Workgroup Ideas

Areas of Focus

Engaging the Public

• Recognition

• Education & recognizing community culture

• Menu of services & transparency of who is PCMH

• Patient choice

Engaging the Public

• Action steps

– Development of message content: must include the voice of the public

• Available data from NCQA, RCCOs, others

• Focus groups, public polls/survey

– How do we deliver the message?

• Utilization of available data/ask the people

Engaging the Public

• Action steps continued

– Addition of others to the planning process (including previously mentioned)

• Chronic care community

• OB/GYN

• Faith-based organizations

• PATIENTS! (with supports)

• Pharmacists

• Etc.

Buying Health Services for Employees

• Decrease employee absenteeism & increase employee production by offering PCMH programs on top of current/existing health insurance programs to decrease lost time from work

– Educate employers on value of primary care & medical homes

Buying Health Services for Employees

• Drivers of health care decisions

– Cost of health care

– Employee productivity

– Health (what is health in eyes of the employer?)

– Direct & immediate access to all needed healthcare

Buying Health Services for Employees

• Parallel a company work-comp/safety program with a work-health health program

– Pathways/contracts for both acute & chronic health care

– Safety: loss ratio linked to premium reduction

– Employer demand for medical homes ( contract with medical homes, similar to work-comp)

Buying Health Services for Employees

• Build a business case for, and explain a clear ROI for the PCMH– Engage in a local conversation with businesses &

organizations

– Infiltrate, integrate, & educate employers at business events• Chamber of Commerce

• Colorado HR Association

• CO Restaurant Association

• Etc.

– Involve & engage health insurers & brokers

Payment Reform

• Convening all stakeholders

• Transparency/alignment of metrics (risk adjustment, benchmarks)

• Understanding real cost of PCMH transformation & sustainability

• Financial incentives for all stakeholders –aligned across payers

Payment Reform

• Transparency – know the cost! Across the public & private plans

• Incentivize with goal in mind allocate more funds to primary care

• Cover all services needed:

– Primary care

– Behavioral health

– Dental

Payment Reform

• Standardize the standards

• Insurance reform

– Must offer same plans & benefits

– Base member on service rather than cost

– Publicly funded – privately serviced

Delivery Reform

• Set medical home as standard of care

• Share the vision

• Build the infrastructure tools/resources extension service model

Delivery Reform

• Action steps

– Support facilitation

– Standard quality measures

• Cost

• Experience

– Partnership (culture)

• Community

• Equitable

Delivery Reform

• Transform with hospitals

• Build facilitator systems

– Equitable

• Culture

– Language

– Patient

• Measures