MiPCT Webinar 1/22/2014
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This document outlines the agenda for a MiPCT Demonstration Project meeting, including: introducing new practice team members, comparing G code billing results between practices, discussing care managers and metrics for 2014. It reviews utilization, clinical quality, and process measures that will be assessed. Learning requirements are outlined for care managers and practice teams, including ICD-10 workshops and a learning collaborative. Participating practice teams are listed and an open discussion is invited.
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MiPCT Webinar 1/22/2014
- 1. MiPCT Demonstration Project Medical Network One January 22, 2014
- 2. Agenda Comparative G code billing results Care Managers Metrics for 2014 2 Introduction of practice unit new team members Learning requirements
- 3. Comparative G Code Use Who is on your practice team? How is your team working together? How can your team be invigorated? What are your practice’s current challenges? 3 Slipped in ranking Tell us how many referrals you’ve received from your PCPs?
- 4. PCMH Accreditation Two national accreditation bodies • URAC • NCQA One local payer designation • BCBSM 4
- 5. What Are We Measuring? Utilization (assessed at PO level) Exceed benchmark or % improvement over previous year Primary care sensitive ED visits (NYU algorithm) Asthma ED Visits for Previously Diagnosed Asthma* Ambulatory Care Sensitive Hospitalizations Hospital Readmissions Claims 5
- 6. What Are We Measuring? Clinical Quality Metrics (assessed at PO level) Exceed benchmark or % improvement over previous year Diabetes: Annual retinal eye exams Breast Cancer Screening Cervical Cancer Screening Well Child Visits - 15 months Well Child Visits - 3-6 years Adolescent immunizations Claims 6
- 7. What Are We Measuring? Clinical Quality Metrics (assessed at PO level) Exceed benchmark or % improvement over baseline Diabetes Control A1C < 8 Diabetes: Blood Pressure < 140/90 CVD: Blood Pressure < 140/90 Hypertension: Blood Pressure < 140/90 Tobacco Use Assessment Weight Assessment for Children and Adolescents Registry and Claims 7
- 8. What Are We Measuring? Process Measures (assessed at practice level) Depression Screening for Patients with Chronic Health Conditions Notification of hospital admissions and discharges Follow-Up Referrals to a Community-Based Program or Agency Self-Management Support Offered for Chronic Condition of Focus Registry, Claims and Quarterly MiPCT Report 8
- 9. Learning Requirements: 2014 9 Specific Care Manager learning requirements Specific Practice Team learning requirements
- 10. Learning Event: Care Managers 10 12 hours Learning events for Care Managers
- 11. Learning Requirement: Practice Unit 11 Care Team Members: It is not “care manager” and the team” Eight hours of group learning
- 12. MiPCT Learning Activities Thanks to Priority Health for their engagement Recommended for physicians, mid level providers, other healthcare professionals and staff ICD-10 goes live on October 1, 2014 ICD-10 Workshop (6 CEUs toward 2014 CMC) • January 30, 2014 • 9am-4pm • Training Center in Madison Heights 12
- 13. MiPCT Learning Activities MiPCT Learning Collaborative Expectation was for 100% of the MNO MiPCT practices to participate Fluctuation of care team activity and competencies • Three Saturday Sessions at Blue Care Network • January 25 from 8am-4pm 13
- 14. MiPCT Collaborative Team Participants Country Creek Family Physicians Country Creek Pediatrics Hampton Medical Center Lifetime Family Care 14 Anchor Bay Clinic Michigan Healthcare Professionals (Angela’s Team)
- 15. MiPCT Learning Collaborative Teams Everingham Clinic Macomb Pediatrics Monroe Medical Woodhaven Pediatrics Ricardo Cabrera, MD Jeetender Matharu, MD Douglas Hames, MD 15 Center for Preventive Medicine Meadowbrook Internists
- 16. CMS Ruling 16 Appeal of the criteria for care managers Review of hiring requirements