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MEDICAL NETWORK ONE  PRIMARY CARE PHYSICIANAND PRACTICE TEAM WEBINAR          JUNE 20, 2012
Welcome and Acknowledgements     Online Introductions     Current PCP membership
Welcome and Acknowledgements     Dedicated PCMH Implementation Team     BCBSM PCMH Designations     Behavior Health rec...
Congratulations:2012 BCBSM PCMH Designations    • Everett Campbell       • James Miller, DO    • Douglas Hames, MD      • ...
Congratulations:2012 BCBSM PCMH Designations    • Richard Fici, DO        • James Miller, DO    • Polly Schmidt, DO       ...
Congratulations:2012 BCBSM PCMH Designations    • David Everingham, DO    • Stephanie Lucas, MD    • Craig Everingham, DO ...
Goals and Purpose of Webinars Restated      Provide information about ongoing company       endeavors both internal and e...
Goals and Purpose of This Webinar      Present an overview of the following:        • CMS Demonstration Project (MiPCT)  ...
Current Activities – Care Teams    Adult    Adolescent/Pediatric    R-Team (Pediatric Healthy Lifestyle)    Behavior H...
Collaborative Activities    Mackinac Learning Collaborative III    Preparation for MLC IV    Practice Coaching    LEAN...
Enterprise Wide Activities    Dedicated PCMH Implementation “A” Team    Organized Systems of Care    Specialist Agreeme...
Enterprise Wide Activities    IMPACT Model co-training with WSUPG Team    Monthly Specialist Focus Group Meetings    Qu...
Internal Activities    Medical Management    Physician Recruitment, Contracting and Retention    Quality Improvement  ...
Current Activities - Ongoing    MiPCT    CDSMP - PATH    Diabetes Crossover    Matter of Balance    Mindful Eating   ...
Clinical Activities    Patient Registry    ePrescribing    Generic Use Rate    QI Activities to Improve Quality Scores...
MiPCT: CMS Demonstration Project    PCMH designated practices for 2 years    Practice transformation payments    Partic...
MiPCT: MNO    Clinical leadership support    Care Manager Support    Implementation of tools and care processes that   ...
MiPCT: MNO and PCP    RN, MSW, PA-C and APRN care managers within     primary care practice settings     • Geisinger     ...
MiPCT: MNO and PCP    Develop processes that enable primary care     practice teams to engage patients and their     care...
MiPCT: PCP    Develop processes that enable collaborative team     care    Enhance access to quality care through:      ...
MiPCT: Deliverables    Year One: Develop primary care practice     infrastructure including enhanced access, all     pati...
MNO Engagement    Travel Team      • Behavior health      • RN      • Dietitians      • Exercise specialists    Medical ...
Our Enterprise… It’s Up To You Now    What do we need to move forward effectively?    What evidence do we have to prove ...
Vision… Revision Required    To be recognized and respected as the premier     independent healthcare organization in Mic...
Ask Yourself This Question…    I know what action steps our organization is taking     next as a result of today’s meetin...
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MiPCT Webinar 6/20/2012

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Transcript of "MiPCT Webinar 6/20/2012"

  1. 1. MEDICAL NETWORK ONE PRIMARY CARE PHYSICIANAND PRACTICE TEAM WEBINAR JUNE 20, 2012
  2. 2. Welcome and Acknowledgements  Online Introductions  Current PCP membership
  3. 3. Welcome and Acknowledgements  Dedicated PCMH Implementation Team  BCBSM PCMH Designations  Behavior Health recruitment  Provider and Health Plan Outreach  Organized Systems of Care  Specialist Contracts
  4. 4. Congratulations:2012 BCBSM PCMH Designations • Everett Campbell • James Miller, DO • Douglas Hames, MD • Tedd March, DO • Elzbieta Rozmiej, MD • Solon L. Alimario, MD • Pam Cox, MD • Anthony Clarke, MD • Al Juocys, DO • Alfred Newton, MD • Shalija Rastogi, MD • Roy Elrod, MD • Elena Stephan, MD • Katrice Herndon, MD • Namir Stephan, MD • Nichole Massie, MD • Rick Poston, DO • Lennox Pike, MD • Michelle Pavlik, DO • Ralph E. Williams II, MD
  5. 5. Congratulations:2012 BCBSM PCMH Designations • Richard Fici, DO • James Miller, DO • Polly Schmidt, DO • Ia Y. Kue, MD • Kevin Klein, DO • Bruce Johnson, DO • Thomas Mianecki, DO • Susan Tam, DO • Karl Emerick, DO • Abdul Kabir, MD • David Ginnenbaugh, MD • John Pradko, MD • Thomas Horrigan, MD • Curtis LaJoie, DO • Ashraf Barry, MD • Taras Lisovsky, DO • Anna Fraymovich, MD • John Floreno, DO • Antoun Oska, MD • Robert Moretzky, DO
  6. 6. Congratulations:2012 BCBSM PCMH Designations • David Everingham, DO • Stephanie Lucas, MD • Craig Everingham, DO • Logan Oney, MD • Gregory Henk, DO • Maan Askar, MD • Vesna Evkoska, DO • Steven Zalla, DO • Ricardo Cabrera, MD • James Kohlenberg, MD • Fayes Shukairy, MD • WSU FP • Jeetender Matharu, MD • WSU IM-5B • Ronald Williamson, MD • WSU IM-4C • Stephen Bell, DO • Samar El-Achkar, MD
  7. 7. Goals and Purpose of Webinars Restated  Provide information about ongoing company endeavors both internal and external  Describe to your colleagues and practice teams what we do and what we are striving for  Identify 3rd quarter goals 7
  8. 8. Goals and Purpose of This Webinar  Present an overview of the following: • CMS Demonstration Project (MiPCT) • Diabetes Cell Phone Project • Behavior Health Initiative • Organized System of Care Activities • Care Manager and Population Manager Training  Draw comments and input regarding: • Communication efforts • Collaborative efforts • Initiatives 8
  9. 9. Current Activities – Care Teams  Adult  Adolescent/Pediatric  R-Team (Pediatric Healthy Lifestyle)  Behavior Health  DSME  Worksite Wellness Programs 9
  10. 10. Collaborative Activities  Mackinac Learning Collaborative III  Preparation for MLC IV  Practice Coaching  LEAN Coaching 10
  11. 11. Enterprise Wide Activities  Dedicated PCMH Implementation “A” Team  Organized Systems of Care  Specialist Agreements 11
  12. 12. Enterprise Wide Activities  IMPACT Model co-training with WSUPG Team  Monthly Specialist Focus Group Meetings  Quarterly Cluster Meetings  Complex Care Manager Training  Moderate Care Manager training 12
  13. 13. Internal Activities  Medical Management  Physician Recruitment, Contracting and Retention  Quality Improvement  IT revamping  AADE audit  Staff training and education  HAP Contract  OMNICARE Contract  Blue Complete Contract 13
  14. 14. Current Activities - Ongoing  MiPCT  CDSMP - PATH  Diabetes Crossover  Matter of Balance  Mindful Eating 14
  15. 15. Clinical Activities  Patient Registry  ePrescribing  Generic Use Rate  QI Activities to Improve Quality Scores  MUSIC: WSUPG Committee Member  Cardiology: WSUPG Committee Member  Transitions of Care  Organized Systems of Care 15
  16. 16. MiPCT: CMS Demonstration Project  PCMH designated practices for 2 years  Practice transformation payments  Participating health plans contribute $3.00 PMPM to the incentive program pool  Performance incentive metrics in place  PO scores will be ranked from high to low and placed into payment deciles, ranging from 82% to 118% of the mean payment 16
  17. 17. MiPCT: MNO  Clinical leadership support  Care Manager Support  Implementation of tools and care processes that enable the primary care practices to achieve practice transformation  Analytical support with generation of reports to measure transformation progress 17
  18. 18. MiPCT: MNO and PCP  RN, MSW, PA-C and APRN care managers within primary care practice settings • Geisinger • University of Massachusetts • PTI 18
  19. 19. MiPCT: MNO and PCP  Develop processes that enable primary care practice teams to engage patients and their caregivers and/or families, as appropriate, in their own care through: Care management Self-management support Navigation and coordination of care Effective transitions of care Linkage with community resources 19
  20. 20. MiPCT: PCP  Develop processes that enable collaborative team care  Enhance access to quality care through: Same day appointments After hours care Electronic access to care: email, e-visits Patient portal 20
  21. 21. MiPCT: Deliverables  Year One: Develop primary care practice infrastructure including enhanced access, all patient registry system and embedding care managers within the primary care practices  Year Two: Optimize care management, improve quality metrics and avoid high cost care  Year Three: Achieve the “Triple Aim” of improved quality of care, improved patient and primary healthcare team experience of care and reduced /stabilized costs of care 21
  22. 22. MNO Engagement  Travel Team • Behavior health • RN • Dietitians • Exercise specialists  Medical Management  Care Management  Quality Improvement  IT 22
  23. 23. Our Enterprise… It’s Up To You Now  What do we need to move forward effectively?  What evidence do we have to prove that our work is making a difference?  What evidence do we have to prove that our work made a difference?  Have we shared the results of our work beyond our organization?  How can we share the results of our work beyond our organization? 23
  24. 24. Vision… Revision Required  To be recognized and respected as the premier independent healthcare organization in Michigan that offers community-based inter-professional patient-centered/family-centered quality care. 24
  25. 25. Ask Yourself This Question…  I know what action steps our organization is taking next as a result of today’s meeting. 25
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