1. January – June 2014
From Abstraction to Action:
A Brief Recap of CPCC Activity

2. Goal for Convenings:
Build the public will for medical
homes to improve health care in
Colorado

3. Steering Committee
Determines Four Areas of Focus
1. Payment Reform
2. Engaging the Public
3. Buying Health Insurance for Employees
4. Delivery Reform

4. Stakeholders Use Convening to
Define and Prioritize
1) Payment Reform:
Cover All Services Needed
2) Engaging the Public:
Education and Community Culture

5. Stakeholders Use Convening to
Define and Prioritize
3) Buying Health Insurance for Employees:
Build a business case for, and explain
a clear ROI for the PCMH
4) Delivery Reform:
Build equitable facilitator systems for practice transformation.

6. Work Groups
Clarify and Add Details
Points considered:
Who is doing what, where, and well?
What isn’t being done? Can we really do it?
Can we augment or support existing efforts?
What value add does CPCC uniquely offer?
What audiences are more likely to respond to PCMH?
How can existing relationships and resources be helpful?
What does target audience want and/or need?
Among other questions…

7. Payment Reform
Cissy Kraft, MD
Cover all services needed
Focus on Primary Care

8. Desired outcome:
Collaborate with key stakeholders to create top-
down support and call for specific payment
changes for primary care across all payers.

9. Target:
Payers
1) Direct payers: health plans, employers, and government
2) Indirect Payers: ACOs, IPAs

10. Partners, conduits, messengers:
Policymakers
Providers

11. Strategy 1:
Build on relationships with policymakers,
providers and organized medical groups
a. Collaboration
b. Seek support and buy-in
c. Legislation as last resort

12. Strategy 2:
Outreach and follow up with payers (i.e. health
plans, employers, and government)
a. Leverage relationships to support the State
Innovation Model (SIM)
b. Meet payers where they are at: understand and
address motivation and incentives
c. Refine and promote message to resonate with all
different models of care delivery

13. Tactic 1:
Use specific data outcomes to make the point:
a. Research to include actionable and missing data
including but not limited to behavioral and dental
b. Identify and assess existing models (e.g. Direct Primary
Care, Bundling, Concierge, etc.)

14. Tactic 1:
Use specific data outcomes to make the point:
c. Analyze existing data  outcome, value, validate medical home
approach, what would work for Primary Care, how can other professionals
on the team/professional organizations be included.
d. Actual cost to transform: reality check to be a primary care practice

15. Tactic 2:
Assert leadership through “bold demonstration of
worth”
a. Would doctors be willing to take stand  “This is a model
that benefits us all and we can’t do it any other way – the need is
to be paid differently to reflect the value proposition.”

16. Tactic 3:
Create and disseminate report to payers with request
for action
a. Provide payers data that emphasizes value, benefit, etc. and ask for
specific payment reform amount (once determined)
b. Seek concrete support from payers to implement payment reform.

17. Tactic 4:
Secure meetings
a. Meet with policymakers (i.e. Governor,
Insurance Commissioner, etc) to create support
and use their help as needed.

18. Engaging the Public
Rick Budensiek, DO
Education and Recognizing Community Culture

19. Desired Outcome:
Empower consumers to use their influence
to raise awareness and create change
through calls to action.

20. Target:
Consumers who are likely advocates for PCMH and who will
influence plans and providers  who is bought in, who is not, who is
paying?
a. Age 50 and up (i.e. Medicare)
b. Women of childbearing age/
“Sandwich Generation”
c. Chronic illnesses

21. Partners, conduits, messengers:
a. AARP, employers, providers (ages 50 to 60)
b. MOPS and other faith based organizations
c. Social media, Planned Parenthood, Ob/Gyn Society, etc. (Women of
childbearing age/Sandwich Gen).
e. Colorado Chronic Illness Committee, advocacy groups such as MS
Society, Epilepsy, etc (Chronic Illness)
f. Advocacy organizations with focus on patient empowerment (grassroots
groups such as Aurora Health Access)

22. Strategy 1:
Outreach and collaboration with partners and trusted messengers,
such as RCCO, Chambers, CPCI to understand needs of and best
ways to reach/empower target population.

23. Strategy 2:
Dissemination of information thru existing channels and efforts,
newsletter articles, health and wellness fairs, Exchange website,
WebMD, Wikipedia, etc. May also include PR tactics efforts such as
PSAs, media stories, etc.

24. Tactic 1:
Inventory and promotion of existing medical home messaging
among supporters (consistency); review messaging from PCPCC,
Colorado PCMH practices, TransforMed, NCQA, RCCO, CAHP,
CDPHE, etc

25. Tactic 2:
Use CPCI (trusted source) focus groups to tailor messaging to target
groups  does PCMH as a term resonate, if not, then what? Can
PCMH messaging be tied into current ACA efforts?

26. Tactic 3:
Craft materials such as practice level resource, one-pager, q and a,
testimonials/stories  make connection to “hot topics”, address
elephant in the room, include call to action

27. Buying Health Insurance for Employees:
Dan Burke, MD
Build a business case for, and explain a clear
ROI for the PCMH

28. Desired Outcome:
Business leaders who advocate for
appropriate support of primary care.

29. Target:
“Innovative Employers” such as Boulder Valley
School District (BVSD), St. Vrain Valley School
District, and Elward Systems Corp. (possibly
hospitals that are self-insured)

30. Partners, conduits, messengers:
a. Colorado Business Group on Health
b. Providers – local; grassroots
c. Chambers of Commerce
d. Brokers
e. Society for Human Resource Management
f. Colorado Hospital Association

31. Strategy 1:
Identify opportunity and next steps through
collaborative conversations.

32. Strategy 2:
Create alliance with local providers and
businesses in community

33. Tactic 1:
Work with Donna Marshall to set up a strategy session with
Bob Jamison from BVSD.
a. Understand motivation and incentive, identify lessons learned,
could employees be engaged?
b. Test existing messaging such as “happier, healthier
employees” and “pay less”
c. Refine messages based on conversation

34. Tactic 2:
Implement next steps in collaboration with
“innovative business” and community providers.

35. Delivery Reform:
Brian Hill, MD
Build equitable facilitator systems for
practice transformation

36. Desired Outcome:
Understand current landscape of primary care practices in Colorado
(including those owned and operated by hospital), sas well as
practice transformation needs. Then, identify opportunities for
meetings to address key issues.

37. Target:
All primary care practices in Colorado

38. Partners, conduits, messengers:
a. CDPHE (has existing work group researching work force issues)
b. AAFP’s Robert Graham Center and Ben Miller (recent paper geo-
coded providers)
c. Research firms, med students, other existing resources
d. Colorado Rural Health Center
e. CCMU
f. Colorado Health Institute
g. CCHAP (Colorado Children’s Healthcare Access Program)

39. Partners, conduits, messengers:
h. CCHN
i. HealthTeamWorks
j. CU Dept of Family Medicine
k. SIM
l. AHRQ
m. Regional Extension Centers
n. TransforMED

40. Strategy 1:
Inventory current practice transformation efforts,
challenges, and gaps.
(use current efforts under way such as SIM and existing
data such as CMS and CAFP surveys from 2009 and 2011)

41. Strategy 2:
Convene providers and other stakeholders in solution-
oriented, accessible, statewide meetings (not just in
metro area) to address key issues related to practice
transformation.

42. Tactic 1:
Conduct needs assessment to the extent possible given challenges
and limitations regarding available data (inventory, assessment,
readiness); consider using National Provider Identifiers (NPI data)
-Define denominator (who are the practices, what is a “practice”)
-Other questions include:
-Who is doing what; who is involved
-How to move from primary care to PCMH?
-What is the need and where (gaps)
-Who is the population; how much do they want
-Who is not doing anything; why?
-Is there a need for building a case for small practices
-What are data challenges and needs (include children)
-What measures reflect value and quality?

43. Tactic 2:
Leverage relationships to assist with
research and create engagement
opportunities for providers

44. Tactic 3:
Use research to identify/validate convening topics such as:
“Should a group be formed to create common measures to
standardize data” – look at CPCI
or
“Should a convening be held around data use and analysis?”

45. Q and A

46. Next Steps:
Join an Action Team
(sign up sheets at your table)
Meeting July 30th
9:30 am: Payment Reform
10:30 am: Engaging the Public
12:30 pm: Delivery Reform
July 7th
9:30 am: Buying Health Insurance for Employees

47. Next Steps:
Action Teams Update
Steering Committee:
September 2014
December 2014

48. Next Steps:
Steering Committee Meets
July 21, 2014
September 22, 2014