Presentation at the CQC/CAPG StarQuest meeting 5APR11, Long Beach, CA

1. a simpler way to manage your
P4P/CMS 5 Star quality
program
wayne pan, md
healthaccesssolutions
foster city, california

2. overview
• who are the key players that need to be
involved in this process?
• how can you engage the players in an effective,
systematic way?
• how can you measure performance and
provide feedback?
• how can you engage patients?

3. how are you going to coordinate
all three stakeholders?
health
plans

4. need a bidirectional messaging
platform

5. need a cost-effective way to
communicate with patients

6. need a way to consolidate all
health plans into one platform

7. NOT

8. office manager’s view

9. Senior
doctor
patients

10. physician’s view

11. Senior
doctor
patients

12. doctor patient

13. how can you affect change
in the physician’s office?

14. payer-provider collaboration
is a team sport

15. patient

16. patient
front desk staff

17. analog to digital
converter

18. 112
MARY SMITH 1/1/2011
1234567890
$5.00
$10.00
$25.00
analog to digital eligibility check
converter

19. how to engage your team in
quality improvement efforts?

20. “put hot triggers in the path of motivated people”
BJ Fogg, PhD
Director, Persuasive Technology Lab
Stanford University

23. Triggers: Are people being triggered at the most
appropriate time and in their workflow (path)? How can I
improve the triggers? Conduct usability testing or A versus B
comparisons to measure effectiveness.
Ability: Have I made it easy for people to act? How can I
make it even simpler? Test prototypes to make sure they are
simple enough to fit the user's level of ability. Conduct task
performance testing to measure efficiency and identify factors
affecting ability.
Motivation: Are people motivated to take action? How
can I increase their motivation? Conduct user needs research
to understand the reasons people take appropriate action.

24. Introducing...
ACCESSEXPRESS

25. ACCESSEXPRESS
Click here to register
for a password or
request more information
Powered by Access ExpressQ-v5.0.#.0.1 Build 2011.04.04.00

26. ACCESSEXPRESS
New Eligibility Response New Message (3)

27. ACCESSEXPRESS
New Eligibility Response New Message (3)
BLUE SHIELD OF CA

28. ACCESSEXPRESS
New Eligibility Response New Message (3)
TH
PA
BLUE SHIELD OF CA
E
TH
IN

29. ACCESSEXPRESS
New Eligibility Response New Message (3)
BLUE SHIELD OF CA

30. ACCESSEXPRESS
New Eligibility Response New Message (3)
BLUE SHIELD OF CA

31. ACCESSEXPRESS
New Eligibility Response New Message (3)
BLUE SHIELD OF CA

32. ACCESSEXPRESS
New Eligibility Response New Message (3)
SMITH, MARY
8/15/1945
1234567890
MAMMOGRAPHY, CRC, CARDIO CARE,
BLUE SHIELD OF CA
DIABETES CARE, HYPERTENSION,
GLAUCOMA, MED MONITOR, FLU VAC,
PNEUMO VAC, DEXA, OSTEOPOROSIS,
RHEUM, COPD

33. ACCESSEXPRESS
New Eligibility Response New Message (3)
ER
SMITH, MARY
8/15/1945
G
1234567890
IG
MAMMOGRAPHY, CRC, CARDIO CARE,
BLUE SHIELD OF CA
DIABETES CARE, HYPERTENSION,
TR
GLAUCOMA, MED MONITOR, FLU VAC,
PNEUMO VAC, DEXA, OSTEOPOROSIS,
RHEUM, COPD
T
O
H

34. ACCESSEXPRESS
New Eligibility Response New Message (3)
SMITH, MARY
8/15/1945
1234567890
MAMMOGRAPHY, CRC, CARDIO CARE,
BLUE SHIELD OF CA
DIABETES CARE, HYPERTENSION,
GLAUCOMA, MED MONITOR, FLU VAC,
PNEUMO VAC, DEXA, OSTEOPOROSIS,
RHEUM, COPD

35. ACCESSEXPRESS
New Eligibility Response New Message (3)
BLUE SHIELD OF CA

36. ACCESSEXPRESS
New Eligibility Response New Message (3)

37. digital to analog converter module

38. ACCESSEXPRESS
New Eligibility Response New Message (3)

39. ACCESSEXPRESS
New Eligibility Response New Message (3)
N
O
TI
VA
TI
O
M

40. ACCESSEXPRESS
New Eligibility Response New Message (3)

42. ACCESSEXPRESS
New Eligibility Response New Message (3)

43. ACCESSEXPRESS
New Eligibility Response New Message (3)

44. ACCESSEXPRESS
New Eligibility Response New Message (3)

45. Description of
measure

46. Capability for
physician office
entry

47. Capability for
physician office
entry
Y
IT
IL
AB

48. ACCESSEXPRESS
New Eligibility Response New Message (3)

51. Ascender HCC module

52. how can you affect change
in the physician’s office?

53. engage your team in quality
improvement efforts

54. “put hot triggers in the path of motivated people”
BJ Fogg, PhD
Director, Persuasive Technology Lab
Stanford University

56. ?

57. thankyou