MiPCT Webinar 1/22/2014

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MiPCT Demonstration Webinar 1/22/2014

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MiPCT Webinar 1/22/2014

  1. 1. MiPCT Demonstration Project Medical Network One January 22, 2014
  2. 2. Agenda   Comparative G code billing results  Care Managers  Metrics for 2014  2 Introduction of practice unit new team members Learning requirements
  3. 3. Comparative G Code Use   Who is on your practice team?  How is your team working together?  How can your team be invigorated?  What are your practice’s current challenges?  3 Slipped in ranking Tell us how many referrals you’ve received from your PCPs?
  4. 4. PCMH Accreditation  Two national accreditation bodies • URAC • NCQA  One local payer designation • BCBSM 4
  5. 5. What Are We Measuring? Utilization (assessed at PO level) Exceed benchmark or % improvement over previous year  Primary care sensitive ED visits (NYU algorithm)  Asthma ED Visits for Previously Diagnosed Asthma*  Ambulatory Care Sensitive Hospitalizations  Hospital Readmissions Claims 5
  6. 6. What Are We Measuring? Clinical Quality Metrics (assessed at PO level) Exceed benchmark or % improvement over previous year       Diabetes: Annual retinal eye exams Breast Cancer Screening Cervical Cancer Screening Well Child Visits - 15 months Well Child Visits - 3-6 years Adolescent immunizations Claims 6
  7. 7. What Are We Measuring? Clinical Quality Metrics (assessed at PO level) Exceed benchmark or % improvement over baseline  Diabetes Control A1C < 8  Diabetes: Blood Pressure < 140/90  CVD: Blood Pressure < 140/90  Hypertension: Blood Pressure < 140/90  Tobacco Use Assessment  Weight Assessment for Children and Adolescents Registry and Claims 7
  8. 8. What Are We Measuring? Process Measures (assessed at practice level)     Depression Screening for Patients with Chronic Health Conditions Notification of hospital admissions and discharges Follow-Up Referrals to a Community-Based Program or Agency Self-Management Support Offered for Chronic Condition of Focus Registry, Claims and Quarterly MiPCT Report 8
  9. 9. Learning Requirements: 2014   9 Specific Care Manager learning requirements Specific Practice Team learning requirements
  10. 10. Learning Event: Care Managers   10 12 hours Learning events for Care Managers
  11. 11. Learning Requirement: Practice Unit   11 Care Team Members: It is not “care manager” and the team” Eight hours of group learning
  12. 12. MiPCT Learning Activities  Thanks to Priority Health for their engagement  Recommended for physicians, mid level providers, other healthcare professionals and staff  ICD-10 goes live on October 1, 2014  ICD-10 Workshop (6 CEUs toward 2014 CMC) • January 30, 2014 • 9am-4pm • Training Center in Madison Heights 12
  13. 13. MiPCT Learning Activities  MiPCT Learning Collaborative  Expectation was for 100% of the MNO MiPCT practices to participate  Fluctuation of care team activity and competencies • Three Saturday Sessions at Blue Care Network • January 25 from 8am-4pm 13
  14. 14. MiPCT Collaborative Team Participants   Country Creek Family Physicians  Country Creek Pediatrics  Hampton Medical Center  Lifetime Family Care  14 Anchor Bay Clinic Michigan Healthcare Professionals (Angela’s Team)
  15. 15. MiPCT Learning Collaborative Teams   Everingham Clinic  Macomb Pediatrics  Monroe Medical  Woodhaven Pediatrics  Ricardo Cabrera, MD  Jeetender Matharu, MD  Douglas Hames, MD  15 Center for Preventive Medicine Meadowbrook Internists
  16. 16. CMS Ruling   16 Appeal of the criteria for care managers Review of hiring requirements
  17. 17. Open Discussion 17

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