PowerPoint Presentation 17 PCPC… · Title: PowerPoint Presentation Author: Carrera Christopher C...
19
Q&A With PCPCH Program Staff November 16, 2016
Transcript of PowerPoint Presentation 17 PCPC… · Title: PowerPoint Presentation Author: Carrera Christopher C...
Q&A With PCPCH Program Staff
November 16, 2016
Patient-Centered Primary Care Institute
Online Modules
Webinars
Website
Learning Collaboratives
Trainings
TA Network
We Want To Hear From You!
Type questions into the Questions Pane at any time
during this presentation
Transformation Center
Q & A with PCPCH Program Staff
Meg Bowen
Compliance Specialist/Site Visitor
Deepti Shinde
Policy Analyst
Amy Harris, MPH
Program and Communications
Specialist
Evan Saulino, MD, PhD
PCPCH Clinical Advisor
Agenda
• Patient-Centered Primary Care Home Program
• PCPCH 2017 Model Revisions
• Questions We’ve Received
• Tiers and 5 STAR
• Preparation Check List
• Application Due Dates
• Additional questions
Patient-Centered Primary Care Home Program
• Established by the Oregon Legislature in 2009 (House Bill 2009)
– Create access to patient-centered, high quality care and reduce costs by
supporting practice transformation
• PCPCH model developed in collaboration with a stakeholder committee
• 640 PCPCHs across the state
– 2/3 of all primary care practices; 35 of 36 counties
• Committee convenes periodically to review PCPCH implementation and
advise OHA on model refinement
• PCPCH 2017 recognition criteria based on the committee’s
recommendations
2017 PCPCH Model Revisions
• 12 standards revised
• One additional must-pass measure – 6.C.0 Patient Experience of
Care
– 11 must pass measures total
• 5 tiers instead of 3 tiers
• 5 STAR aligns with current 3 STAR criteria
Questions We’ve Received So Far…
• CAHPS or patient experience of care surveys
– 25 completed surveys/provider
• Completed surveys have >50% of the questions answered
• Residents (not empaneled) or providers <6 months in the practice
when the survey was administered are excluded
– New must pass measure 6.C.0
• Patient experience of care survey
• Must contain questions regarding the following: Access to care,
provider or team communication, coordination of care, staff helpfulness
• 25 completed surveys/provider
Questions We’ve Received So Far…
• Meaningful Use
– Meeting MU will now be worth 5 points
– Greater emphasis on quality improvement
• Demonstrating Improvement
– 10 percentage point improvement rather than 10 percent improvement
2017 PCPCH Model Tiers
Tier Points Additional Requirements
Tier 1 30 - 60 points + All must-pass standards
Tier 2 65 -125 points + All must-pass standards
Tier 3 130 – 250 points + All must-pass standards
Tier 4 255 -380 points + All must-pass standards
Tier 5
(5 STAR)
255 – 380 points + All must-pass standards
+ Meet 11 out of 13 specified measures
+ All measures verified at a on-site visit
Tier 5 - 5 STAR
• Tier 5 – called 5 STAR – designates clinics on the forefront of primary care
transformation.
– Attest to 255 points or more on application
– Implement multiple advanced PCPCH measures
– Required site visit from PCPCH program staff to
verify all measures are being met.
• Currently, only 7 clinics of out 640 meet this criteria
(3 STAR)
Preparation Check-List
Thoroughly read the PCPCH 2017 Recognition Criteria Technical Specifications and
Reporting Guide
Use the PCPCH Self-assessment Tool to help you determine which standards your
clinic meets. Download it here >>>
Start preparing a documentation binder by collecting any information needed to
support your clinic’s application.
Log-in to the online application so you are familiar with the format. Log-in name is
your email address. Email [email protected] for help with your log-in.
Application Due Dates
For recognized PCPCHs, if your clinic last applied in ….
• in 2014: your due date is January 1, 2017. There is a 90 day grace period.
• in 2015: your due date is 2 years from the recognition date. For example, if
clinic was recognized on 4/09/15, due date is 4/09/17. There is a 30 day
grace period.
• in 2016: your due date is January 1, 2017. There is a 90 day grace period.
Clinics applying for recognition for the first time can submit an application at any
time.
Application Process and Timeline
• Applications are submitted online with required and optional information.
• New in 2017: Seven must pass measures require additional information
about how the clinic is meeting the measure.
• PCPCH staff review each application and will contact you by email if any
information on your application needs clarification or correction.
• After your application is processed, a letter, certificate and poster will be
mailed to your clinic congratulating your clinic on it’s PCPCH recognition.
Resources and Information
• PCPCH Website -- www.primarycarehome.or.gov
• Sign up to receive emails from the PCPCH Program.
• PCPCH 2017 Recognition Criteria Online Learning Modules at Patient-
Centered Primary Care Institute
• PCPCH 2017 Standards Webinar (recording) watch here >>>
Findings From Recent PCPCH Evaluation
• A recent study by Portland State University found that the PCPCH Program
has been very successful in meeting the goals of cost-effective, system-wide
care transformation embodied in the Triple Aim. A few highlights:
– For every $1 increase in primary care expenditures related to the PCPCH
program, there is a $13 in savings in other services, such as specialty
care, emergency department and inpatient care.
– For a clinic that has been a PCPCH for 3 years, the total cost of care per
member, per month is lowered by $28. This is double the overall average
savings of $14 per member, per month for a PCPCH in the 1st year of
recognition.
Questions?
What Questions Do You Have?
Type questions into the Questions Pane at any time
during this presentation
