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MiPCT Webinar 04/04/2012

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mednetone
mednetone

This document summarizes a webinar for the Michigan Primary Care Transformation Demonstration Project. It discusses the definition of the project and statewide rollout, participation and funding updates, care management training requirements, and next steps practices need to take to meet metrics for care managers and quality measures in the coming months. The webinar focused on establishing care management teams, training requirements, and planning activities to support self-management for patients with chronic conditions.

Health & Medicine
1 of 21
Michigan Primary Care Transformation Demonstration Project April 4, 2012 Webinar #4
Agenda  Definition of MiPCT and brief explanation  Statewide Rollout Update  Participation Update  Funding Update including Metric Update  Care Management Training Update  Next Steps… 2
Clarification of MiPCT  Michigan Primary Care Transformation Demonstration Project (MiPCT)  Eight states selected other states, besides Michigan are Maine, Minnesota, New York, North Carolina, Pennsylvania, Rhode Island and Vermont  Practices eligible to participate in MiPCT were either NCQA PCMH Level 2 or 3 before July 1, 2010 and/or BCBSM PCMH designation 2010 and 2011  No PCMH is obligated to participate 3
MiPCT Rollout  Day-long, all-partner MiPCT Launch Meeting occurred on March 28, 2012  MNO Care Manager Team attended  MNO PCMH teams participated 4
MiPCT Funding  Practice transformation payment - $1.50 per member per month ($2.00 for Medicare)  Performance incentives - $3.00 per member per month  Care coordination payment - $3.00 per member per month ($4.50 for Medicare)  Additionally, a $.26 per member per month administrative fee is contributed by payers 5
MiPCT Expectations  In return for receiving these payments, practices and providers are being held accountable for achieving gains in • efficiency • appropriateness • quality of care that in turn should improve the patient’s experience of care and the health status of the patient population 6
MNO Expectations  Attendance at webinars • Share current information • Brief training moments • 100% practice representation • eMail addresses of physicians • Hold each other accountable and create buddy relationships • Create inter-professional collaborative care teams 7
Moderate Care Manager Training  Required by all including Master Trainers and Leaders  Formal training curriculum with competency assessment  Certificate of Completion  Must be well versed in “self management strategy” 8
Definition of Self Management Support  Self-management support is the systematic provision of education and supportive interventions by health care team members to increase patients’ skills and confidence in managing their health problems, including regular assessment of progress and problems, goal setting, and problem-solving support. 9
Definition of Self Management  Self-management is the tasks that individuals must undertake to live well with one or more chronic conditions. These tasks include having the confidence to deal with medical management, role management, and emotional management of their conditions. 10
Self Management Training  Certain existing training programs are not acceptable • Stanford Chronic Disease Self- Management Training: Peer led by 2 lay leaders  Clinician guided plans • Flinders • Teamlet: Dr. Bodenheimer • Generic 11
Moderate Care Manager Training  Moderate Care Manager (PA-C, CNP, RN, APRN, or MSW) • Focus on Self Management Support and Skills • Completed by June 30, 2012 • Calendar, offerings and curriculum emailed to all and MNO online • Physicians do not qualify for Care Manager designation • Moderate Care Manager Job Description 12
Care Team Composition  Lead Care Manager • RN, MSW, CNP, PA-C, APRN • Must complete Care Manager Training  Other Qualified Healthcare Professionals • LPN, CDE, RD, nutritionist, clinical pharmacist, respiratory therapist, certified asthma educator, certified health educator specialist (bachelor’s degree or higher), licensed professional counselor, licensed mental health counselor, certified health educator specialist (bachelor’s degree or higher), licensed 13
PCMH Care Planner  Works in concert with Care Manager  “What should they be called” population coach, care designer  Focus on Self Management • Completed by June 30, 2012 • Calendar, offerings and curriculum emailed • It is recommended that each PCMH identify a team member to complete the training 14
Complex Care Manager Training  Geisinger: PROVENHEALTH® NAVIGATOR program  Selected by MiPCT Steering Committee • Steering committee comprised of mix: primary care physicians, researchers • Sub committees: Primary care physicians, researchers and operations  First cohort will be trained on April 19, 2012  8 MNO “complex” care managers attending first training event 15
Pay for Performance: 6 Months (August 2012)  Moderate Care Manager in place  Complex/Hybrid Care Manager in place  Patient e-Registry orEMR/EHR with registry capabilities  HEDIS Quality Scores for the population  Extended Access 16
Pay for Performance: 12 Months (February 2013)  Moderate Care Manager in place  Complex Care Manager in place  Patient Registry or EMR/EHR with registry capabilities: Generate Trend Reports  HEDIS  Extended Access  Additional items: Depression Screening PHQ-2, PHQ-9 17
12 Month Metrics: Challenge  Metrics for care managers • Difficult to reach agreement • What should be measured • How does a patient’s experience fall into the mix 18
Next Steps  By April 20, 2012 schedule a one hour all practice meeting to begin planning with your care manager  By May 1, 2012 with the assistance of your care manager your practice should complete “community mapping”  Locate a spot in your practice that a care manager can call “home”  With the assistance of your care manager plan a process to complete “population profiling” 19
Next Steps  With the assistance of your care manager review specialty linkages such as • Home health care • Community resources • Payer connection 20
Comments Issues in 3 x 5 21

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MiPCT Webinar 04/04/2012

  • 1. Michigan Primary Care Transformation Demonstration Project April 4, 2012 Webinar #4
  • 2. Agenda  Definition of MiPCT and brief explanation  Statewide Rollout Update  Participation Update  Funding Update including Metric Update  Care Management Training Update  Next Steps… 2
  • 3. Clarification of MiPCT  Michigan Primary Care Transformation Demonstration Project (MiPCT)  Eight states selected other states, besides Michigan are Maine, Minnesota, New York, North Carolina, Pennsylvania, Rhode Island and Vermont  Practices eligible to participate in MiPCT were either NCQA PCMH Level 2 or 3 before July 1, 2010 and/or BCBSM PCMH designation 2010 and 2011  No PCMH is obligated to participate 3
  • 4. MiPCT Rollout  Day-long, all-partner MiPCT Launch Meeting occurred on March 28, 2012  MNO Care Manager Team attended  MNO PCMH teams participated 4
  • 5. MiPCT Funding  Practice transformation payment - $1.50 per member per month ($2.00 for Medicare)  Performance incentives - $3.00 per member per month  Care coordination payment - $3.00 per member per month ($4.50 for Medicare)  Additionally, a $.26 per member per month administrative fee is contributed by payers 5
  • 6. MiPCT Expectations  In return for receiving these payments, practices and providers are being held accountable for achieving gains in • efficiency • appropriateness • quality of care that in turn should improve the patient’s experience of care and the health status of the patient population 6
  • 7. MNO Expectations  Attendance at webinars • Share current information • Brief training moments • 100% practice representation • eMail addresses of physicians • Hold each other accountable and create buddy relationships • Create inter-professional collaborative care teams 7
  • 8. Moderate Care Manager Training  Required by all including Master Trainers and Leaders  Formal training curriculum with competency assessment  Certificate of Completion  Must be well versed in “self management strategy” 8
  • 9. Definition of Self Management Support  Self-management support is the systematic provision of education and supportive interventions by health care team members to increase patients’ skills and confidence in managing their health problems, including regular assessment of progress and problems, goal setting, and problem-solving support. 9
  • 10. Definition of Self Management  Self-management is the tasks that individuals must undertake to live well with one or more chronic conditions. These tasks include having the confidence to deal with medical management, role management, and emotional management of their conditions. 10
  • 11. Self Management Training  Certain existing training programs are not acceptable • Stanford Chronic Disease Self- Management Training: Peer led by 2 lay leaders  Clinician guided plans • Flinders • Teamlet: Dr. Bodenheimer • Generic 11
  • 12. Moderate Care Manager Training  Moderate Care Manager (PA-C, CNP, RN, APRN, or MSW) • Focus on Self Management Support and Skills • Completed by June 30, 2012 • Calendar, offerings and curriculum emailed to all and MNO online • Physicians do not qualify for Care Manager designation • Moderate Care Manager Job Description 12
  • 13. Care Team Composition  Lead Care Manager • RN, MSW, CNP, PA-C, APRN • Must complete Care Manager Training  Other Qualified Healthcare Professionals • LPN, CDE, RD, nutritionist, clinical pharmacist, respiratory therapist, certified asthma educator, certified health educator specialist (bachelor’s degree or higher), licensed professional counselor, licensed mental health counselor, certified health educator specialist (bachelor’s degree or higher), licensed 13
  • 14. PCMH Care Planner  Works in concert with Care Manager  “What should they be called” population coach, care designer  Focus on Self Management • Completed by June 30, 2012 • Calendar, offerings and curriculum emailed • It is recommended that each PCMH identify a team member to complete the training 14
  • 15. Complex Care Manager Training  Geisinger: PROVENHEALTH® NAVIGATOR program  Selected by MiPCT Steering Committee • Steering committee comprised of mix: primary care physicians, researchers • Sub committees: Primary care physicians, researchers and operations  First cohort will be trained on April 19, 2012  8 MNO “complex” care managers attending first training event 15
  • 16. Pay for Performance: 6 Months (August 2012)  Moderate Care Manager in place  Complex/Hybrid Care Manager in place  Patient e-Registry orEMR/EHR with registry capabilities  HEDIS Quality Scores for the population  Extended Access 16
  • 17. Pay for Performance: 12 Months (February 2013)  Moderate Care Manager in place  Complex Care Manager in place  Patient Registry or EMR/EHR with registry capabilities: Generate Trend Reports  HEDIS  Extended Access  Additional items: Depression Screening PHQ-2, PHQ-9 17
  • 18. 12 Month Metrics: Challenge  Metrics for care managers • Difficult to reach agreement • What should be measured • How does a patient’s experience fall into the mix 18
  • 19. Next Steps  By April 20, 2012 schedule a one hour all practice meeting to begin planning with your care manager  By May 1, 2012 with the assistance of your care manager your practice should complete “community mapping”  Locate a spot in your practice that a care manager can call “home”  With the assistance of your care manager plan a process to complete “population profiling” 19
  • 20. Next Steps  With the assistance of your care manager review specialty linkages such as • Home health care • Community resources • Payer connection 20

Editor's Notes

  1. Some of the MNO Practices participating in the Launch: Anchor Bay Clinic Country Creek Family Physicians Country Creek Pediatrics Oakland Medical Group Family Physicians
  2. Master Trainers: Marie Beisel, Donna Mimikos, Sue Vos, and Lynn Klima They are to train in specific regions assigned to them by MiPCT Thomas Graf, MD, is Chairman, Community Practice Service line for Geisinger Health System, graduated from University of Michigan Medical School and completed Family Medicine residency training at Henry Ford Health System in Detroit and he served on the faculty of the Henry Ford Family Practice Residency
  3. A-D; E-I; J-M; N-Q; R-U; V-Z Using your practice management system run a report of high fliers Ask your physician to identif y patients that need
  4. A-D; E-I; J-M; N-Q; R-U; V-Z Using your practice management system run a report of high fliers Ask your physician to identif y patients that need