Reminder: Center Call Agenda, Tuesday October 20th, 3:00PM EST

Center to Promote Public Payer Implementation
Tuesday, October 20, 2009
3:00pm-4:00pm, EST
Call in number: 712.432.3900   Code -  471334#    Moderator/Speakers - *406354

Please press *6 to mute your line and *7 to unmute.
(Moderators/Speakers use #0 to mute all participant lines and #1 to unmute.)

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. Legislative Activity Update - Henry Bachofer, Division of Delivery System Demonstrations & Jim Coan, Division of Health Promotion and Disease Prevention Demonstration
 
Health and Human Services Secretary Kathleen Sebelius, VT Governor Jim Douglas and Director of the White House Office of Health Reform Nancy-Ann DeParle recently announced Medicare to join state-based healthcare delivery system reform initiatives.
The initiative will allow Medicare to join Medicaid, and private insurers in state-based efforts to improve the way health care is delivered.  Innovative models of delivering primary care around the country are examples of the types of programs that will be part of the President’s health reform plan.  These are models that improve care for patients, give primary care providers better information about their patients and achieve greater value for the health dollars spent.
 
The new demonstration will build on a model being tested in Vermont. Under the Vermont model, private insurers work in cooperation with Medicaid to set uniform standards for “Advanced Primary Care (APC) models” also known as medical homes. These models provide incentives for doctors to spend more time with their patients and offer better coordinated higher-quality medical care.
 
Henry Bachofer from the Division of Delivery System Demonstrations will speak to the Medicare Advanced Primary Care Demonstration which was recently announced by Secretary Sebelius, and Jim Coan of the Division of Health Promotion and Disease Prevention Demonstration will provide information regarding the status of the Medicare Medical Home Demonstration as described in section 204 of the Tax Relief and Health Care Act of 2006.
 
III. Registration for the PCPCC Annual Summit on October 22nd is Now Open
 

The shape of health care is changing, and the patient centered medical home is front and center in every proposal on the Hill. Don't miss this opportunity to learn about the mission-critical steps that organizations must take in order to advance the patient centered medical home.                            

Congresswoman Allyson Schwartz (D. Pa.) will offer the keynote address. National Economic Council Special Assistant to the President Robert Kocher, MD, will be among participants in a panel discussion of the role of the PCMH in health reform. Joining him on the panel will be Stephen Cha, professional staff majority, House Energy & Commerce Committee; Ree Sailors, program director, health division, Center for Best Practices, National Governors Association; and Ahaviah Glaser, American Association for Retired Persons.
Two new PCPCC publications will be introduced at the Summit.  Across the nation, dozens of patient centered medical homes are already organizing or operating at the local, regional and state levels. 'Proof in Practice: A compilation of patient centered medical home pilot and demonstration projects' reports the progress of pilots and initiatives, providing descriptions and details of how they are structured and what they are achieving.
Consumer engagement and collaboration in care are vital components for PCMH success.  'A Collaborative Partnership: Resources to help consumers thrive in the medical home' presents resources for consumer engagement developed by the PCPCC and partner organizations, as well as industry resources and the latest data on how pilots are working to connect with consumers.  

To register, if you have not already done so, please click here.
 

IV. Wrap-up and Next Agenda

Next call is: Tuesday November 17th, 2009; 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