Patient-Centered Medical Home Learning Community for Michigan Health Centers


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Patient-Centered Medical Home Learning Community for Michigan Health Centers

  1. 1. OverviewPCMH Learning Community Dec 6, 2011 Mazhar Shaik, Chief Clinical Officer Lynda Meade, Program Manager
  2. 2. Agenda• Why We are Doing it? How We are Doing it? What Does the PCMH Initiative Entail?• Goals and Aspirations of This Collaborative• Features, Benefits and Value Proposition• Approach, Structure and Requirements• Tools and Resources• Q&A (MPCA/PCDC)
  3. 3. Why MPCA is Initiating the PCMH Learning Community? Prioritization Grid of Health Center Areas of Need (Operations)MPCA is responding to our stakeholders’ needs.
  4. 4. Preferred Methods of LearningAgain, MPCA is responding to stakeholders’ needsand preferences.
  5. 5. How Are We Doing It?We are executing the PCMH initiative in partnership with a nationalexpert agency.MPCA identified the national expert agency on PCMH through anevaluation process:- Interview - Presentations- Proposal Evaluation - Reference CheckNational Pool Finalists WinnerNCQA TransforMed PCDCJACHO PCDCAAAHCTransforMedPCDC
  6. 6. What Does the PCMH Program Entail? Goals and Aspirations:This 12-month program, entitled the “PCMH Learning Community”will equip Health Centers with knowledge, tools, resources andone-on-one consultations to successfully:• Compile an NCQA PPC‐PCMH survey submission with the goal ofobtaining PCMH recognition at a level appropriate for theorganization• Collect and organize data for required Stage 1 MU objectiveswith the goal of attesting• Identify future areas for improvement that fully embody theprinciples behind PCMH and MU concepts
  7. 7. PCMH Learning Community Road Map • The Regulations • The Objectives Understand • The Measures • The Collaborative • PCMH Readiness Assess • MU Readiness • The Gaps • The Organization • Medicaid/Medicare • Level 1,2,3 Decide • 2011, 2012 • The Collaborative • Join the Collaborative • Redesign Map • Collect and Organize • Attest and recognize
  8. 8. Features of This Collaborative• Builds a learning community – brings together organizations committed to making improvements in care delivery• Uses evidence-based best practices as framework for designing improvement at individual sites/practices• Is an action-learning approach – you learn and do and learn…• Change is specific, measureable and directly related to an improvement outcome• Uses teams (in partnership with leaders) to learn, test and lead implementation of change improvement• Builds in sustainability at all points• Coaching and technical assistance support (e.g., coaching calls, webinars, on-site and virtual site visits)• Increases the degree of improvement achieved
  9. 9. Strengths of Learning Community1. Cost-effective/scalability (leverage experts)2. Activity (real world) focused3. Leads to actionable work plan4. Peer networking5. High participant accountability6. Action period reinforces learning7. Supports self-paced learning8. Allows for wider organizational participation
  10. 10. Benefits  Timeline flexibility/resource availability  One effort, two results (PCMH/MU)  Content value  Not a cookie cutter approach - we meet you where you are  CHC expertise  Build capability - preparing for future stages of PCMH and MU
  11. 11. Benefits …  MPCA has high knowledge of CHCs, has established working relationships with CHCs  MPCA is a trusted partner of Michigan CHCs  PCDC trusted consultant to the Primary Care Community  PCDC reputation with collaborative assistance for over 400 locations  MPCA/PCDC have the capacity and capability to do this work  Dollar savings $20,000 - $25, 000 per CHC
  12. 12. PCDC: A Learning Community Partner December 6, 2011 Peter Cucchiara, BSMIS ,MBA, Managing Director Deborah Johnson Ingram, Sr. Program Manager
  13. 13. PCDC Background
  14. 14. A Sample of Significant PCDC Activities Funded by New York Community Trust Manual Released 11/09 “Comprehensive “How To” 10,000 Downloads At more than 20 conferences, forums, webinarsPresentations Several 1-2 day training sessions Focus on rationale, standards and processPCMH/MU Partnered with CHCANYS (NY PCA) Collab. 12 CHC in Wave 1; Planning Wave 2 Focus on achieving two results in one effort Redesign FaciliationTechnicalAssistance Project Management Coaching Consulting toward HH recognition and MU certification
  15. 15. PCDC Partners with PCA’sPCMH/MU CHCANYS/PCDC Collaborative PCMH Assessment/Facilitation Services• Access CHC • Bassett Healthcare Network• Basics/Promesa Systems Inc • Lutheran Family Health Center• Bronx Lebanon Hospital • Maimonides Medical Center – ICL• Brooklyn Plaza Medical Center • Montefiore Community Pediatrics Program• Charles B. Wang CHC • Montefiore Medical Group• East Harlem Council for Human Servics Inc. • St. Barnabas Ambulatory Care Clinics• Joseph P. Addabbo FHC • Stepping Stone Pediatrics• Morris Heights Health Center • Bedford Stuyvesant FHC (Emblem)• Pediatrics 2000 • Primary Medical Care – PC (Emblem)• Settlement Health • SL Quality Care DTC (Emblem)• Soundview Healthcare Network • Fort Drum Region Health Planning Org. PCMH/MU Training/Educational Sessions for PCAs • Alabama Primary Health Care Association • Alaska Primary Care Association, Inc. • Bi-State Primary Care Association (Vermont & New Hampshire) • California Primary Care Association (120 Centers) • Community Health Care Association of the Dakotas • Michigan PCA • Wisconsin Primary Health Care Association (April 2011) • CTPCA • OKPCA • SCPCA
  16. 16. % of NYS Practices PCDC Assisted with PCMH Recognition as of 12/2011 10% PCDC 75 NYS 739 94%
  17. 17. % of U.S. Practices PCDC Assisted with PCMH Recognition as of 10/2011 3.0% PCDC USA 97.0%
  18. 18. Value Proposition Considerations
  19. 19. Value Proposition Considerations Average Cost of Two Day Conference $3,000 Average Cost EMR 2 day education $1,500 Average Cost for HIT 2 day education $1,500 NCQA PCMH Training 1 ½ day $1,000 Plus Travel Expenses $3,000 Total Range $4500 - $6000 PCMH MU Collaborative 4 Learning Sessions (4 days) 12 Webinars Weekly T/A Coaching for PCC Weekly T/A Coaching for PCA Other: Webinars Webinettes Sharepoint Tools Resources Total Price for 12 month package $5,000
  20. 20. Value Proposition Considerations What Comes With your HRSA 35KGoing it alone yields: Joining the MPCA collaborative yields:• A link to tools and resources from NCQA • 12 months of direct/ indirect consultant services• The challenge to stretch from industry experts your 35K to gain NCQA submission/recognition • Guided process to getting a – Hire a private consultant (> submission completed in $30,000.00) not including in kind projected time frame cost • Projections of ROI (inclusive – Send staff to NCQA training (1.5 day training w/ travel and hotel of in-kind costs*) >$1700.00) not including in kind cost
  21. 21. Medicaid FFS10,000 Medicaid FFS visits/yearLevel 1: 10,000 * $ 5.50 = $ 55,000/yearLevel 2: 10,000 * $11.25 = $112,500/yearLevel 3: 10,000 * $16.75 = $167,500/yearMedicaid Managed Care (PMPM)3,000 Medicaid Managed Care patientsLevel 1: 3,000 * $2 * 12 months = $ 72,000/yearLevel 2: 3,000 * $4 * 12 months = $144,000/yearLevel 3: 3,000 * $6 * 12 months = $216,000/year
  22. 22. • Practice with 10 providers that sees 10,000 Medicaid managed care patients per year and achieves level 3 PCMH and MU Stage 1 by 2011 could generate by 2015 a total of: – MU • $63,750/EP/five years X 10 MDs = $ 630,750 – PCMH • L3: 10k pts X $6/Pt/yr = $720,000/year X 5yrs = $3,600,000 Projected 5 Year Total = $4,230,750
  23. 23. PCDC Approach
  24. 24. Guiding Principles Balance – test/principles Measure twice cut once Map – see the path Three work strands as one before we walk it 2 Decision Catalogue1 Teams & Collaboration
  25. 25. Our Traditional Approach Focuses on system design as source of results Integrated Redesign of specific system elements for Approach desired results and outcomes Client needs through use of a targeted, results- andUnderstanding outcomes-focused assessment (combination of data, interviews, observations and organizational strategic goals) Synthesize data and observations Identify key opportunities for change Develop an implementation plan focused on redesignImplementation for high impact results and sustainable changes Training supports implementation to enable Coaching effective, sustainable changes in operations and results.
  26. 26. Work Area Considerations Knowledge & Skills The Team Trusted Colleague Protected Time Assessing Scope & Capacity Decisions Getting Organizational Backing The MessagesCommunications The Audience Detailed Assessments – evaluating readiness/capabilityAssessments Defining gaps Optimization Outlining Plan, Resources, Timeline Workplan Managing the Plan and by the Plan Making the Adjustments
  27. 27. PCMH/MU Overlap Summary 100% of MU is incorporated into PCMH but 1 Only 44% of PCMH is met by MU and You only get 1 must pass element out of 6 MU objectives fall in All 6 standards 2 12 of the 27 elements 34 of the 149 factors In several cases, multiple PCMH factors relate to 1 MU 3 objective E.g., MU C8 incorporates 5 PCMH factors When choosing 6 MU clinical measures …align them with the 3 diagnostic conditions you selected for PCMH and your UDS clinical measures
  28. 28. Structure
  29. 29. Activity PeriodsLearning Events Theme Objectives Objectives Core Concepts/Topics Activities (Based on Topics) Activities Progress Monitoring Tools Work Tools Resources Work Aids/Resources Delivery Methods
  30. 30. Phase 1: Pre- Work (October December 2011-January 2011)The first phase of the project called “pre-work” will place strong emphasis on completing assessments of each of the 18 practices. Using several of PCDC’s tools from its 2009 publication ObtainingPatient-Centered Medical Home: A How-To Manual, and other tools. Practices will conduct comprehensive practice profiles and self-assessments to provide understanding of their operational andtechnological capacity as it relates to the four clinical interventions. PCDC will analyze the data from these assessments and earlier data, as well as conduct an on-site visit to each practice, toproduce gap analyses and generalized project work plans. This phase will include a number of webinars and virtual meetings to orient practices to the goals of the collaborative and to useassessment and profile tools effectively. This pre-work phase takes a blended approach of using site visits and virtual coaching to establish and reinforce the coach/practice relationship. Objectives Topics/Activities Tools/Resources Recommended Delivery Methods Introduction and overview of the Leadership Orientation (PCDC/ Practice Team Leaders) 1. PCDC Practice Profile: Webinars – pre training Learning Collaborative model and Completing “practice profile” a. PCDC PCMH 2011 Self- Site Visits curriculum. Selecting a team Assessment: focus on Recorded Webinars and Webinettes Kickoff (PCDC/ Practice Teams) standards directly related to Conference calls Identify and evaluate each practice’s Introduction to CCBC four clinical interventions the four interventions (e.g. Virtual weekly meetings with PCDC operational and technological Preliminary exploration of goals and measures Standard 2 Element D “using coaches via Webex, conference call, strengths and gaps related to the Organizational Impact Review data for Population video conference, etc. four clinical interventions Pre-Training Management) Case Studies Introduction to PCDC’s PCMH 2011 Self- b. Depth of PCMH review Simulations Identify change/process management Assessment Tool c. Post-recognition dashboard steps that need to be taken in order On-Site Visits (PCDC Coach) 2. Team Selection Grid Estimated T/A time allocation: 5 hours per to ensure successful adoption of Review results and deliver feedback of practice 3. Team Selection Toolkit practice, per week performance improvement practices profile and self-assessment 4. EMR Assessment Tool to identify Identify practice goals and units of measure for Clinical Decision Support, Health CCBC clinical quality measures Information Exchange, e-prescribing Design general project workplan (to be expanded and reporting capabilities and customized in Learning Session 1) Additional activities (for each site): Collect baseline data and assess practice capabilities Assess ability to collect data, run reports, use registries and current care management capabilities Identify current staff/clinical team member composition Collect and review any prior assessment data Evaluate level of technical assistance required
  31. 31. Tools and Resources
  32. 32. Sample Resource Inventory1 – Pre Work Tools Team Chart and Team Development Template PCMH Assessment, Gap Analysis Template Workplan Development Template Communications Campaign Outline2 – Webinars & Webinettes Beginning your Team Journey Webinettes for Every Standard Meaningful Use/PCMH FAQ3 - Reference Manuals – PCMH, CDSS MU/PCMH Vendor Guide Vendor Inquiry
  33. 33. Deborah Johnson Ingram Peter Cucchiara BSMIS, MBA Senior Program Manager Managing Director Performance Improvement22 Cortlandt St. 22 Cortlandt St.New York, NY 10007 New York, NY 10007212-437-3935
  34. 34. Questions? More information and to access information, resources and tools: Shaik, Chief Clinical Officermshaik@mpca.net517.827.0487Lynda Meade, Program Managerlmeade@mpca.net517.827.0470