MiPCT Webinar 10/31/2012

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MiPCT Webinar 10/31/2012

  1. 1. Michigan Primary Care TransformationDemonstration Project October 31, 2012
  2. 2. Agenda Context and Overview Payer Updates • BCBSM • BCN • Medicaid • Medicare 2
  3. 3. Seeking Nomination MiPCT is soliciting nominations for one slot for a PO representative with financial expertise on the Steering Committee. The purpose of the Steering Committee is to provide strategic direction to MiPCT Leadership and monitor progress toward the goals and objectives of MiPCT. 3
  4. 4. Care Management Reporting The care management activity reporting requirements have been finalized and will be incorporated into the Quarterly Report beginning in the first quarter of 2013. Number of Care Manager face-to-face encounters (by Care Manager, by practice, by primary payer) 4
  5. 5. Care Management Reporting Number of Care Manager telephone or electronic encounters by Care Manager, by practice, by primary payer Number of unique patients by Care Manager, by practice, by primary payer 5
  6. 6. PDCM Codes and FeesCODE SERVICE FEE*G9001 Initial assessment $112.67G9002 Individual face-to-face visit (per encounter) $56.3498961 Group visit (2-4 patients) 30 minutes $14.0898962 Group visit (5-8 patients) 30 minutes $10.4798966 Telephone discussion 5-10 minutes $14.4598967 Telephone discussion 11-20 minutes $27.8198968 Telephone discussion 21+ minutes $41.17*Net of Incentive amount 6
  7. 7. New MiPCT Files MiPCT has sent the most recent data participating practices and physicians, respectively. NPs/PAs that serve as PCPs and bill separately have been added to the file. The same billing information needed for physicians is needed for NPs/PAs. To receive Medicaid payments, the NP/PA must be the PCP of record for Medicaid managed care members and must be enrolled in CHAMPS. 7
  8. 8. MDC Dashboard The first MDC Dashboard is available for MNO and the practices within it. This release was constructed using 2010-2011 Medicare and Medicaid claims data and September attribution lists. 8
  9. 9. MDC Baseline Data This release provides baseline data for MNO and each practice for Medicare and Medicaid (as it reflects data January 2010 through December 2011). More recent data will be integrated over time and other payers will be added to aid in identifying opportunities for improvement (and best practice). 9
  10. 10. MDC Baseline Data The next release of dashboards is scheduled for January 2013 and will include BCBSM data. Future dashboards will be released every two months to provide data on your performance over time. 10
  11. 11. Moderate Care Manager Program Place: Physicians’ Training Center 26550 John R Madison Heights Mi 48071 Contact: Mike Mellor, mmellor@transformcoach.org Modality/schedule: Live, in-person Course dates: November 6, 7, 14, 15. 8:30am- 4:30pm (Must all four days) 11
  12. 12. Documenting Success Stories Robert Wood Johnson video submission for possible full length story Interviews by national research organization Interviews by CMS representatives 12
  13. 13. Upcoming Events Practice meeting to discuss Care Manager integration Billing and coding Group assessment of current quality scores and gap analysis Learning Collaborative beginning December 5, 2012 Mini Learning Collaboratives 13

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