This document summarizes updates from the Michigan Primary Care Transformation Demonstration Project webinar on November 14, 2012. It discusses adding nurse practitioners and physician assistants as primary care providers, collecting success stories from care managers, enhancing eligibility checking capabilities, finalizing care management reporting requirements, and introducing community care team enhancements including new clinical and operations leads. Upcoming events mentioned include a practice meeting in December and the Mackinac Learning Collaborative in early December.

1. Michigan Primary Care
Transformation
Demonstration Project
November 14, 2012
Webinar

2. MiPCT and Mid‐level Providers
 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.
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3. Documented Success Stories
 Robert Wood Johnson video submitted
• Debby Kobayashi, LMSW
• William Porter, RN
 Interviews by national research organization
completed
• Monroe Medical Associates: Tedd March, MD
• William Porter, RN
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4. Documented Success Stories
 Care Managers were asked to provide a narrative
of a patient/family success story
 Six submissions from care managers
 Awaiting pediatric success story
 Narratives will be sent to MiPCT for publication in
newsletter
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5. Enhanced Eligibility Capability
 Providers can currently check whether a patient
has active BCBSM/BCN coverage using the Web‐
DENIS or CAREN IVR system
 Pending functionality in Web‐DENIS that will allow
providers to check whether a patient is eligible for
PDCM/MiPCT
 The process will be finalized in the next few
months
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6. Pay for Performance
 The data for six month incentive distribution has
been secured
 MiPCT is in process of rechecking each element to
ensure accuracy
 Data collaborative at U of M is providing the
expertise to verify the data
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7. Pay for Performance
 If incomplete information is submitted by a PO
follow up occurs
 Incomplete information may be on a data element
or is in conflict with care manager training
completion
 If this occurs, POs will receive their scores and will
review them during a one‐week appraisal period
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8. 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
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9. Care Management Reporting
 Number of Care Manager face‐to‐face encounters
(by Care Manager, by practice, by primary payer)
 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
 Did referral to outside agency occur
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10. Community Care Team
Enhancements
 Community Care Teams
• Community Care Travel Team
• Community Care Permanent Team
 Bill Porter, RN: Community Care Clinical Lead
 Erica Ross: Community Care Operations Lead
 Dave Johnson, MSW: Behavior Health Consultant
 Lori Zeman, PhD: Behavior Health Expert
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11. Community Care Team
Enhancements
 Bill Porter, RN: Community Care Clinical Lead
 Monitor clinical activities at all practice sites
 Oversee case reviews with practice team and care
manager
 Design quality improvement activities with practice
team and care manager
 Work with Erica Ross to determine appropriateness
of care manager assignments
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12. Community Care Team
Enhancements
 Erica Ross: Community Care Operations Lead
 Monitor care manager assignments at practice sites
 Working with Bill Porter and practice team to
determine appropriateness of care manager
assignments
 Create and oversee satisfaction surveys and meet
with practice teams and physicians to include them in
pertinent assessments of care managers
 Reviewing overall productivity statistics of care
managers
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13. Community Care Team
Enhancements
 Erica Ross: Community Care Operations Lead
 MNO Care Managers assignments and schedule
 Monitor care manager assignments at practice sites
 Working with Bill Porter and practice team to
determine appropriateness of care manager
assignments
 Create and oversee satisfaction surveys and meet
with practice teams and physicians to include them in
pertinent assessments of care managers
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14. Community Care Team
Enhancements
 Erica Ross: Community Care Operations Lead
 Review overall productivity statistics of care
managers
 Review statistics of care managers employed by
practices
 Review requests from practice units for additional
assistance with various activities
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15. Upcoming Event
 MNO MiPCT practice meeting on December 12,
2012 at the Polish Cultural Center Discuss Care
Manager integration
• Current payments
• Quarterly financial report
• Billing and coding
• Quality scores and all practice metric selection
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16. Upcoming Events
 Mackinac Learning Collaborative IV
• December 5, 2012
• Kevin Taylor, MD and Lori Zeman, PhD co chair
• Topic focused on integrated, collaborative or co‐
located behavior health
• Currently behavior health specialists are integrated
into several adult and pediatric practice
• Hoping 100% participation from MiPCT Teams
 Mini Learning Collaboratives
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17. Thank You: Cluster Meetings
• Updates
• Discussions of new
topics
• URAC
• Malpractice
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18. Open Discussion
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19. Happy Thanksgiving!
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