Multi-Payer Primary Care Transformation Webinars

Optimizing Mental Health in Advanced Primary Care: The Collaborative Care Model and Measurement-based Care

January 2019

Psychiatrist and advocate Henry Harbin, and health economist Michael Schoenbaum of the National Institute of Mental Health, discuss the efficacy and centrality of behavioral health access, tracking, and measurement in the CPC+.  Mental illness and substance use are major drivers of disability and costs. Effective treatments exist, but currently there are not enough specialty providers to provide the necessary care. By effectively integrating behavioral health care with primary care we can increase access to care, improve health outcomes, and lower costs.

See presentation slides here.

See Medicare Learning Network Fact Sheet here.

See New England Journal of Medicine article here.

See The Kennedy Forum article here.

See the Collaborative Care Model here.

 

CPC Classic Government, Commercial, and Medicare Advantage Population Outcomes in Ohio

November 2018

Richard F. Shonk, MD, PhD, of The Health Collaborative, shares the results of the extensive analysis of member outcomes from CPC Classic.  In contrast to the minimal impacts observed in Medicare fee-for-service beneficiaries, Dr. Shonk’s presentation describes the substantial increases in utilization, cost decreases in the participating Ohio payers’ commercial and Medicare Advantage populations, and the importance of looking at results across payer types when evaluating outcomes. Dr. Shonk and Dr. Laura Sessums recently published their findings in a Health Affairs Blog post, The Comprehensive Primary Care Initiative: Another Side of the Story.  This post provides their perspectives as physicians active in primary care transformation and offers insights gleaned in discussions with private payers and physicians who participated in CPC.

See the presentation slides here.

 

Data Aggregation, Feedback, & Quality Measurement Alignment: Supporting the CPC+ Model

October 2018

Guest speaker Craig Jones, MD, formerly the director of the Vermont Blueprint for Health, and now an independent consultant for Deloitte as well as with the Office of the National Coordinator at the U.S. Department of Health and Human Services is doing technical and cultural assessments of CPC+ regions’ information technology capacity, and has found some compelling and informative patterns.  He shared the important results of his multiple site visits and interviews.

See the presentation here.

See the discussion topics here.

 

Understanding the Role of the Patient-Centered Medical Home in Building a Strong Primary Care Foundation

September 2018

Dr. Johnson, Vice President for Enterprise Data & Analytics Blue Cross Blue Shield of Kansas City, presented a summary of her study on the BCBS Kansas City Medical Home Program. Her study, which is the basis of her doctoral dissertation, examines three important questions: 1) How do basic characteristics of medical homes and non-medical homes differ? 2) Does medical home implementation influence physician practice patterns? 3) Does medical home ownership influence total cost of care or utilization rates for high-cost services? Dr. Johnson and participants in the webinar discuss the implications this study has for building a strong primary care foundation and the potential roles that payers have in enhancing financial incentives, reducing administrative burdens, implementing benefit design that promote primary care, and focusing on accountable care agreements that move beyond primary care.

See the presentation slides here.

 

CPC+ Market Update Tool Webinar

May 2018

The results of the most recent CPC+ Market Update Tool indicate several payer milestones that are proving to be challenging to achieve, notably in data aggregation and in Track 2 payment.  We heard about strategies being used and progress being made in these areas in two CPC+ regions.

  • Milestone 4 – Alternative Payment Model for Primary Care.
    • May Kjemperud and Josué Aguirre of CareOregon, one of the Oregon region’s payers, presented their approach to moving towards Track 2 payment.
  • Milestone 6 – Data Support to Practices
    • Erik Muther, the convener for the Greater Philadelphia Area, shared their regional process and progress for data aggregation decision making and implementation.

 

Special Milbank CPC+ Webinar – Direct Provider Contracting

May 2018

The CMS Innovation Center (CMMI) released a Request for Information (RFI), seeking input on the concept of Direct Provider Contracting (DPC). The public comment period for this is quite brief, ending on May 25, 2018. This presents us with a critical and time-sensitive opportunity to inform the future focus of CMMI by sharing your organizations’ and personal opinions.

Several colleagues generously offered to share their experience and opinions about DPC in a panel presentation set up by the Fund, to be followed by an facilitated question and answer session.

 

Looking at Primary Care Spending

April 2018

Rachel Block, Milbank Memorial Fund Program Officer, and report co-author Mark Friedberg of the Rand Corporation will discuss the methods and findings of a study, published in 2017 by the Fund, on Standardizing the Measurement of Commercial Health Plan Primary Care Spending.

 

Strategies for Engaging Self-Insured Employers in Multi-Payer Primary Care Transformation

March 2018

Our colleagues from Blue Cross and Blue Shield of Kansas City, Qiana Thomason, Vice President for Population Health Solutions, and Karen Johnson, Vice President for Healthcare Insights & Partnerships, share their experiences bringing their administrative services only lines of business into the CPC+ effort.

 

Interprofessional Education at the University of Arkansas for Medical Sciences (UAMS)

November 2017

UAMS faculty members Wendy Ward, Stephanie Gardner, Mark Jansen, and Kathryn Neill describe their groundbreaking innovative curriculum and its implementation.

See the presentation slides.

Click here and here for additional resources.


Patient and Caregiver Engagement in Primary Care Transformation

May 2017

The Multi-State Collaborative hosted a webinar featuring Diane Bechel-Marriott, DrPH, CPC+ Michigan Convener and Manager of Multipayer Initiatives at the University of Michigan, and Ann Greiner, President and CEO of the Patient-Centered Primary Care Collaborative. They discussed the role of patient and caregiver engagement in transforming primary care. Patient and caregiver engagement represents one of the five functions of CPC+. The others are access and continuity, care management, planned care and population health, and comprehensiveness and coordination.

  • Bechel-Marriott discusses how Patient and Family Advisory Councils (PFACs) contribute to the CPC+ vision for comprehensive primary care by incorporating patient and caregiver perspectives that might not be obvious to the practice that can help to decrease barriers to engagement, and identify new ways to overcome challenges.  She describes the Michigan Primary Care Transformation Project (MiPCT) five-year multi-payer demonstration’s use of Patient and Family Advisory Councils at the practice level, and at the program level.
  • Greiner outlines PCPCC patient engagement efforts with over 100,000 practices across the country through the Transforming Clinical Practice Initiative (TCPI). Patient-centered care is a concept that is gaining a foothold with practices, including those not enrolled in CPC+. Many are turning to best practices in patient engagement to shift their cultures and create stronger patient outcomes while strengthening the patient-clinician relationship.

Both Greiner and Bechel-Marriot explain how patients can become involved in practice design that leads to care that is more responsive to patient needs. They also highlight patient and clinician education as an important first step. While patient and caregiver engagement is only one of the five CPC Plus function domains, Bechel-Marriot notes its potential for benefiting the other four.

Go to the PCPCC’s TCPI  resource page, which provides free tools for practice transformation coaches and practices related to patient and family engagement. See Bechel-Marriot’s presentation slides here.


Lessons Learned from the Evaluation of the Comprehensive Primary Care Initiative: Third Annual Report

April 2017

The Multi-State Collaborative (MC) hosted a webinar featuring researchers from Mathematica Policy Research. Erin Taylor, director of health research, Grace Anglin, researcher, and Debbie Peikes, senior fellow, discussed findings from the third annual evaluation report on the Comprehensive Primary Care (CPC) initiative, which ended in December 2016. They shared information about multi-payer collaboration and how payers can come together to support best practices in improving patient care.  The presenters also discussed lessons learned that could be applied to the Comprehensive Primary Care Plus (CPC+) initiative, which started its first of five years in January 2017.

(The webinar begins at the 2:50 mark; it is sound only.)

The webinar focuses on some of the challenges faced by CPC regions: aligning quality measures across payers (given that different payers may serve different enrolled populations); overcoming the unanticipated complexity of the process of payer data aggregation; and engaging self-insured payers in the region in transforming care delivery.

The speakers highlighted several lessons from CPC that payers may apply to CPC+ or other multi-payer initiatives:

  • Involve as many payers as possible so signals to practices are aligned and support is substantial
  • Engage self-insured clients early in the process and communicate regularly about the goals and progress of the initiative; payers that required participation of their self-insured clients in CPC (or at least required them to actively opt out of CPC) had more success than those using an opt-in policy
  • Consider areas for collaboration, including aggregating data for performance feedback to practices, or at least aligning the measures presented in individual payer reports; aligning quality metrics across payers; and where possible, coordinating supports to practices
  • Identify goals and set realistic timelines for collaboration activities
  • Consider hiring a strong, neutral facilitator to support regional transformation efforts
  • Coordinate as much as possible with other existing regional initiatives

Read CPC’s third annual evaluation report.


Data Aggregation, Analytics, and Reporting

March 2017

The Multi-State Collaborative (MC) hosted a webinar on data aggregation, analytics and reporting in multi-payer environments. David Jorgenson and Melanie Pinette of Onpoint Health Data shared their experiences developing and building data integration, analytics, and reporting systems in the Multi-Payer Advanced Primary Care Practice (MAPCP) demonstrations in Vermont and Rhode Island. The presentations were followed by a Q&A session facilitated by Lisa Dulsky Watkins, MC Director.  Read an additional resource with background information from the webinar presenters.