PCPCC Center for Accountable Care Questionnaire: Snapshot of Results and Proposed Future Plans
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Transcript of PCPCC Center for Accountable Care Questionnaire: Snapshot of Results and Proposed Future Plans
PCPCC Center for Accountable Care
Questionnaire:
Snapshot of Results and Proposed Future Plans
PCPCC Center for Accountable Care Call
December 19, 2011
Page 2
Q1: “CMS recently published the draft final ACO rule. What are your overall impressions of the final rule
verses the initial ACO rule?”
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CMS was responsive toconcerns raised from
multiple stakeholders andmade significant positivemodifications to the rule.
While CMS was veryresponsive made and many
positive changes to rule, thisis new territory for manyhealthcare organizations,several of which may have
concerns about applying forone of the programs
I have some ongoingconcerns about the rule.
I have not reviewed the finalrule.
Page 3
Q2: “At the present time, what is your organization’s intent regarding submitting an application for one of the CMS Programs?”
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Pioneer MSSP T1 MSSP T2 Bundled Payment ComprehensivePrimary Care
Not eligible Eligible but notparticipating
Page 4
Q3: “If you answered yes to MSSP T1 or T2, when would you plan on submitting your SSP application?”
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In time for 4/1/12 In time for 7/1/12 In time for 1/1/13 In time for 1/1/14 or later
Page 5
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Avera
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Pioneer MSSP T1 MSSP T2 Bundled Payment CPC None
Q4: “If you allocate percentages to each of the CMS programs based upon what percentage of health care organizations you predict will ultimately choose one program versus another, how would you assign those percentages (your total should add up to 100% because organizations cannot participate in more than one program)?”
Page 6
Q5: “Many are concerned about patients’ responses to ACOs. What would make ACOs attractive to patients?”
(Please check all that apply)
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Evidence aboutbetter outcomes of
care
Lower costs, bothout-of-pocket and
significantreductions in
annual premiumincreases
Evidence that careis more patient-
centered
Evidence that careis truly coordinated
between settingsand amongclinicians
Emphasis onaccess that doesn’t
require visits todoctors’ offices
Impossible-patients will neverbe attracted to an
ACO
Page 7
Q6: “Once our communities and patients are more informed and educated regarding medical homes, what would you expect the
marketplace response will be? (Please check all that apply)
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Patients will seek out MedicalHomes because they will be
viewed as “The GoldStandard” primary care
practice
Patients will shy away fromMedical Homes because
“Medical Home” will becomesynonymous with “Managed
Care”
Health Care Organizations willuse the Medical Homedesignation or NCQA
Accreditation as a means ofattracting more patients
Patients will select andchoose health care
organizations as they havehistorically- Medical Homedesignation will not have an
impact on their choice.
Page 8
Q7: “I would recommend that the PCPCC ACO Center concentrate on the following top-priority topics in the areas of Accountable Care Operations (Task Force #1 Focus)”
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Methods to reduce clinical costs
Methods to improve patient satisfaction
Strategies to meet CMS quality metric standards
Methods to re-design clinical care and staffing mix
Examples of successful EHR Optimization
Innovative and effective incentives and compensation redesign
Medical Business Intelligence
Strategies to meet Patient-Centeredness expectations
Stategies to manage Population Health and Risk
Successful Care Coordination models
Strategies to manage advanced access
Page 9
Q7: “I would recommend that the PCPCC ACO Center concentrate on the following top-priority topics in the areas of Accountable Care Operations (Task Force #1 Focus)”
• Other– How to partner with other non clinical members of the healthcare
industry (ie pharmaceutical companies)– Fiscal and IT infrastructure requirements.
Page 10
Q8: “I would recommend that the PCPCC ACO Center concentrate on the following top-priority topics in the areas of Education and Advocacy (Task Force #2 Focus)”
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Strategies to educate our community and our patients about ACOs
Strategies to educate our community and patients about theinterrelationship between ACOs and Medical Homes
Strategies to advocate to legislators about the critical role ofMedical Home in high-performing ACOs
Strategies to advocate to employers about the critical role ofMedical Home in high-performing ACOs
Strategies to influence and redesign medical and nursing educationand residency programs to prepare graduates for Medical
Home/ACO models of delivering care
Strategies to design easily comprehensible materials explainingwhat ACOs are
Strategies to design easily comprehensible materials explainingwhat Medical Homes are
Page 11
Q8: “I would recommend that the PCPCC ACO Center concentrate on the following top-priority topics in the areas of Education and Advocacy (Task Force #2 Focus)”
• Other– Strategies to educate physicians about their role as independent
physicians in the Medical Home concept. – What resources are available outside of consulting services to
help organizations achieve progress towards ACO/PCMH (ie NCQA, AMA, Big Pharma resources, etc.)
Page 12
Q9: “Now that the final ACO rule has been published and organizations will move from a regulatory focus to a more operational one, what additional areas of focus should the PCPCC ACO Center’s Regulatory Task Force concentrate on?”
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Advance additional legislationthat w ill further spur healthcareproviders to move toward more
coordinated and integrateddelivery programs
Track and provide comment onthe anticipated annual rule and
comment period for ACOs
Support work of federalagencies in implementation and
adoption of key programs
Page 13
Question 10: “As the PCPCC’s ACO Center seeks to solidify primary touch (and/or avoid duplicating work) with other PCPCC centers, what would you highlight as the top potential areas of synergy with other centers”
• MD/Hospital, MD/Insurance, and PCP/Specialist integration (3)
• Efficacious care delivery & coordination (3)
• Employer strategies (2)
• Consumer engagement-education on ACO/med. Home (2)
• ACO relationship with payers (2)
• Payment models/reform (2)
• Process re-design/optimizing use of EHRs & technology (2)
• Data sharing
• Population management
• Means to share patient information in appropriate ways
• ACO resource utilization from industry partners (biotech, pharma, etc)
• Lab results, other test results
• Medical Neighborhood
• Regulatory Advocacy
Page 14
Q11: “Would you be willing to volunteer to participate in calls with one of more of the ACO Center Task Forces? If so, which one(s)?
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Operations/Best Practices Education/Advocacy Regulatory Integration with otherCenters
Page 15
Team Volunteers
• Operations/Best Practices • David Gans- MGMA ([email protected])
• Richard May- HuTech Resources ([email protected])
• Scott Morgan- JH Cohn ([email protected])
• Sherri Miller- Proactive Health Strategies, Inc. ([email protected])
• Education/Advocacy• Sharon West- CAP ([email protected])
• Ken Bertka- Catholic Health Partners ([email protected])
• Regulatory • Kathryn Bradshaw- Bradshaw Healthcare Solutions ([email protected])
• Ellen VanBuskirk- Trizetto ([email protected])
• Integration with Other Centers • Aileen Wehren- Porter Starke Services ([email protected])
• Anita Tanner- COCMHC ([email protected])
• Amy Gibson- PCPCC ([email protected])
Page 16
Co-Chair Recommended Next Steps
1. Consolidate Four Sub-Groups into Two– Operations and Best Practices Team (Co-Chairs Samitt and
Safran)– Education and Advocacy Team (Co-Chairs Epperly and Childs)
2. Modify Focus of Monthly Calls– Convert monthly member calls into Webinars to review
prioritized topics of interest (see next slide)– Coordinate quarterly calls of two sub-groups to prioritize focus
of future webinars– Co-Chairs will have separate quarterly calls to assure
coordination and alignment with PCPCC Strategic Plan
Page 17
Prioritized Topics via Questionnaire
Operations & Best Practices
1. Successful Care Coordination Models
2. Examples of successful EHR Optimization
3. Methods to re-design clinical care and staffing
4. Examples of successful MD/Hospital, MD/Insurance, PCP/Specialist Integration
5. Innovative incentive and compensation design
6. Methods to reduce clinical costs
7. Strategies to manage advanced access
8. Strategies to manage population health/risk
Education & Advocacy
1. Strategies to influence and redesign medica and nursing education and residency programs to prepare graduates for Medical Homes/ACOs
2. Strategies to educate our community and our patients about ACOs
3. Advance additional legislation that will further spur healthcare providers to move toward more coordinated and integrated delivery programs
4. Strategies to advocate to legislators about the critical role of Medical Home in high-performing ACOs
5. Strategies to design easily comprehensible materials explaining what ACOs are
6. Strategies to advocate to employers about the critical role of Medical Home in high-performing ACOs
Page 18
Discussion and Next Steps