareo - Patient-Centered Practice And Healthcare Reform Kareo - Patient-Centered Practice And Healthcare Reform Presentation Transcript

  • 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 hashtag #KareoTip Join our other social media channels for constant updates!
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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 Billing & Remittance • Scheduling & Practice Management • Electronic Health Records • Medical Billing Services 20,000 Providers Nationwide
  • 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 • Meaningful Use
  • 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 Discover Kareo’s Role 4 Answer Questions
  • 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!