Call Agenda, Thursday, March 11th, 11:00 AM EDT

G.  Newsweek Article on Issue of Primary Care Physician Shortage

Following President Obama's Health Care Summit held at the Blair House in Washington D.C., Newsweek printed an article addressing the growing concern over primary care physician shortages int he country.  'After taking a month to regroup, the White House has put health care back at the top of its agenda, asking Republicans for new ideas and trying to regain momentum for old ones. But last week's summit came down mostly to the same old talking points. And even if the president does manage to get some version of health-insurance reform passed in the next few months, he and the country are still going to be dealing with the related crisis of America's doctor shortage. Primary-care physicians, family docs, general practitioners—whatever you call them, they're the country's first line of defense, the ones responsible for promoting preventive care, finding ways to keep people from getting sick in the first place, and thus bringing down costs throughout the system. If every American went to one of these doctors regularly, health-care costs might come down as much as 5.6 percent a year, saving $67 billion, according to one estimate. Yet we don't have nearly enough doctors to make that happen, and fewer are being produced every year.'  The full article can be found here.

H. Metropolitan Health Networks First in Florida to Achieve NCQA Patient-Centered Medical Home Recognition

Metropolitan Health Networks, Inc., a leading provider of healthcare services in Florida, announced that it has been Recognized by the National Committee for Quality Assurance (NCQA) as a level 3 National Physician Practice Connections(R) -- Patient-Centered Medical Home(TM) (PPC(R)-PCMH(TM)). This recognizes Metropolitan's "Metcare of Florida" primary care practices that today care for 25% of the company's 35,000 Medicare Advantage customers. Metropolitan is the first health care organization in Florida to receive the certification.

The 12 month Results

Utilization:

• Hospital days per 1000 customers dropped by 4.6 percent compared to an increase of 36 percent in the control group.
• Hospital admissions per 1000 customers dropped by three percent, with readmissions running six percent below Medicare benchmarks.

Financial:

• Emergency room expense rose by only 4.5% for the Metcare group compared to an increase of 17.4% for the control group.
• Diagnostic imaging expense dropped 9.8 percent compared to an increase of 10.7 percent for the control group.
• Pharmacy expense increases were limited to 6.5 percent versus a 14.5 percent increase for the control group.
• Overall medical expense for the Metcare group rose by only 5.2 percent compared to 26.3 percent increase for the control group.

Quality:

• Preventative breast and colorectal cancer screening was 13.3 percent and 6.3 percent higher respectively, compared to the control group.
• Seasonal influenza vaccination rates increased nine percent to 64 percent, compared to the national average of 43 percent.
• Average LDL cholesterol levels dropped by 1.8 percent, and customers with levels below 100 (a target level) rose by 4.0 percent.
• Ninety-four percent of diabetic patients had an A1C level of less than nine percent.
• Customer satisfaction results improved or stayed the same in 45 of 61 categories.

For more information, please click here.

I.  ONC Announces Proposed Rule for Certifying EHRs 

The Office of the National Coordinator for Health Information Technology announced Tuesday the proposed rule for certifying EHRs. The rule addresses how electronic medical records (EHRs) and EHR modules move through the testing and certification process. Entities that want to test and certify EHRs must be accredited by ONC. A temporary certification phase will allow EHRs to be certified by Oct. 1, 2010--in time for providers to start applying for 2011 stimulus funds.To learn more, please click here.

J. MDdatacor Announces New Health Plan Contract to Facilitate Medical Home Program; Blue Cross and Blue Shield of Kansas City Launching 2-Year Medical Home Initiative

MDdatacor, Inc., a leader in health care quality management solutions for insurers and health care providers, today announced a new contract with Blue Cross and Blue Shield of Kansas City  (Blue KC) to provide the technology that will support the medical home program.  Blue KC invited internal medicine, family practice and pediatricians in their networks to participate in a two-year medical home initiative, intended to enhance patient care, help maintain or reduce health care costs and to improve physicians' job satisfaction. The program was scheduled to begin in January 2010.  During the initiative, primary care physicians use MDdatacor's MDinsight® system to identify opportunities for additional patient care and ensure patients are treated according to best practices as outlined in clinical guidelines.  The MDinsight system extrapolates clinical data from a physician's records and analyzes it against evidence-based guidelines to help physicians identify care opportunities among their patients. Care opportunities alert physicians about patients in need of medical tests or follow-up visits for chronic conditions such as diabetes or for preventive care like cancer screenings.  The system is unique in that it can also identify patients with test values that are high, such as showing a physician a list of all diabetic patients whose last A1c blood sugar test was above the recommended guidelines.  For more information, please click here.

K. Free Webinar: The Patient Centered Medical Home and Evolving Care Management Processes, March 31, 2010, 12:30 PM EST

Join Health Care Service Corporation’s Vice President and Chief Medical Officer for Blue Cross and Blue Shield of Oklahoma (BCBSOK) Dr. Joe Nicholson, MEDecision Executive Vice President and Chief Medical Officer Dr. Andrew Schuyler and Matt Adamson, Vice President of MEDecision’s medical home initiatives, as they examine the medical home concept and how it correlates with care management processes that have evolved within the payer space. The session will feature a look at BCBSOK’s medical home philosophy. It will also discuss MEDecision’s two-fold philosophy toward providing products and services to support medical home pilot projects, which is to enable access to complete and comprehensive patient clinical data in order to positively impact care quality; and to provide tools that assist payers, providers and patients in the implementation of the medical home. To Register for this free webinar click here.

L.  Webinar: Shared Savings in the Medical Home, March 31, 2010, 1:30 PM EST

Grand Junction, Colorado, with its high-quality and lower healthcare costs, has been cited by many as an example of how health reform should be structured. A key component of its system is a shared vision and shared incentives. A hospitalist from St. Mary's Hospital in Grand Junction will examine how to structure a shared savings agreement during "Shared Savings in the Medical Home," a 45-minute webinar on March 31, 2010 at 1:30 Eastern sponsored by the Healthcare Intelligence Network. For more information, please click here.

M.  New Report - Medical Home Case Studies: Profiles in the Patient-Centered Approach

The patient-centered medical home is a centerpiece of health reform and a critical catalyst for improving quality and containing costs across all sectors of the healthcare industry - from Medicare and Medicaid populations to commercial products. The 11 profiles in the 'Medical Home Case Studies: Profiles in the Patient-Centered Approach' document experiences on the adoption, organization, delivery, funding and outcomes of the medical home model.
This 100-page special report profiles the efforts of 11 healthcare organizations as they explore the benefits, opportunities and challenges of the patient-centered medical home model from the viewpoints of payor, hospital, physician, nurse practitioner, case manager and C-suite executive. To learn more on this report, including to view information on these case studies and how to order the report, please click here.

N. PCMH Guide - "Partnering with your Doctor: The Medical Home Approach"

"Partnering with your Doctor: The Medical Home Approach"  was developed by the Region 4 Genetics Collaborative's Medical Home Education Workgroup. The guide is intended to help families connect with their child's doctor, other medical professionals and caregivers through a medical home. You can download a copy here.

This guide is designed to:

• Be a source of specialized information for parents to help them care for their child
• Provide a detailed definition and description of the medical home concept
• Lay the foundation for understanding and advocating for a medical home
• Provide tools and examples for parents to use and learn from while creating and maintaining the medical home with their doctor
• Bring attention to the importance of linking families of children with genetic conditions to a medical home
• Provide advice on how to effectively partner with your child's doctor
• Define family centered care and demonstrate how it benefits families
• Demonstrate how to seek culturally effective, compassionate care
• Assist families through the transition process by providing resources and tips
• Provide a list of resources and links to organizations that support families and the medical home concept

O.  New York-based HMO to Expand Medical Home Pilot

Capital District Physicians’ Health Plan, Inc., an Albany, N.Y.-based not-for-profit individual practice association model health maintenance organization, launched the PCMH in May 2008 to seek improvements in the quality and efficiency of healthcare through transformation of the way primary care is practiced and reimbursed. The second phase of the pilot is expected to encompass 100 Albany-area practitioners serving nearly 100,000 members.

Current pilot participants Community Care/Latham Medical Group, Community Care/Schodack and CapitalCare/Clifton Park Family Practice have undergone 18 months of practice transformation and concluded the first year of testing a new payment model.  To learn more, please click here.

P. Video on the PCMH: From the Wisconsin Academy of Family Physicians

Please click here to view a short video on the Patient Centered Medical Home.  After viewing the video, please feel free to explore the associated links to the right of your video player. There you can view more information, if you so choose.

Q. Utah and Idaho Receive Federal Grant to Improve Children's Medical Care

Utah and Idaho state health departments have received a $10.3 million federal grant to better coordinate care of chronically sick children enrolled in public health insurance plans. The money, spread out over five years, will help staff at pediatric and specialists' offices create a "medical home" for children who are enrolled in Medicaid or the Children's Health Insurance Program who have conditions like asthma, diabetes, congenital heart disease or cancer.
Those children often see several specialists who may not collaborate on care. With a "medical home," a coordinator will ensure all providers are on the same page.
The grant will also boost the use of electronic medical records among those providers.
It is unknown how many children will benefit from the grant; the money will help identify them. It was awarded to the Utah Department of Health and the Idaho Department of Health and Welfare. Nine other grants were also awarded.

R. New Learning Collaborative to Prepare Clinicians for Better Chronic Care

HealthSciences Institute will sponsor a new learning collaborative for health care professionals, teams and organizations who serve individuals at risk of, or affected by, chronic diseases in employer, health plan, medical home and other provider settings.
The collaborative will offer free, noncommercial webinars on topics, solutions and case studies in chronic disease prevention, management and care improvement. Each webinar will include a brief presentation, ask-the-expert segment, and targeted discussion on the application of new learning to participant job roles. Discussion will continue online between sessions.
The collaborative is a component of a new HealthSciences Institute-sponsored Partners in Improvement initiative that will offer free online chronic care improvement resources and tools to health care organizations and professionals.
“Nurses and other professionals who serve at-risk individuals—in settings from health plans to medical homes—want affordable, noncommercial learning activities that prepare them for the real-world challenges of chronic care. They also understand that some of the most valuable lessons are learned through collaboration and problem-solving with peers,” cites Blake Andersen, PhD, President and CEO of HealthSciences Institute.
Learning Collaborative Event Schedule

• 6/4/2010 Community-Based Strategies for Primary Prevention of Diabetes with David Marrero, Ph.D., Professor of Medicine, Indiana School of Medicine.
• 8/6/2010 Minimally Disruptive Medicine with Victor Montori, MD, Endrincrinologist and Professor of Medicine, College of Medicine, Mayo Clinic.
  All events held 10:30 to 11:30(CT); CCP Community Calls 11:30 to Noon (CT).

To learn more, please click here.

S. Medical Home and the Nurse Practitioner: A Policy Analysis

As chronic disease and health care costs escalate, nurse practitioners (NPs) are in a pivotal position to participate in the Medicare Medical Home Demonstration Project (2006) that allows for NP-led patient-centered medical home practices to be reimbursed for coordination of chronic care, specifically for those complex patients with multiple chronic conditions. This policy analysis reviews the evidence for three potential patient-centered practice design alternatives, to evaluate the most viable patient-centered medical home practice design alternative for NPs. Strategies are included for NPs to actively participate in this endeavor.  To purchase the full article, please click here.

T. URAC’s 2010 Best Practices Awards Recognize Innovative Leadership and Successful Health Programs

URAC, the nation’s leading health care accreditation and education organization, has issued a call for entries for its 2010 Best Practices Awards in Health Care Consumer Empowerment and Protection to find which companies are setting the standard in advancing the role of consumers as active participants in health care.

“At a time when everyone is looking for health care value, transparency, and accountability, the URAC Best Practices Awards give health care organizations an opportunity to showcase best practices and receive recognition for their commitment to engage consumers as partners,” said Alan P. Spielman, president and CEO of URAC. “We are delighted to honor those who are leading the health care industry through innovation and providing proven practices that advance patient safety and empower consumers.”  The competition is open to six types of health care organizations: Health Care Provider Practices, Health Information/Decision Support Companies, Health Management Companies, Health Plans and Health Networks, Pharmacy Management Companies, and Workers’ Compensation Companies. For more information, please click here.

U. Indiana, North Carolina host Medicare quality demos - Physicians and health systems in the two states will share savings from coordinating care and developing medical homes.

American Medical News - The Centers for Medicare & Medicaid Services on Jan. 27 announced two new Medicare demonstrations that provide incentives for physicians and others to improve the quality of care for Medicare beneficiaries while reducing costs.

One of the programs, in Indiana, is in partnership with the Indiana Health Information Exchange, which was formed in 2004 to promote the efficient exchange of medical records among doctors and hospitals. Under the new demonstration, IHIE will use Medicare data to give participating physicians the information necessary to lower costs and boost quality.

The project, which involves a coalition of roughly 800 physicians, also will examine the impact of quality measures reporting and pay-for-performance.

"Under the current health care system, patient data is often inconsistent and housed in different systems, making it less useful to physicians," said CMS Acting Administrator Charlene Frizzera. The IHIE project will work to combine fragmented data and standardize quality reporting and pay, she said.

In North Carolina, a new demonstration will extend the medical-home concept to low-income Medicare beneficiaries through a partnership with the North Carolina Community Care Networks. The organization consists of eight regional health care networks that combine care coordination and health information technology to manage care more effectively.

The networks, consisting of community physicians, hospitals, health departments and others, will provide medical homes for beneficiaries who are eligible for both Medicare and Medicaid. Each network has clinical care coordinators who will work with practices on medical-home plans for their patients.

Both demonstrations are set up to allow the organizations to share in a portion of Medicare savings once care quality and efficiency objectives are met, CMS said.

• Agenda with Speaker Presentation Materials
• Speaker Bios

• PCPCC Stakeholders' Working Group Meeting - Tuesday, March 30, 2010
• PCPCC Stakeholders' Working Group Meeting - Thursday, July 22, 2010
• PCPCC Annual Summit - Thursday, October 21, 2010 
   

• CT Health Policy Project
   

• Center for Multi-Stakeholder Demonstration: Identify community-based sites to test and evaluate the concept; share information and best practices about pilots within a collaborative community; and serve as the connector to technical, quality improvement and education resources to facilitate ongoing demonstrations.
• Center to Promote Public Payer Implementation: Assist public payers as they implement and refine programs to embed the Patient Centered Medical Home model by offering technical assistance; sharing best practices and giving guidance on the development of successful funding models.
• Center for Employer Engagement: Create standards and buying criteria to serve as a guide and tool for large and small employers/purchasers in order to build the market demand for adoption of the Medical Home model.
• Center for eHealth Information Adoption and Exchange: Evaluate use and application of information technology to support and enable the development and broad adoption of information technology in private practice and among community practitioners.
• Center for Consumer Engagement: Engage the consumer in  awareness activities through three ways: day-to-day operations, messaging and pilots.  The center will continue the use of “Patient Centered Medical Home”, but focus on how the concept and its components are communicated to the public and partner with large consumer groups to capitalize on their visibility and existing efforts.

I.  Introductions

Co-Chairs: Duane Putnam, Pfizer, Inc.; Bruce Sherman, MD, The Goodyear Tire & Rubber Company; Robert Dribbon, Merck & Co., Inc.

II. Update on PCMH/VBID white paper

III.  Scheduling of Guest Speakers for 2010   -- (Please find spreadsheet of confirmed speakers attached)

IV.  Speaker Presentation:  “Central Ohio Patient-Centered Medical Home Project”   Jeff Biehl – President -  Access HealthColumbus

V. New upgraded PCPCC / CEE Website

To view the agenda for the CEE call, please click here. 

• Introductions

Jeffrey Hanson, MPH – CeHIA Co-Chair and Vice President, Healthcare & Science, Thomson Reuters

• Update on Meaningful Use White Paper
• Speaker Presentation:  “Pennsylvania Chronic Care Initiative”   - Phil Magistro, Deputy Director, Program Implementation, PA Governor’s Office of Healthcare Reform

The Chronic Care Commission created by PA Governor Rendell crafted a strategic plan that calls for implementing the chronic care model developed by Dr Ed Wagner and the MaxColl Institute in all primary care practices across the Commonwealth.  This initiative is being implemented in stages throughout all regions of the state.  The efforts are being led by the Governor’s Office of Health Care Reform and involve strong collaboration among providers, payers and professional associations.  The initiative incorporates the PCMH standards as a validation tool that practices are transforming their care delivery to effectively manage chronically ill patients.  There are seven regional learning collaboratives underway across the Commonwealth.  Phil will speak to us about the HIT implementation challenges associated with this large statewide project.

NOTE: Attached, please find the presentation materials for the call's speaker.

• New upgraded PCPCC / CeHIA Website

• PCPCC National Thursday Calls Phone Number: 712.432.3900 Pass Code: 471334– Thursday, 11 AM EST: 2010 -  2/18, 2/25, 3/4, 3/11, 4/8, 4/15, 4/22, 4/29, 5/6, 5/13, 5/20, 6/3, 6/10, 6/17, 6/24, 7/8, 7/15, 7/29, (no August calls) 9/9, 9/16, 9/23, 9/30, 10/7, 10/14, 10/28, 11/4, 11/18, 12/2, 12/9, 12/16
• General PCPCC Briefings Phone Number: 712.432.3900 Pass Code: 471334 – Monthly - Tuesday, 11 AM EST: 2010 - 3/9, 4/13, 5/4, 6/1, 7/13, (no August call) 9/14, 10/5, 11/2, (no December call)
• Center for Multi-Stakeholder Demonstration Phone Number: 712.432.3900 Pass Code: 471334 – Bi-weekly - Tuesday, 2 PM EST: 2010: 3/2,  4/6, 5/4, 6/15, (no August calls) 10/5, 11/6, 12/7
• Center for Public Payer Implementation Phone Number: 712.432.3900 Pass Code: 471334 – Monthly - Tuesday, 3 PM EST: 2010 -  3/16, 4/20, 5/18,6/15, 7/20, (no August calls) 9/21, 10/19, 11/16, 12/21 
• Center for Employer Engagement Phone Number: 712.432.3900 Pass Code: 471334 – Bi-weekly - Wednesday, 3 PM EST: 2010 - 2/24, 3/10, 4/14, 4/28, 5/12, 6/9, 6/23, 7/14, 7/28, (no August calls) 9/15, 9/29, 10/13, 10/27, 11/10, 12/15
• Center for eHealth Information Adoption and Exchange Phone Number: 712.432.3900 Pass Code: 471334 – Monthly - Thursday, 1 PM EST – 2nd and 4th Thursday of the Month: 2010 -  2/25, 3/11, 4/15, 4/29, 5/13, 6/10, 6/24, 7/15, 7/29, (no August calls) 9/16, 9/30, 10/14, 10/28, 12/16
• Center for Consumer Engagement Phone Number: 712.432.3900 Pass Code: 471334 – Last Friday of the month, 12pm EST: 2/26, 3/26, 4/30, 5/28, 6/25, 7/30, 9/24, 10/29, 12/3
• Taskforce Activity Calls
• Mobile Health Communication and Technology in the PCMH Taskforce - Bi-weekly - Thursday, 2pm EST: 2/25, 3/11, 3/25, 4/8, 4/22, 5/6, 5/20, 6/3, 6/17
• Training the Workforce and the PCMH - Bi-weekly - Wednesday, 4pm EST: 2/24, 4/7, 4/21, 5/5, 5/19, 6/16, 6/30, 7/14, 7/28, 9/8, 9/22, 10/6, 10/20, 11/3, 11/17, 12/8
• Care Coordination and the PCMH (to include Transitions in Care, Home Health, Hospice, and Long Term Care) - Bi-weekly - Wednesday 4pm EST: 2/17, 3/31, 4/14, 4/28, 5/12, 5/26, 6/9, 6/23, 7/21, 9/15, 9/29, 10/13, 10/27, 11/10, 12/1, 12/15
• Integrating Behavioral Health into the PCMH - Bi-weekly - Thursday 10am EST: 2/25, 3/11, 3/25, 4/8, 4/22, 5/6, 5/20, 6/3, 6/17
• Payment Reform and the PCMH - Bi-weekly - Monday/Tuesday 4pm EST:  2/22, 3/2, 3/9, 3/15, 3/23
• Medication Management and the PCMH - Calls are scheduled as needed
   

Co-Chairs: Dr. David Nace, McKesson Health Solutions ([email protected]), William Rollow, IBM ([email protected]), Dr. James Crawford, North Shore-Long Island Jewish Health System ([email protected]), and Jeff Hanson, Thomson Reuters ([email protected])
Executive Director - Chris Nohrden ([email protected])

Four New Center Task Groups:

• Participatory Engagement - Lead: Steve Adams ([email protected])
• HIT Resource Center - Lead: Jim Crawford ([email protected])
• Meaningful Use - Lead: William Rollow ([email protected])
• Decision Support - Lead: Pete Martinez ([email protected])

Edwina Rogers
Executive Director
Relja Ugrinic
Director of Operations and External Affairs

Patient Centered Primary Care Collaborative
The Homer Building
601 Thirteenth Street, NW, Suite 400 North
Washington, DC 20005
Edwina Direct:  (202) 417-2081
Edwina Cell: (202) 674-7800
Relja Direct:  (202) 724-3332
Relja Cell: (703) 585-9165
Fax: (202) 393-6148

[email protected]

[email protected]