The Michigan Primary Care Transformation (MiPCT) Project: December PGIP Meeting Update
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Transcript of The Michigan Primary Care Transformation (MiPCT) Project: December PGIP Meeting Update
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The Michigan Primary Care Transformation (MiPCT) Project: December PGIP Meeting Update
MiPCT TeamDecember 2, 2011
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Agenda
• Introduction• MiPCT Participation• Care Management Update• Funding Update• MiPCT Next Quarter Timeline• Invitational Launch Meeting• Care Manager Practice Integration
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MiPCT Participation StatisticsJanuary April
(yes/tentative)
Total
POs 29 3 32
Practices 387 70 457
Providers 1,628 154 1,782
Patients 1,111,290 127,961 1,239,251
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MiPCT Care Management Update• Self Management Training programs
• MiPCT Implementation Guide Part 1
• Complex Care Manager Training Update
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Self Management and Moderate Risk Care Management (MCM) Training Programs
A summary of Self Management and Moderate Risk Care Manager training programs
▫ training programs reviewed by MiPCT team
Self Management training ▫ programs must be MiPCT approved▫ required for all Care Managers
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Self Management Training Program- MiPCT Criteria•Self management support – background•Motivational Interviewing and/or
Empowerment skills•Individualized patient assessment•Collaborative goal setting•Problem solving•Systematic follow up, support•Minimum 6 hours didactic •Opportunity for learner to practice new
skills▫Post didactic - trainer facilitated webinar,
conference call, face to face meetings to discuss case studies
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Self Management and Moderate Risk Care Management (MCM) Training Programs MCM and self management training programs “at a glance”
Programs vary: some are specific to self management training, a few address both MCM and self management training
• Program objectives/content • Program contact • Resources • Modality • Duration, location • Trainer qualifications• Certification, CEs• Statewide or regional• Cost
“Self Management and MCM Training Programs" posted: mipctdemo.org
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Self Management and Moderate Risk Care Management (MCM) Training Programs
• The self management and MCM training document will continue to expand • MiPCT will continue to review and add training
programs
• How you can help• Contact [email protected]
• if you have an existing self management or MCM training program you would like reviewed or
• find another one that you are interested in pursuing
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Self Management Resources
• Self Management resources – summary document• May be used as a supplement to a self management
training program• Ex. toolkits, videos, modules
• How you can help• Please submit self management resources to
“Self Management Resources” posted: mipctdemo.org
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MiPCT Implementation Guide – Part I• Background
• Overview of care management• Successful components of care management
• Care Management Model and Staffing Four models: travel team, integrated, hybrid and central
Description of models Pros and cons of each model
Steps to identify a care management model that is a good fit
Includes table with potential models to consider based on patient population, CCM & MCM FTE, and practice locations
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MiPCT Implementation Guide – Part I cont.
Essential characteristics/skills for Care Manager
Strong communication skills Motivated, self-directed
“People” skills Engagement of patients and providers
Critical thinking skills Psychosocial aspects of chronic conditions
Patient engagement and activation skills Basic computer skills
Negotiating and conflict resolution skills
Ref: Geisinger Health Plan, The Medical Home Case Manager, April 2010
• Roles - Care Managers, Panel Management
• Hiring Care Managers
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MiPCT Implementation Guide – Part I cont.Operations• Training CCMs, MCMs
• Integration of care manager into practice setting
• Team roles
• Identification of patients for care management
“MiPCT Implementation Guide Part I” posted: mipctdemo.org
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MiPCT Implementation Guide – Part II planned – topics •G codes•Geisinger specific CCM curriculum •Care Management Software•MiPCT Data reports, Patient Lists•Team roles
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Complex Care Manager (CCM) Training•MiPCT will provide required training for
CCMs ▫Tentative - MiPCT partnership with
Geisinger▫Expect plan to be finalized within 1 - 2
weeks•Train the Trainer Model•MiPCT Webinar 12/9 3-5 pm
▫ Update CCM training
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MiPCT Training for Complex Care Managers (CCMs ) and Hybrid CMs
•CCMs and Hybrid Care Managers▫Mandatory completion of MiPCT CCM
training MiPCT team provides standardized CCM
training CCM training will take place in Michigan
•Time line -tentative▫CCM Master Trainers – training occurs
Jan/Feb 2012▫Group 1 CCM - training occurs (ideally) Feb
2012▫Plan rolling training for several months
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Complex Care Manager (CCM) Training• CCM train the trainer model
• 10 – 15 Master CCM Trainers• Master Trainers
Located Regionally Receive training directly from Geisinger
• Master Trainer role Preceptor for new MiPCT CCMs Patient caseload
• Cost Some salary subsidized by MiPCT
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MiPCT Clinical Resources• MiPCT clinical content
• temporary location - mipctdemo.org• Michigan Care Management Resource
Center website - live Jan 2012• micmrc.org• will transition MiPCT clinical content from
mipctdemo.org to the micmrc.org website - Jan 2012
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Funding Update
•BCBSM – off-cycle payment for portion of first three months funding will be sent next week (tentative date December 9)▫ Purpose is to “jump-start” care management▫ Balance of first quarter payments will be sent in January
PGIP payment, represents $3 PMPM payment•BCN – will determine within the next
week when they will start G-codes/CPT codes▫ Understand that POs/PHOs/practices need ramp up time
to begin G-code billing▫ Committed to paying $3 PMPM until that time
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MiPCT Timeline – next 4 mos.
Implementation Plan Part C Due December 8, 2011MiPCT Webinar: Care Management software, CCM training
December 9, 2011 3-5 pm
MiPCT Webinar: Financial reporting and Performance Incentive metrics
December 14, 2011 3-5 pm
Post positions, interview, and hire Care Managers
In progress, continue (high priority)
Plan training for MCM Care Managers: • Select a MiPCT approved self
management training program
• Review MCM general recommended training topics
Schedule training programs for MCMs – align with hiring dates
MiPCT Invitational Launch Meeting
March – April 2012
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Michigan Primary Care Transformation Project (MiPCT) Launch Invitational Meeting
Supporting Your Success in Partnering with Patients to Improve Care Experience,
Outcomes, and Value
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Launch meeting• Goal of Meeting
▫To advance our practice unit’s and organization’s capabilities to implement the MiPCT program in their networks. Provide a motivational kick off to the
program Create network opportunities and best
practice sharing Develop the knowledge and skills necessary
for success• Multiple Meetings (2 or 3)
▫Located in South, West, North Regions• Who should attend
▫1 Representative from each PO/PHO • Dates:
▫March-April 2012
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One Day Program• Key Note Speaker
▫ Motivational• MiPCT Overview and Updates• Skill Building Session
▫ Change management and practice transformation• Breakout sessions
▫ Transitions in Care▫ Medication Reconciliation▫ Extended Access and Patient Awareness▫ Patient Advisory Council▫ Data Collaborative Update▫ Care Management Resource Center: An In-depth Look
• Sharing our stories ▫ Our Practice’s Best Practice for PCMH▫ What Do We Do Well?▫ Identifying Our Opportunities for Improvement
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Care ManagerPractice Integration
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Care Management Models ▫Travel Team
Consists of MCM and CCMs that are responsible for a patient caseload at multiple practices
▫Integrated Consists of MCMs and CCMs that are located on
site at the practice ▫Hybrid
The role of the CCM and MCM is filled by one individual
▫Central The Care Manager is located off-site and
supports multiple practices Care Manager spends at least 50% FTE onsite at
practice location The role of the CCM and MCM may be filled by
one individual or may be separate individuals
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We need to let them into the PCMH !!
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Let them on the Team – Care Management at the Practice Level
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Integrating Care Management into Primary Care
•Care Management Resource Center •Experience of the 5 pilot BCBSM PDCM
physician organizations ▫Henry Ford ▫U of M ▫Genesys ▫Lakeshore Health Network ▫Integrated Health Partners
•Participation in learning opportunities in 1st to 2nd quarter 2012
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Questions and Discussion
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