Center to Promote Public Payer Implementation Call Agenda, TODAY, Tuesday April 20th, 3:00PM EST

Center to Promote Public Payer Implementation
Tuesday, April 20, 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, GlaxoSmithKline; Allen Dobson, North Carolina Department of Health and Human Services, retired; 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. Speaker - Matthew Quinn, Agency For Healthcare Research & Quality (AHRQ) Center for Primary Care, Prevention and Clinical Partnerships (CP3)
 
Matthew Quinn will speak with the group briefly on what AHRQ is currently involved in regarding the medical home.  Mr. Quinn is a Special Expert in the Health IT Program.  Before joining AHRQ, Mr. Quinn was the Health Care Program Manager for Teradata, the global leader in data warehousing and analytic technologies, and was responsible for health care strategy and partnerships for the company. Prior to that, he led marketing for Quantros, a patient safety and clinical outcomes improvement software company, managed GE Healthcare's "Six Sigma for Healthcare" clinical outcomes performance improvement consulting services and data analytic products, helped build an early Personal Health Record company, and served as an Army Engineer Officer. Mr. Quinn's has published work in a variety of health care and technology publications and journals, and he has spoken at the World Health Care Congress, eHealth Initiative's Health IT Summit, and other national and international venues. Mr. Quinn earned a Bachelor's degree from the United States Military Academy at West Point and a Master's degree in Business Administration from Colorado State University.

III.  NASHP Update

Related Resources and Links from NASHP:

(1)  Webcast: “Evaluating the Patient-Centered Medical Home: Potential and Limitations of Claims-Based Data.” - May 4, 2010, 2:30-4:00 pm (EDT)

Presented by the National Academy for State Health Policy, with the support of The Commonwealth Fund 

In order for states to sustain support for medical home projects, they will need to show results: do these projects improve care and contain costs? Can claims-based Medicaid data provide answers to these questions? Please join NASHP on May 4, from 2:30-4:00 p.m. eastern, for a webcast supported by The Commonwealth Fund entitled “Evaluating the Patient-Centered Medical Home: Potential and Limitations of Claims-Based Data.” Mary Takach, MPH, RN, Program Manager from NASHP will moderate this webcast of  national and state experts including Mark Friedberg, MD, MPP, an Associate Natural Scientist from RAND Corporation, Deidre Gifford, MD, MPH the Project Director for the Rhode Island Chronic Care Sustainability Initiative, Patricia Johnson, RN, BS, the Quality Assurance/Improvement Director at the Oklahoma Health Care Authority, and Kelly Botten, BS, a Reimbursement Manager with the Oklahoma Health Care Authority, about the pros and cons of using claims-based data as well as other sources of Medicaid data that can be used to evaluate medical home projects.

To register, please click here.

 

(2)  NASHP is monitoring state efforts to advance medical homes for Medicaid and CHIP participants. We have identified 37 states that met the following criteria: (1) program implementation (or major expansion or improvement) in 2006 or later; (2) Medicaid or CHIP agency participation (not necessarily leadership); (3) explicitly intended to advance medical homes for Medicaid or CHIP participants; and (4) evidence of commitment, such as workgroups, legislation, executive orders, or dedicated staff. Please click on a state highlighted in red to learn more about its efforts.

To learn more, please click here

VI. Open Discussion

Next call is: Tuesday May 18, 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