1. Michigan Primary Care
Transformation
Demonstration Project
October 31, 2012

2. Agenda
 Context and Overview
 Payer Updates
• BCBSM
• BCN
• Medicaid
• Medicare
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3. Seeking Nomination
 MiPCT is soliciting nominations for one slot for a
PO representative with financial expertise on the
Steering Committee.
 The purpose of the Steering Committee is to
provide strategic direction to MiPCT Leadership
and monitor progress toward the goals and
objectives of MiPCT.
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4. Care Management Reporting
 The care management activity reporting
requirements have been finalized and will be
incorporated into the Quarterly Report beginning
in the first quarter of 2013.
 Number of Care Manager face-to-face encounters
(by Care Manager, by practice, by primary payer)
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5. Care Management Reporting
 Number of Care Manager telephone or electronic
encounters by Care Manager, by practice, by
primary payer
 Number of unique patients by Care Manager, by
practice, by primary payer
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6. PDCM Codes and Fees
CODE SERVICE FEE*
G9001 Initial assessment $112.67
G9002 Individual face-to-face visit (per encounter) $56.34
98961 Group visit (2-4 patients) 30 minutes $14.08
98962 Group visit (5-8 patients) 30 minutes $10.47
98966 Telephone discussion 5-10 minutes $14.45
98967 Telephone discussion 11-20 minutes $27.81
98968 Telephone discussion 21+ minutes $41.17
*Net of Incentive amount
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7. New MiPCT Files
 MiPCT has sent the most recent data participating
practices and physicians, respectively.
 NPs/PAs that serve as PCPs and bill separately
have been added to the file.
 The same billing information needed for
physicians is needed for NPs/PAs.
 To receive Medicaid payments, the NP/PA must be
the PCP of record for Medicaid managed care
members and must be enrolled in CHAMPS.
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8. MDC Dashboard
 The first MDC Dashboard is available for MNO and
the practices within it.
 This release was constructed using 2010-2011
Medicare and Medicaid claims data and
September attribution lists.
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9. MDC Baseline Data
 This release provides baseline data for MNO and
each practice for Medicare and Medicaid (as it
reflects data January 2010 through December
2011).
 More recent data will be integrated over time and
other payers will be added to aid in identifying
opportunities for improvement (and best
practice).
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10. MDC Baseline Data
 The next release of dashboards is scheduled for
January 2013 and will include BCBSM data.
 Future dashboards will be released every two
months to provide data on your performance over
time.
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11. Moderate Care Manager Program
 Place: Physicians’ Training Center
26550 John R Madison Heights Mi 48071
 Contact: Mike Mellor,
mmellor@transformcoach.org
 Modality/schedule: Live, in-person
 Course dates: November 6, 7, 14, 15. 8:30am-
4:30pm (Must all four days)
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12. Documenting Success Stories
 Robert Wood Johnson video submission for
possible full length story
 Interviews by national research organization
 Interviews by CMS representatives
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13. Upcoming Events
 Practice meeting to discuss Care Manager
integration
 Billing and coding
 Group assessment of current quality scores and
gap analysis
 Learning Collaborative beginning December 5,
2012
 Mini Learning Collaboratives
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