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NACCHO 2018 National Conference – Medicare Access Improvement Program
- 1. Medicare Access Improvement Program Presented by Sarah Fraser Quality Systems Team
- 2. our health, our choice, our way …why • Increasing financial pressures • Focus on improving management of chronic conditions • Member service needs • Managerial and clinical staff requests
- 3. our health, our choice, our way …aims • Training resource and program • PowerBI Strategy for on-site implementation Sustainable clinic systems Increase Medicare revenue
- 4. our health, our choice, our way …the program Part One •Printed resource •2-day program •Presentations •Learning aids Part Two •PowerBI models •SQL reports •Report framework
- 5. our health, our choice, our way …PowerBI models Medicare Model •AHW/AHP/RN items •Health Checks •Care Plans & Team Care Arrangements •QAAMS items •Practice Incentive Payments •Cycle of Care Population Health / Clinical Model •Ear Disease •Rheumatic Fever / Rheumatic Heart Disease •Population / Demographics •Chronic Diseases •Sexually Transmitted Infections
- 6. our health, our choice, our way …Part one pilot • Two-day Medicare training • 12 participants • Free training • Case studies • Off-site access to services
- 7. our health, our choice, our way …feedback
- 8. our health, our choice, our way …Part two pilot • Data extracted and imported • Analysis and critique of data • Report • On-site visit • Recommendations and part implementation • Report • Follow-up visit meet with staff and extract data at three and six months
- 9. our health, our choice, our way …future plans • Re-run the 2-day Medicare training program • Offer profession specific sessions • Offer on-site service specific training • PowerBI tool in more services • Quality Improvement
- 10. 220 Franklin Street, Adelaide South Australia 5000 T 08 8273 7200 F 08 8273 7299 E ahcsa@ahcsa.org.au www.ahcsa.org.au
Editor's Notes
- Thank you To begin with, I too acknowledge the traditional owners of the land we meet today and I respect their spiritual relationship with their Country and recognise elders; past, present and future. Today I am going to talk about the development and pilot of a Medicare Improvement Program This program forms part of the work of some members of the Quality Systems Team at the Aboriginal Health Council of South Australia
- The idea to develop a Medicare Improvement Program was brought about by a number of factors. - Firstly, by an awareness of the ever increasing financial pressures being placed on community controlled health services - By an increase in a focus on improving the management of chronic conditions, and how this is relates to Medicare revenue - Through individual member service needs, for example for new service initial systems set up to claim Medicare, and for other services, for Medicare reconciliation support - However most importantly, The programs was developed as a response to both member service managerial and clinical staff requests for training
- Following a number of consultations with multiple people in the sector, we decided the aims of the program were to: - Create a practical training resource and corresponding two day training program - And develop an easy to use data model that enables a critique of health service Communicare data - To support these tools we recognized the need for us to develop a develop a strategy for implementation - With the hope of developing the capacity of staff employed in member services to achieve sustainable clinic systems that enable maximum Medicare revenue without compromising best practice care - All inevitably aiming to support ACCHS to increase long-term Medicare revenue
- The program was developed and separated into two parts. - For part one we developed A printed training resource, that included pathways and strategies related to the community controlled sector With specific Communicare guides And a 2 day formal training package which included case studies - For part two Two PowerBI models where developed to enable a critique of data and display it in a user friendly way SQL reports were written to facilitate extraction of data And a report framework was prepared for using to report feedback to services
- The powerBI models were separated into a Medicare model and a Population health model - The first model, called the Medicare model looks at general health check and chronic disease item numbers Along with specific item numbers relevant to the community controlled sector For example AHW and AHP items numbers and those related to QAAMS - The second model focuses on population and demographic data With the inclusion of a focus on a small selection of specific conditions These conditions were chosen to complement other quality systems team work, and the work of some other teams at AHCSA
- We piloted Part one of the program in July this year - One participant from each of the community controlled services across south Australia were invited to attend the two days of training - We capped the number of participants to 12 in total because the programs was designed to be very interactive - The training was free, and health services covered the costs of participant travel - The trailing was facilitated by three of the QST members, two of which are RN with extensive PHC experience and we presented case studies to support ideas and clinic flow - Participants arranged for off-site access to their health service system to engage in real life examples.
- Participants were asked to complete an evaluation survey at the end of each day’s training. The overall general feedback from participants was very positive. Almost all participants said they Have confidence to use new knowledge in their health service Thought the handouts were useful Would tell others about what was presented Thought the workshop was well organized Said information was relevant and clear
- In august of this year, CEOs were sent an email with an overview of the PowerBI models and options for participation in this part of the Medicare Improvement Program This tool has been partially piloted at one site. - Data extracted externally and imported into the PowerBI Models - Data was then analysed and critiqued - This was followed by a report to the CEO and a telephone conversation, and arrangements were made for an on-site visit - During the first on-site visit we met with teams and made initial recommendations around quality improvement and partially implemented these All in close consultation with the program/team managers - Another report was prepared summarizing key recommendations, strategies implemented and further plans This was provided to the CEO and clinic manager - Following which a second on-site visit was arranged We have received some anecdotal positive feedback from the CEO regarding the program so far - The plan now is assess if improvements have been made and sustained at 3 and 6 months This will be done through qualitative data collection with staff about how changes in practices have gone and been sustained And also to extract data again to enable comparisons to be made
- - Re-run the 2-day Medicare training program - Offer profession specific sessions eg AHW/AHP ro PN - Offer on-site Medicare training to whole of service staff were appropriate - Use the PowerBI tool in more services - Continue to engage services in conversation around quality improvement activates using their data