Kareo - Patient-Centered Practice And Healthcare Reform

KAREO | CONFIDENTIAL

The Patient-Centered PracticeMeeting the Demands of Health Reform


Your Hosts Today…

Judy CapkoCapko & Company

Lea ChathamContent Marketing Manager, Kareo


How to Participate Today…

Follow us on Twitter @GoKareo

We’ll be tweeting live using the hashtag #KareoTip

Join our other social media channels for constant updates!

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=8XZKYtjeLpVMXM&tbnid=Fx9VjA8QUnwe_M:&ved=0CAUQjRw&url=http://blog.hubspot.com/blog/tabid/6307/bid/30030/LinkedIn-277-More-Effective-for-Lead-Generation-Than-Facebook-Twitter-New-Data.aspx&ei=8wEUUfroM83OigLe64CAAw&psig=AFQjCNG1N5n8gUwndYXUd1JEpyi8TjAfcA&ust=1360352111200902

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=TWcUd2aPgXS_6M&tbnid=q6P79bH2duqWSM:&ved=0CAUQjRw&url=http://www.johnhaydon.com/2011/08/9-steps-getting-started-google-plus-for-your-nonprofit/&ei=UwIUUdawIeGyiQKHqoCIBA&psig=AFQjCNGT0cSKQRrFnY8KC1IGtg7Ryb30-Q&ust=1360352161519564


Our Schedule for Today…

1 Introduction & Welcome Judy

2 The Patient-Centered Practice

3 Discover Kareo’s Role

4 Answer Questions


Judy Capko

Founder of Capko & Company

Nationally-recognized practice management and healthcare consultant with over 25 years experience

Focus on patient-centered strategies, improving leadership, and valuing staff contributions

Judy authored best-selling book Secrets of the Best-Run Practices

New book The Patient-Centered Payoff due out next month

Capko & Companywww.capko.com/blog

[email protected]

http://www.capko.com/blog






4 Answer Questions


Course Objectives

1. Learn the basics of the patient-centered movement and the motivation behind it.

2. Examine financial incentives related to patient satisfaction and outcomes.

3. Discuss key program standards of Patient-Centered Medical Home.

Copyright Capko & Company 2013


Patient-Centered: Historical Perspective

Institute of Medicine:

Crossing the Quality Chasm Report 2001

Motivation for change: “Faced with such rapid changes, the nation’s health care delivery system

has fallen far short in its ability to translate knowledge into practice and to ap ply new

technology safely and appro priately.”



What is Patient-Centered?

Quality Chasm Report Definition:

Providing care that is respectful of and responsive to individual patient preferences, needs, and

values, and ensuring that patient values guide all clinical decisions.



Identified Six Quality Aims

1. Safe

2. Effective

3. Patient-centered

4. Timely

5. Efficient

6. Equitable



Healthcare Planners/Leaders Debate and Resolve

• Evidence-based medicine: Meant to improve healthcare of the population Proponents accept: Good outcome must be defined in

terms of what is meaningful and valuable to the individual patient.

• Patient-centered efforts and actions must strengthen the patient-clinical relationship.



Strengthening the Patient-Clinical Relationship

Strengthen

Promote

Help

Facilitate

• Patient-Clinical Partnership

• Communication: About things that matter

• Patients know more about their health

• Patients involvement in their care



CMS Pays Hospitals Based on Performance

•Hospitals scored on performance

•Medicare Value Based Purchasing (VBP)Payment adjustments based on Hospital Consumer

Assessment of Healthcare Provider Survey (HCAPS)• 30% patient experience of care domain (thru 2015)• 70% clinical process of care domain

• Intention: Improve healthcare of populationControl the cost of care



Patient Experience of Care Dimensions

1. Nurse communication

2. Doctor communication

3. Hospital staff responsiveness

4. Pain management

5. Medicine communication

6. Hospital cleanliness & quietness

7. Discharge information

8. Overall hospital rating



CMS Physicians Quality Measures

• Physician Quality Reporting Initiative, PQRI Link financial payment to quality reporting Claims-basis, as much as 1.5% bonus

• Physician Quality Reporting System, PQRS Penalty: Eligible physician who do not collect and report

data reduced payment –2015 = 1.5%

–2016 = 2%

*PQRI: SCHIP Extension Act 2007

**PQRS MIPPA Act 2007



In the Beginning

• The Patient-Centered Medical Home (PCMH) Consortium establishes 2007 Joint principles

–American Academy of Family Physicians, AAFP

–American Academy of Pediatrics

–American College of Physicians

–American Osteopathic Association

*Consortium: Representing 333,000 physicians



PCMH Joint Principles

1. Personal physician

2. Physician directed medical practice

3. Care coordinated and/or integrated

4. Quality and safety

5. Enhanced access

6. Appropriate payment



PCMH Momentum and Strength 2008-2010

• Recognition programs emergeAccreditation Association for Ambulatory Health CareNational Committee for Quality Assurance, NCQA

• AAFP Demonstration project results releasedPolitical actions support the Medical Home

• Patient Protection and Affordable Care Act, PPACA, 2010



NCQA Gains PCMH Traction

• 2011 program expansion of Physician Practice Connection recognition program

• NCQA declares its standards First and most widely used

• NCQA program promotes goalsImproving patient experienceRecognizing clinicians’ effortsProviding confidence for purchasersValue for money spent on quality care

• Payers implement bonus and payment systems based on PCMH recognition



2011 Revised PCMH Standards

• Guidance on developing better chronic care management programs, enhancing patient engagement and improving patient outreach

• Aligned with New healthcare IT Meaningful use criteria



PCMH Recognition

Meeting specific elements in six standard categories

1. Enhance access and continuity

2. Identify and manage patient populations

3. Plan and manage care

4. Provide self-care support and community resources

5. Track and coordinate care

6. Measure and improve performance



Must Pass Recognition Elements

• Tiered levels of PCMH recognition

• At any level required to meet these elements:Standard 1A: Access during office hoursStandard 2D: Using data for population managementStandard 3C: Care managementStandard 4A: Self-care processStandard 5B: referral tracking and follow-upStandards 6C: Implement continuous QI process

For a free copy of the PCMH Standards and Guidelines go to: www.ncqa.org/pcmh.


http://www.ncqa.org/pcmh


2010 PCMH

• Key Health Information Technology Domains 1. Telehealth

2. Measurement of quality and efficiency

3. Care transitions

4. Personal health records

5. Registries

6. Team care

7. Clinical decision support for chronic diseases



Technology Rules

• Collect and report accurate dataMeasures quality outcomes nationallyResults in better payment CMSPayment bonus plans & incentive payment other

payersCMS payment incentive with meaningful use

• Meeting criteria for EMR implementation and reporting



Patient-Centered Physicians and Managers

• Messaging is critical Communicate and demonstrate involvement in

improving the patient experience–The staff, patients, community, payers

Collecting and reporting data is essential Patient surveys matter Outcomes will tell the story



Actions You Can Take

1. Promote staff understanding

2. Demonstrate your commitment

3. Educate and support staff

4. Manage the score care

5. Coach the team

6. Attain best practices (measure and manage)



Look Forward – Not Backward

1. Read and stay informed Gain objectivity Lower level of resistance

2. Explore opportunities

3. Recognize the potential gains



“We need to move from what’s the matter with our patients to what matters to our patients.”

Source: Patient-Centered Care: What it Means and How to get there; www.healthaffairs.org; blog posted January 24, 2012


James Rickert, MD

http://www.healthaffairs.org/






4 Answer Questions


Discover Kareo’s Role

“…Make Your Practice a Best Practice!”



• Cloud-based

• Medical Billing

• Patient Payment Services

• Insurance Billing & Remittance

• Scheduling & Practice Management

• Electronic Health Records

• Medical Billing Services

20,000 Providers Nationwide



• Patient Education




• Care Recommendations





• Patient Portal





• Patient Portal

•Meaningful Use






4 Answer Questions


Let’s Answer Your Questions

888.775.2736 x1

[email protected]

http://kareo.com/chat

mailto:[email protected]

http://kareo.com/chat


The Patient-Centered PracticeMeeting the Demands of Health Reform

Thank you for attending!

Kareo - Patient-Centered Practice And Healthcare Reform

Health & Medicine

Transcript of Kareo - Patient-Centered Practice And Healthcare Reform