MiPCT Webinar 04/17/2013

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MiPCT Webinar 04/17/2013

  1. 1. Michigan Primary Care TransformationDemonstration Project April 17, 2013 Webinar
  2. 2. Congratulations! Anchor Bay Clinic • Karl Emerick, DO • Kevin Klein, DO • Raquela LePera, DO • Thomas Mianecki, DO • Debra Moses, DO • Irene Scott, Office Manager • Angie Siegmon, RN, Care Manager 2
  3. 3. Upcoming URAC Audits Hampton Medical • Bruce Johnson, DO • Susan Tam, DO Country Creek Family Physicians • Al Juocys, DO • Shailaja Rastogi, MD Douglas Hames, MD 3
  4. 4. Upcoming URAC Audits Rosa Parks Geriatrics Ron Williamson, MD 4
  5. 5. URAC Deadline Extended URAC has given a green light for deadline extension 5
  6. 6. Care Manager Training Moderate Care Manager Training Complex Care Manager Training 6
  7. 7. Liability Insurance All MNO care managers carry full liability coverage $1,000,000/$3,000,000 7
  8. 8. Liability Coverage Letter from carrier Letter from MNO endorsing malpractice carrier Average annual premium $7,000 Approximate 20-30% savings Dinner meeting on Wednesday, May 22, 2013 from 6:00-7:30pm ay APCC 8
  9. 9. Liability Coverage “Reserve” Plan only available to MNO primary care physicians in wave one URAC PCMH accreditation Annual team training including risk training Quality scores at 70% 9
  10. 10. iExaminer Project lead One iExaminer/MiPCT office Training tool Appropriate ophthalmoscope 10
  11. 11. Diabetes Pilot Project Project lead Poor enrollment Outreach Assistance 11
  12. 12. Shared Visits Hampton Medical Anchor Bay Clinic 12
  13. 13. Financial Incentives Year one distribution Care manager funding 1st Quarter 2013 report 13
  14. 14. Billing and Coding Seminars Throughout May, regional meetings will be held throughout the state, facilitated by BCBSM, BCN, and Medicare Advantage G and CPT care management codes 14
  15. 15. Billing and Coding Seminars Sessions will be approximately three hours long (morning or afternoon) Billers, coders, care managers, PO representatives, and others involved in the coding and billing process should attend 15
  16. 16. Sequestration President Obama signed an order that imposes across-the-board Federal spending reductions (also known as sequestration) for Federal payments effective as of April 2013. If Congress does not take action to avert this, monthly payments to practices and POs will be reduced by 2% beginning April 1, 2013 and this will continue until there is resolution about the Federal budget and Federal deficit. 16
  17. 17. Metrics Year Three You’ve referred patient out…what next? Behavioral health metrics supplied by Dr. Zeman Committee meets to review all process and clinical outcome proposed metrics 17
  18. 18. Physician Engagament Highly engaged Moderately engaged Minimally engaged Totally disengagement 18
  19. 19. Open Discussion 19
  20. 20. QUESTIONS? 20

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