Center Call Agenda, Tuesday June 15th, 3:00PM EST

Center to Promote Public Payer Implementation
Tuesday, June 15, 2010
3:00pm-4:00pm, EST
Call in number: 712.432.3900   Code -  471334#    Moderator/Speakers - *406354

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Call Agenda

I. Introductions

Co-Chairs: Terry McInnis, Blue Thorn Inc; Donna Lichti, Pfizer Health Solutions; Gary Jacobs, Universal American Corp.; Lesley Reeder, Colorado Department of Health Care Policy and Financing
PCPCC Executive Director: Edwina Rogers
 
II.  Vince Keenan, Executive Vice President & Gordana Krkic, CAE Deputy Executive Vice President of Communications, Government Relations, and Marketing, Illinois Academy of Family Physicians
 
The Illinois Academy of Family Physicians (IAFP) is a state chapter of the American Academy of Family Physicians.
 
In Illinois, the IAFP work closely with the Medicaid program's primary care case management model and disease management program. The two Illinois Medicaid Medical Home programs, Illinois Health Connect, the primary care case management program, and Your Healthcare Plus, the disease management program saved $320 million in FY2009, up from $180 million in FY2008.
 
As part of their effort to spread the word on medical home and make Illinois' model programs replicable for other states, the IAFP is working with the Robert Graham Center to develop a case statement of the Illinois Health Connect - IHC (www.illinoishealthconnect.com) and Your Healthcare Plus - YHP (www.yourhealthcareplus.com) programs. The case statement will describe IHC and YHP from a healthcare and social system perspective. 
 
The evaluation will describe Illinois Health Connect and Your Healthcare Plus so that future policies can determine which parts of the programs to change or expand.  Additionally, IAFP intends to use this qualitative evaluation to create a foundation for a larger evaluation to look specifically at clinical and financial outcomes of both programs. The IAFP expects the case statement to be completed by August 2010.
 
Gordana and Vince will join the group to discuss these affairs and IAFP's involvement in the PCMH movement.
 
III. Speaker - Angela Tobin, MA, LSW, Manager, Technical Assistance, & Michelle Z. Esquivel, MPH, Director, Division of Children with Special Needs, Director, National Center for Medical Home Implementation, American Academy of Pediatrics; Rebecca A. Malouin, Ph.D., M.P.H., Assistant Professor, Director of International Programs, Department of Family Medicine and Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University
 
The speakers will join the call to discuss the development of a monograph titled “Measuring Medical Homes: Tools to Evaluate the Pediatric Patient- and Family-Centered Medical Home”.  The purpose of this monograph is to present various tools available and in use to identify, recognize, and evaluate a practice as a pediatric medical home. With increasing national interest in health care reform, the provision of medical homes for all is seen as a method to improve population health as well as reduce health inequities and health care expenditures. Because no one tool is recognized as the de facto tool to assess pediatric practices, a review of the relative merits of existing tools will help inform purchasers, payers, providers, and patients in evaluating pediatric practices. Many of the multi-stakeholder and single-payer medical home demonstration projects focus on adult populations and adult outcomes. An understanding of tools to assess pediatric practices may assist such pilots in incorporating and evaluating pediatric practices in both practice transformation and payment reform. The National Center for Medical Home Implementation contracted with Rebecca Malouin, PhD, MPH on the development of same.
 
The speakers will also give a brief, 5-10 minute informational overview about their "Building Your Medical Home" tool kit and its content.
 

IV.  NASHP Update

V. Open Discussion

Next call is: Tuesday July 20, 2010; 3:00 PM EST

Resources
Center to Promote Public Payer Implementation Website
http://www.pcpcc.net/content/center-promote-public-payer-implementation

Purchasers Guide: http://www.pcpcc.net/content/purchaser-guide
Pilot Guide: http://www.pcpcc.net/content/pcpcc-pilot-projects
 

 

Deliverables' Timeframe

 

Goal/Deliverable

Estimated Resources Required

Inform callers on “hot topics,” such as:

–        Return on investment projections

–        Health information technology infrastructure

–        Best practices for care coordination

–        Help navigating new federal legislation with regard to effect on Medicaid and SHIP programs

–        Identifying federal funding opportunities

 

CPPI leadership time; staff support; recruiting speakers for calls

More information on the publicly funded world

-     Private client/Investment Drives

-     How does Stimulus fund match state funding to clinics, how can this engage state and private insurance

-     How can we plan hospital investments on Meeting new patients needs in underserved areas (places of disparity)

-     Where are the medical homes from the legislature aspects? How is it going forward?

CPPI leadership time; staff support; recruiting speakers for calls

What is the Defense Military Perspective?

-     Some of these things are already paid for by the VA

-     Questions about how to see where there is overlap in the State Department

PCPCC staff time investigating speakers; CMD leadership time

Address the many permutations of payment reform seen in Medicare RUC recommendations, state Medicaid and SCHIP programs as well as other reimbursement methodologies related to supporting PCMH. This includes:

-     FFS Medicare, reimbursement that pays for quality of quantity

-     What are the pay-fors for demonstration projects?

-     Rural areas- how do you define meaningful care in these areas.

-     What are the resources necessary to become a medical home

CPPI leadership time; PCPCC research; recruiting speakers for calls; NASHP support

Advocating for PCMH model in Federal and State programs

-     Support states in developing legislation

-     Support PCMH Medicare demonstration pilot

-     Foster Medical Homes as a key element of Health Reform

Support from PCPCC in lobbying efforts at federal level; CPPI leadership time

Continue Medication Management Taskforce

      - Regular calls with all stakeholders

      - Develop Comprehensive Medication Management in the   PCMH Guide as PCPCC Publication

CPPI leadership time, staff and resources for guideline development publication

Develop and implement a process for seeking feedback on the CPPI calls so that they will continue to provide the participants with relevant and timely information*

CPPI leadership time; staff support

Update the CPPI portion of the PCPCC website to more accurately reflect the goals and expected deliverables of the CPPI, including the implementation of some interactive sections to better engage participants, if feasible

Staff support; limited CPPI leadership time