1.
Creative Disruption of COVID-19 &
Implications for Team-Based Care
May 12, 2020

2.
Today’s Faculty Panel
Thomas Bodenheimer
Founding Director
Center for Excellence in
Primary Care
Tom Bodenheimer, MD, MPH is a general internist who received his medical degree at
Harvard and completed his residency at UCSF. He spent 32 years in full-time primary
care practice in San Francisco's Mission District – 10 years in community health centers
and 22 years in private practice. He is currently Professor Emeritus of Family and
Community Medicine at University of California, San Francisco and Founding Director of
the Center for Excellence in Primary Care. Dr. Bodenheimer developed CEPC’s health
coaching model that has been shown effective at improving cardiovascular health,
medication adherence, and patient experience. He led development of the 10 Building
Blocks model, a roadmap to high performing primary care based on site visits to 23 highly
regarded practices across the United States. He is currently focused on improving the
quality of primary care residency practices. He is co-author of Understanding Health
Policy, 8th Edition, 2020, and Improving Primary Care, 2006 (both McGraw-Hill). He has
written numerous health policy articles in the New England Journal of Medicine, JAMA,
Annals of Family Medicine, and Health Affairs.

3.
Today’s Faculty Panel
Rachel Willard-Grace
Director
Center for Excellence in
Primary Care
Rachel Willard-Grace, MPH, Director, began her career as a medical assistant and
pharmacy tech, and later Executive Director of a free clinic, where she became so
smitten with primary care that she abandoned her plans for a career as a historian.
She worked with Tom Bodenheimer and Kevin Grumbach to develop the 10 Building
Blocks of Primary Care based on a study of high-performing practices across the
United States. She conducts research related to burnout, health coaching, and
primary care transformation. She also guides CEPC’s extensive training program,
which provides training in patient-centered communication and practice
transformation to organizations across the United States. Rachel has a master’s
degree in Public Health from the University of North Carolina at Chapel Hill.

4.
Today’s Faculty Panel
Julita Mir
Chief Medical Officer
Community Care Cooperative
(C3)
An internist and infectious diseases physician with extensive experience in community
health and serving the most vulnerable populations, Dr. Julita Mir is Chief Medical Officer
of Community Care Cooperative (C3), a position she has held since 2017. In this role,
she oversees medical operations for C3 and its network of 19 community health centers
throughout Massachusetts.
Dr. Mir has a more than 20-year career working as a clinician in Boston’s federally
qualified health centers and managing HIV and Hepatitis programs locally. Prior to her
work for C3, she served as Chief Medical Officer for DotHouse Health in Dorchester,
Massachusetts, where she continues to see patients weekly.
Dr. Mir completed her medical degree at the Universidad Central de Venezuela, where
she first developed her passion for community health and serving the most vulnerable.
She is a graduate of the Boston University School of Medicine, where she has continued
to teach residents and medical students as an Assistant Professor since 1999.

5.
https://www.weitzmaninstitute.org/
Our Training Opportunities
MA Training in Partnership with
Primary Care Practices
Providing educational opportunities that
address workplace shortages in
primary care.
UpSkillMA
Providing practicing medical assistants
with next-level training and expertise to
excel in high-performing primary care
teams.
https://www.weitzmaninstitute.org/upskillmahttps://www.nimaa.org
https://www.nimaa.org

6.
Using Zoom
Note the Q&A option:

7.
Series Objectives
Provide an analysis of how COVID-19 has impacted the
practice of patient-centered team-based care regarding the
provider/MA relationship.
Highlight the importance of a team-based care approach as
we transition from a COVID-response practice model to a new
practice reality.
Explore and reaffirm the role of the MA as vital to the team,
during COVID-19 and moving forward.

8.
Today’s Faculty Panel
Mary Blankson
DNP, APRN, FNP-C
Chief Nursing Officer
Community Health Center, Inc.
Thomas Bodenheimer
MD, MPH
Founding Director
Center for Excellence in
Primary Care
Rachel Willard-Grace
MPH
Director
Center for Excellence
in Primary Care
Julita Mir
MD
Chief Medical Officer
Community Care
Cooperative (C3)

9.
We want to hear from you!

10.
Today's Session Objectives
Provide an understanding of the medical assistant role in TBC
prior to COVID-19 and the changes experts foresee for this
role in the post-COVID-19 reality.
Discuss necessary policy changes to support and better
leverage the new roles of the medical assistant.
Explore the role of the medical assistant in the delivery of
telehealth and the implications for transitioning and/or
expanding into this new role.

11.
Tell us about your
organization

12.
The Role of the MA Pre and Post COVID-19
Some functions
are the same pre
and post COVID,
but have new
workflows
Other post COVID
functions are new
Primary care now
takes on more
responsibility for
public health

13.
Old Functions with New Workflows: Examples
Rooming patients
virtually
Med rec virtually (best
with video visits)
Identifying and closing care-
gaps when patients receive
routine immunizations and
cancer screenings is a clinic
policy issue and MAs need to
explain the policy to patients
Helping patients
navigate lab, imaging,
pharmacy, referrals
Helping patients
delay services that
are not urgent
Helping patients
arrange home
deliveries if available

14.
New Functions: Examples
Explaining telehealth to patients — why and how to do it
Scheduling telehealth visits — phone or video (unless front desk
does it)
Triaging whether patients need to come in and if so, separate
them into sick and not sick (respiratory or not respiratory)
For sick respiratory patients who need to come in, rooming
functions and COVID testing with PPE
Health coaching because patients will need to take more responsibility
for their own health. For health coaching materials, visit the UCSF Center
for Excellence in Primary Care: https://cepc.ucsf.edu/health-coaching

15.
Public Health Functions
Education of clinic’s
patients about COVID
Collecting testing
samples in COVID
area outside the clinic
Training contact
tracers with local
health department
Coaching patients on
COVID behaviors,
helping them solve
problems they face

16.
Health Center
Gross Charges
Baseline
% Change from
Baseline (Week 5)
Z $180,000 -63.6%
G $900,000 -59.0%
A $3,050,000 -58.6%
B $1,120,000 -56.5%
O $390,000 -55.2%
J $260,000 -54.8%
R $750,000 -48.4%
S $260,000 -44.4%
H $680,000 -43.2%
K $520,000 -42.6%
Average $570,000 -41.2%
L $690,000 -40.5%
Health Center
Gross Charges
Baseline
% Change from
Baseline (Week 5)
Y $180,000 -38.6%
E $440,000 -36.0%
D $250,000 -25.8%
P $350,000 -25.7%
W $90,000 -24.1%
U $630,000 -20.7%
M $40,000 -19.5%
I $350,000 -16.0%
T $180,000 -9.9%
Q $390,000 -8.2%
N $1,240,000 -5.0%
X $200,000 -4.1%
Revenue at Week 5 vs. Baseline
(Average of Jan-Feb 2020)

17.
Sustainability – Which Curve Will We Be On?
Telehealth reverts to niche and novelty
Promising advances in multi-line
telehealth not sustainable due to policy
and reimbursement
Sustainable and expanding
1
2
3

18.
Join us for our next session:
Elizabeth Murphy, MM, CMA (AAMA)
Associate Director of Education at NIMAA
Josie Llaneza
Director of Programs and Health Equity at Erie Family Health Centers
Lucia Mendisabal, CMA
Medical Assistant at Salud Family Health Centers
May 19, 2020
3:00PM EDT
https://www.nimaa.org https://www.weitzmaninstitute.org/