1. Michigan Primary Care
Transformation
Demonstration Project
April 17, 2013
Webinar

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
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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
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4. Upcoming URAC Audits
 Rosa Parks Geriatrics
 Ron Williamson, MD
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5. URAC Deadline Extended
 URAC has given a green light for deadline
extension
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6. Care Manager Training
 Moderate Care Manager Training
 Complex Care Manager Training
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7. Liability Insurance
 All MNO care managers carry full liability coverage
 $1,000,000/$3,000,000
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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
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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%
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10. iExaminer
 Project lead
 One iExaminer/MiPCT office
 Training tool
 Appropriate ophthalmoscope
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11. Diabetes Pilot Project
 Project lead
 Poor enrollment
 Outreach
 Assistance
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12. Shared Visits
 Hampton Medical
 Anchor Bay Clinic
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13. Financial Incentives
 Year one distribution
 Care manager funding
 1st Quarter 2013 report
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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
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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
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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.
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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
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18. Physician Engagament
 Highly engaged
 Moderately engaged
 Minimally engaged
 Totally disengagement
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19. Open Discussion
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20. QUESTIONS?
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