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Under One Roof: Integrating Primary Care & Behavioral Health in the Medical Home held on 7/1/09. Recording Available.
Presenters: Laura Galbreath, Director of Policy and Advocacy for the National Council for Community Behavioral Healthcare (NCCBH), and Liz Reardon, president of Reardon Consulting and former Managed Care Director for Vermont Medicaid.
Listen to Liz Reardon's pre-session comments:
SAMHSA's 10 by 10 Campaign aims to add 10 more years to the lives of people with chronic mental illness.
Person-centered healthcare homes are critical to address significant health disparities for people with serious mental illnesses, according to the NCCBH report, "Behavioral Health/Primary Care Integration and the Person-Centered Healthcare Home." This presentation by Galbreath and Reardon joined current developments in the patient-centered medical home model with evidence-based approaches to integration of primary care and behavioral health.
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Medical Home Contracting: Building a Solid Framework held
on 7/8/09. Recording Available.
Presenter: Barbara Walters, DO, MBA, Senior Medical Director, Dartmouth-Hitchcock Medical Center.
Listen to Barbara Walters' pre-session comments:
A healthcare organization should bring clinical credibility to the medical home contract negotiating table.
As a member of the contracting team for Dartmouth-Hitchcock Medical Center's medical home initiatives, Dr.
Barbara Walters shared how to effectively prepare, negotiate and contract with payors for the medical
home model of care. Dr. Walters examined the core components associated with managing relationships,
understanding financial models and contracting with payors to prepare organizations for a seat at the
negotiating table.
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Meet the Medical Home Neighbor: Accountable Care Organizations held on 7/29/09. Recording Available.
Presenter: Dr. Craig Samitt, MBA, President and CEO of Dean Health System.
Listen to Dr. Craig Samitt's pre-session comments:
Accountable care organizations are the broader framework that encompass the medical home model.
The accountable care organization (ACO) — a network of primary care physicians, one or more hospitals and subspecialists that provide patient-centered care — is receiving increasing attention as healthcare reform unfolds. Learn how Dean Health System, where leveraging high-value, high-quality healthcare is a hallmark, has implemented a series of best practices to create an ACO that provides a high-value patient-centered care experience. Dean Health System President and CEO Dr. Craig Samitt, MBA, described this series of business best practices, including effective recruiting,
incentives and performance management to provide high quality care.
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Patient Engagement and Education in the Medical Home: Perspectives from Several Pilots held on 8/5/09. Recording Available.
Presenter: Barbara Wall, President and CEO, Hagen Wall Consulting.
Listen to Barbara Wall's pre-session comments:
Scrubbing the appointment schedule paves the way to improved patient recall and outreach.
At the core of the patient-centered medical home is the engagement and education of the patient. Drawing
upon her recent consulting roles with two separate medical home models used in pilots in the Northwest,
Barbara Wall from Hagen Wall Consulting described the essential process changes that improve patient
outreach and keep the patient at the center of the medical home.
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Constructing Care Transitions to Reduce Hospital Admissions held on 8/26/09. Recording Available
Janet Tomcavage
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Doreen Salek
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Presenters: Janet Tomcavage, Vice President of Health Services, Geisinger Health
Plan and Doreen Salek, Director, Business Operations of Health Services, Geisinger Health Plan.
Listen to Doreen Salek's pre-session comments:
A "clean and clear handoff" of a patient from one care site to another should include a focus on this key area.
Already on CMS' agenda this year, a focus on transitions in care can significantly affect health outcomes, ER utilization, cost to
patients, providers and insurers and burdens on caregivers and family members.
The Transitions of Care is a critical component of Geisinger Health Systems successful medical home program and a huge opportunity to improve care delivery and outcomes. Janet Tomcavage and Doreen Salek shared the essentials behind the transition teams for a medical home
pilot at Geisinger that reduced hospital admissions by 20 percent and overall healthcare costs by 7 percent while improving patient
satisfaction and clinical outcomes.
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Successful Models of Care for the Medical Home: Staffing and Roles of the Care Team held on 9/9/09. Recording Available.
Presenter: Michael Erikson, Vice President, Primary Care Services, Group Health Cooperative.
Listen to Michael Erikson's pre-session comments:
A patient's understanding of his care team relies heavily on his physician.
By increasing its primary care staff by 30 percent and expanding its multi-disciplinary clinical teams to include family doctors, general internists, physician assistants, nurses, medical assistants and clinical pharmacists, Group Health Cooperative decreased not only its emergency room and urgent care visits, but also inpatient hospital stays.
This patient-centered medical home pilot produced this rapid return on investment in just one year. During this 45-minute webinar, Michael Erikson described the staffing strategies it implemented to reduce these downstream utilization costs — from the skill sets required by the staff to the workflow changes needed to accommodate this model of care.
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Medical Home Reimbursement: Exploring Bundled Payment Options held on 9/16/09. Recording Available.
Presenter: Michael Zucker, Chief Development Officer, Baptist Health System.
Listen to Michael Zucker's pre-session comments:
Healthcare reform was part of the impetus behind Baptist Health System's participation in the CMS ACE bundled payment pilot.
Several pilot programs across the country are testing a bundled payment method — also known as "case rates" or "episode-based payments" —
under which care is reimbursed on a case or episode rate.
During this 45-minute webinar, Michael Zucker shared Baptist Health System's experience
thus far in preparing for the pilot and early feedback. We heard details on how they've
structured the payment, adjusting for severity, coordination and negotiation of the services
and preparing for transitioning to real-life application.
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Adopting and Implementing Evidence-Based Guidelines in the Medical Home held on 10/6/09. Recording Available.
Presenter: Dr. Richard J. Baron, President and CEO, Greenhouse Internists
Listen to Dr. Richard J. Baron's pre-session comments:
Looking beyond the EHR's note generation capability has made Greenhouse Internists more productive with less staff.
Many physician groups report that one of the most difficult aspects of building an advanced medical home is the adoption and implementation of evidence-based guidelines. During this session, you'll hear how Greenhouse Internists overcame the challenges associated with following evidence-based guidelines for each patient.
Dr. Baron will share his practice’s evidence-based guidelines experience, from working with physicians on documentation, staff training and work flow redesign to using the data to improve practice performance.
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Achieving NCQA's Patient-Centered Medical Home Recognition held on 10/21/09. Recording Available.
Dr. James Kerby
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Barbara Luskin
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Presenters: Dr. James Kerby, Vice President of Medical Affairs
and Barbara Luskin, Quality Manager, Grand Valley Health Plan.
Listen to Barbara Luskin's pre-session comments:
From workgroup to champion, GVHP's multifaceted approach supports the NCQA recognition process.
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Grand Valley Health Plan has been recognized as a Patient-Centered Medical Home by the National Committee for Quality Assurance.
During this webinar, Dr. James Kerby, vice president of medical affairs and Barbara Luskin, quality manager at Grand Valley Health Plan, shared Grand Valley Health Plan's experience to date on the basics of preparing for and achieving recognition from NCQA's Physician Practice Connections® - Patient-Centered Medical Home™ — from the daily workflow changes and processes that need to be in place for patient access, communication, education and tracking, care management and performance reporting and improvement, to the adoption and implementation of evidence-based guidelines, one of the more challenging aspects of recognition for most practices.
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Effective Case Management in the Medical Home held on 11/11/09. Recording Available.
Presenter: Diane Littlewood, RN, Regional Manager of Case Management for Health Services, Geisinger Health Plan and Joann Sciandra, RN, Regional Manager of Case Management for Health Services, Geisinger Health Plan
Listen to Joann Sciandra's pre-session comments:
Sciandra attributes Geisinger's reduction in hospital readmission rates to this single strategy.
The role of the case manager in the healthcare system has been steadily increasing as the need to manage healthcare expenditures and utilization grows. Whether by phone, in the home, in the emergency room, in the physician's office or at the time of discharge, case managers are charged with helping patients gain access to needed medical, social, educational and other services for chronic conditions.
During this 45-minute webinar, Diane Littlewood, RN, and Joann Sciandra, RN, both regional managers of case management for health services at Geisinger Health Plan, examined the key components of an effective case management program — from the background of the case manager to their responsibilities and training. They shared strategies for training case managers, managing case loads, case management tools, techniques, principles and practices and case management stratification.
- Risk Adjustment in the Medical Home: Building an Effective Reimbursement Strategy held on 12/16/09. Recording Available.
Presenter: Jeff Schiff, MD, MBA, Medical Director, Minnesota Health Care Programs, Minnesota Department of Human Services
Listen to Jeff Schiff's pre-session comments:
There's a business case for putting patients at the care planning table.
Medical home reimbursement models need to take into account the case mix differences in the patient population being treated.
During this 45-minute program, we will examine the risk factors that need to be considered in a risk-adjusted medical home reimbursement strategy, from the challenges associated with risk adjustment to strategies for adjusting risk and incentivizing physicians to participate in medical home programs through an attractive risk-adjusted strategy.
The Minnesota Department of Human Services, Minnesota’s Medicaid agency, has begun a process to transform healthcare delivery in the primary care setting. Legislation passed in both 2007 and 2005 and a Medicaid Transformation Grant have allowed the state to begin work on the creation of a payment support infrastructure for primary care in the form of risk-adjusted care coordination capitation. The existing model of fee-for-service is being replaced by proactive care planning and management with the patient and families.
The payment methodology takes into account both medical and social/demographic factors associated with medical care coordination. Dr. Jeff Schiff will describe this methodology and will explain how Minnesota addresses the challenges associated with risk adjustment, including
the “year two” problem and the addition of clinical data to the model.
Dr. Schiff will cover:
- Alternative payment models and logics;
- Risk adjustment principles; and
- Methodologies developed and being considered for payment risk adjustment.
- Medication Therapy Management in the Patient-Centered Medical Home held on 1/6/10. Recording Available.
Presenter: Beth Chester, PharmD, MPH, BCPS, senior director of clinical pharmacy services and quality, Kaiser Permanente Colorado
Listen to Beth Chester's pre-session comments:
There are five populations that will benefit most from medication therapy management.
From free and discounted prescription drug costs to medication reconciliation in the office, medical home programs are taking a number of steps to ensure patient medication compliance.
During this 45-minute webinar, an industry expert will share the key components of medication therapy management programs in the medical home. You’ll get details on the roles of the physician practice’s staff and the pharmacist in medication management, the use of technology and how financial incentives and reimbursement can play a role in improving medication compliance.
Dr. Chester will cover:
- The rationale for including pharmacists in the medical home;
- Medication therapy management practice examples that are improving patient care;
- Facilitating factors; and
- Overcoming the challenges associated with medication therapy management.
- Multi-Payor Medical Home Programs: Addressing Funding and Organizational Challenges held on 1/20/10. Recording Available.
Presenter: Julie Schilz, BSN, MBA, manager, IPIP and PCMH for the Colorado Clinical Guidelines Collaborative
Listen to Julie Schilz's pre-session comments:
A single tool can help transform practices, improve quality and deliver evidence-based care — and it's not an EHR.
A multi-payor medical home pilot in Colorado, consisting of six private payors and the Colorado Medicaid program, is using an enhanced payment structure for between 10 and 15 practices that provide care to up to 30,000 patients. The multi-payor pilot, which launched in 2009, maximizes the practice investment cost for the medical home.
During this 45-minute webinar, Julie Schilz, manager, IPIP and PCMH for the Colorado Clinical Guidelines Collaborative, will share
Colorado's experience to date in creating this multi-payor initiative, from the development of the program to the challenges that need to be addressed in working with multiple payors.
Ms. Schilz will cover:
- Addressing anti-trust issues;
- Establishing guidelines and gaining stakeholder commitment;
- Including public and private payors in demonstrations;
- Considerations for healthcare payment reform and alignment with demonstration goals;
- Funding a multi-payor collaborative; and
- Overcoming the challenges of working with multiple payors.
- Embedded Case Managers: Navigating Care Transitions, Gaps in Care and Patient Compliance held on 3/10/10. Recording Available.
Presenter: Diane Littlewood, RN, Regional Manager of Case Management for Health Services, Geisinger Health Plan
Listen to Diane Littlewood's pre-session comments:
A few basics up front can help to accurately define the embedded case manager's responsibilities.
Whether embedded in a primary care practice, hospital or nursing facility, embedded case managers are helping patients to navigate the healthcare system in terms of care transitions and compliance to care plans.
During this 45-minute webinar, Diane Littlewood, RN, Regional Manager of Case Management for Health Services, Geisinger Health Plan, will examine an embedded case manager program, from the factors that will help you determine if a program is right for your organization and deciding on the placement to defining roles and responsibilities for a program.
Ms. Littlewood will cover:
- Working with physician practices to embed case managers to assist with care transitions and patient compliance;
- Identifying which patients would benefit from this type of case management;
- Skill sets, roles and responsibilities of the embedded case manager;
- Case load management;
- Coding and reimbursement for case management; and
- Results from the Geisinger Health Plan's embedded case manager program.
