In-Person CPC+ Payers’ Meeting Highlights the Impact of Integration on Patient Experience

March 29, 2018

Program:  Multi-Payer Primary Care Transformation

The Milbank Memorial Fund’s Multi-State Collaborative has been bringing together a diverse group of payers for the last three years. They may be in competition with one another, but they are eager for the opportunity to learn from experts and each other.

The largest group of this kind to be hosted by the Fund—40 people, representing 23 public, private, regional, and national insurance companies—gathered in Denver, Colorado, on March 20 to learn from Colorado’s experience in multi-payer collaboration.

One focus in particular was how the innovative Colorado Multi-Payer Collaborative is integrating behavioral health care with primary care at the local level. Leaders from Colorado described how local commitment, gubernatorial and state legislative support, and federal funding have resulted in transforming practice and information operations to be more patient-centered and seamlessly coordinated. Presenters explained the myriad details of creating and implementing the complicated support infrastructure, girded by a responsive yet secure health care information technology system.

To demonstrate how behavioral health integration works on the local level, the audience heard from a patient at Roaring Fork Family Practice, a clinic that has been actively engaged in quality improvement over several years through both the Comprehensive Primary Care (CPC) and State Innovation Model (SIM) programs. Mary Katherine Conger drove partway across the state, from Carbondale to Denver, to tell the insurance company representatives about a very personal part of her life—namely, seeking diagnosis and treatment for mental health issues.

“We are so focused on gathering and sharing the ever-increasing evidence of the efficacy of multi-payer primary care transformation, but it’s the patient stories that are essential, literally fleshing out the astounding impact a coordinated caregiving team can have on a patient and his or her family,” said Lisa Dulsky Watkins, Multi-State Collaborative director. “While the outcomes data, documenting positive changes in utilization and clinical improvement, are key to financial sustainability, they don’t paint the whole picture.”

Mary Katherine shed much-needed light on the patient’s perspective, explaining that the Roaring Fork staff  “worked with her rather than talking to her,” that they knew who she was, and were behind her when it came to supporting her and her family.

As Mary Katherine put it, she “found her voice” through the process of becoming a patient advocate, recruiting new members to join the patient advisory council on which she serves, and speaking at national conferences. One of her recent successes was creating a policy that enables hospitalized patients to get a full six hours of sleep at night, decreasing the frequency of vital sign checks when medically safe.

To hear Mary Katherine, Heather Grimshaw, communications director for Colorado SIM, and several team members from Roaring Fork Family Practice talk about their experiences delivering and receiving high-quality care, listen to this episode of Innovation Insights.