Blueprint Integrated Pilot Programs Evaluation & Financial Impact

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Blueprint Integrated Pilot Programs Evaluation & Financial Impact"

Transcription

1 Blueprint Integrated Pilot s Academy and CommonWealth Fund State Institute May 27 28, 2009 Craig Jones MD Director, Vermont Blueprint for 1 Coordinated System Hospitals Mental & Substance Use Disorders Team Nurse Coordinator Social Workers Dieticians Workers OVHA Coordinators Specialist IT Framework Global Information Framework Evaluation Framework Operations 2 1

2 Coordinated System Hospitals Behavioral & Substance Abuse Team Nurse Coordinator Social Workers Dieticians Workers OVHA Coordinators Specialist Information Framework System Information Framework Framework Operations & Uses Framework s Practice Systems Hospital Information Systems s Practice Systems Hospital Information Systems Multi-payer claims database bases Chart reviews NCQA Scores Expenditures ROI Indicators Evaluation Activation / Policy 3 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 4 2

3 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 5 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 6 3

4 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 7 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 8 4

5 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 9 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 10 5

6 Why measure? Average = 7.46 Average = 7.36 Group 1 Good Disease Control Group 2 Intermediate Disease Control Group 3 Poor Disease Control Percentage of Vermont population participating 6.7% 9.8% 13.0% 20.0% 40.0% Participating population 42,179 61,880 82, , ,852 # Teams

7 Model Microsoft Office el Worksh Microsoft Office d Docum Model Double click to open Key Assumptions Double click to open 13 Building a Scalable Model Build a multidimensional evaluation framework Support patient care & population management Support ongoing quality improvement Evaluate trends in clinical outcomes Evaluate trends of financial impact Support sustainability & expansion 14 7

8 Additional Slides 15 Blueprint Integrated Pilot Summary 1. Financial reform (2 major components - includes MCAID & commercial insurers) - Payment to practices based on NCQA score - Shared costs for Teams 2. Multidisciplinary care support teams (CCT Teams) - Local care support & population management 3. Information Technology - Web based clinical tracking system () - Visit planners & population reports - Electronic prescribing - Updated s to match program goals and clinical measures in - information exchange network 4. Activation & - specialist as part of CCT - profiles & risk assessments - Evidence based interventions 5. Evaluation - NCQA score (process quality) - process measures - status measures - Multi payer claims data base - Indicators 16 8

9 & Payment $3.00 $ PPPM per provider $2.50 $2.00 $1.50 $1.00 $0.50 PPPM Payment 5 of 10 MP 10 of 10 MP $ NCQA Score 17 Team Physicians Nurse Practitioners Physician Assistants Behavioral Specialist Connections VT Department of COMMUNITY CARE TEAM PRIMARY CARE OFFICE Chronic Coordinator Managers (OVHA, AAA, Umbrella, etc.) 18 9

10 Building a Scalable Model Build a model for effective and sustainable reform Multi Insurer Financial Reform (PCP payment, CCTs) Financial Incentives (balance volume & quality) Environment (, CCTs, PH specialists, IT) Focus (quality, wellness, prevention) Evaluation (multidimensional, routine) Culture (self management, engaging yet objective) 19 10

Blueprint Integrated Pilot Programs Building an Advanced Model of Primary Care

Blueprint Integrated Pilot Programs Building an Advanced Model of Primary Care Blueprint Integrated Pilot Programs Building an Advanced Model of Primary Office of Reform Office of Vermont Health Access Vermont Health Reform 312 Hurricane Lane, Suite 201 Williston, VT 05495 Blueprint

More information

Development of a Vermont Pilot Community Health System To Achieve the Triple Aims

Development of a Vermont Pilot Community Health System To Achieve the Triple Aims Development of a Vermont Pilot Community Health System To Achieve the Triple Aims Webinar February 23, 2010 Jim Hester PhD Director Vermont Health Care Reform Commission Outline Context: Vermont Health

More information

Blueprint Integrated Pilot Programs Building an Integrated System of Health

Blueprint Integrated Pilot Programs Building an Integrated System of Health Blueprint Integrated Pilot Programs Building an Integrated System of Health Craig Jones, MD Blueprint Executive Director craig.jones@ahs.state.vt.us 6/3/2010 1 Office of Healthcare Reform Office of Vermont

More information

HIE: The Vermont Version

HIE: The Vermont Version HIE: The Vermont Version David Cochran, MD President and CEO Vermont Information Technology Leaders, Inc. Topics VITL Overview Vermont Health Reform Blueprint for Health Health Information Exchange Snapshot

More information

House Committee on Healthcare. CMS Evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration

House Committee on Healthcare. CMS Evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration House Committee on Healthcare CMS Evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration HUD and ASPE Evaluation of Vermont s Support & Services at Home Program February 25, 2015 2008Q3

More information

Finding Common Ground: Vermont s Blueprint for Health and ACO Shared Savings Programs

Finding Common Ground: Vermont s Blueprint for Health and ACO Shared Savings Programs Finding Common Ground: Vermont s Blueprint for Health and ACO Shared Savings Programs Presentation to: Rhode Island Care Transformation Collaborative February 27, 2015 Pat Jones, Health Care Project Director,

More information

Opportunities for Home Care Providers in Working with Medical Homes October 2014. EMHS Vice President Continuum of Care Chief Advocacy Officer

Opportunities for Home Care Providers in Working with Medical Homes October 2014. EMHS Vice President Continuum of Care Chief Advocacy Officer How to Establish Partnerships and Opportunities for Home Care Providers in Working with Medical Homes October 2014 Lisa Harvey-McPherson, RN, MBA, MPPM EMHS Vice President Continuum of Care Chief Advocacy

More information

Research Insights. Prevention and Health Reform. Summary. Introduction

Research Insights. Prevention and Health Reform. Summary. Introduction Research Insights Prevention and Health Reform Summary Prevention has not played a big part in health reform discussions to date. Polling suggests that the public is generally supportive of prevention,

More information

Piloting an ACO: A Community Provider Network Which Achieves the Triple Aims

Piloting an ACO: A Community Provider Network Which Achieves the Triple Aims Piloting an ACO: A Community Provider Network Which Achieves the Triple Aims December 1, 2008 Jim Hester PhD Director VT Health Care Reform Commission Outline Pilot goals The context: Vermont Health care

More information

Community Health Centers and Health Reform: Issues and Ideas for States

Community Health Centers and Health Reform: Issues and Ideas for States Community Health Centers and Health Reform: Issues and Ideas for States Ann S. Torregrossa, Esq. Deputy Director & Director of Policy Governor s Office of Health Care Reform Commonwealth of Pennsylvania

More information

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company?

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures

More information

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Disclosures. Overview 3/10/2015

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Disclosures. Overview 3/10/2015 What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures

More information

No. 96. An act relating to naturopathic physicians. (S.209) It is hereby enacted by the General Assembly of the State of Vermont:

No. 96. An act relating to naturopathic physicians. (S.209) It is hereby enacted by the General Assembly of the State of Vermont: No. 96. An act relating to naturopathic physicians. (S.209) It is hereby enacted by the General Assembly of the State of Vermont: Sec. 1. 8 V.S.A. 4088d(a) is amended to read: (a) A health insurance plan

More information

Who Reports NQF 18 NCQA

Who Reports NQF 18 NCQA Who Reports NQF 18 Various providers & health care systems are required and/or incentivized to annually report this clinical measure to payers such as CMS and national quality entities. The next slides

More information

Vermont Blueprint for Health

Vermont Blueprint for Health Department of Vermont Health Access 312 Hurricane Lane, Suite 201 Williston, VT 05495 hcr.vermont.gov [phone] 802-879-5988 Vermont Blueprint for Health 2011 Annual Report January 2012 Department of Vermont

More information

Accountable Care and Value Based Payments 101: Government Programs Update

Accountable Care and Value Based Payments 101: Government Programs Update 1 Accountable Care and Value Based Payments 101: Government Programs Update June 24 th, 2014 Dave Neiman, FSA, MAAA Senior Consulting Actuary DaveN@Wakely.com (720) 226-9806 2 Caveats Opinions expressed

More information

Collaborative Care Tips for Sustainability. Virna Little, PsyD, LCSW r, SAP The Institute for Family Health NYS Collaborative Care Initiative

Collaborative Care Tips for Sustainability. Virna Little, PsyD, LCSW r, SAP The Institute for Family Health NYS Collaborative Care Initiative Collaborative Care Tips for Sustainability Virna Little, PsyD, LCSW r, SAP The Institute for Family Health NYS Collaborative Care Initiative Teamwork Applies to Billing Too!!! Combine with other initiatives

More information

Attachment 1 - Population Health Work Group Meeting Agenda 12-09-14

Attachment 1 - Population Health Work Group Meeting Agenda 12-09-14 Attachment 1 - Population Health Work Group Meeting Agenda 12-09-14 001 VT Health Care Innovation Project Population Health Work Group Meeting Agenda Date: Tuesday, December 9, 2014 Time: 2:30-4:00 pm

More information

Aligning Payers and Practices to Transform Primary Care:

Aligning Payers and Practices to Transform Primary Care: EXECUTIVE SUMMARY Aligning Payers and Practices to Transform Primary Care: A Report from the Multi-State Collaborative by Lisa Dulsky Watkins, MD Since the mid-2000s, a number of states have developed

More information

February 21, 2011. Regina Benjamin, MD, MBA U.S. Surgeon General Office of the Surgeon General 5600 Fishers Lane, Room 18-66 Rockville, MD 20857

February 21, 2011. Regina Benjamin, MD, MBA U.S. Surgeon General Office of the Surgeon General 5600 Fishers Lane, Room 18-66 Rockville, MD 20857 February 21, 2011 Regina Benjamin, MD, MBA U.S. Surgeon General Office of the Surgeon General 5600 Fishers Lane, Room 18-66 Rockville, MD 20857 Dear Dr. Benjamin: I want to take this opportunity to express

More information

Proven Innovations in Primary Care Practice

Proven Innovations in Primary Care Practice Proven Innovations in Primary Care Practice October 14, 2014 The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2014 Society for Healthcare

More information

TESTIMONY TO THE HEALTH IT POLICY COMMITTEE. Advanced Health Models and Meaningful Use Workgroup

TESTIMONY TO THE HEALTH IT POLICY COMMITTEE. Advanced Health Models and Meaningful Use Workgroup TESTIMONY TO THE HEALTH IT POLICY COMMITTEE Advanced Health Models and Meaningful Use Workgroup Nancy Rockett Eldridge, CEO, Cathedral Square Corporation June 2, 2015 Support And Services at Home (SASH)

More information

Prevention and Management of Chronic Illness in Vermont. Don Dickey Joint Fiscal Office January 16, 2007

Prevention and Management of Chronic Illness in Vermont. Don Dickey Joint Fiscal Office January 16, 2007 1 Prevention and Management of Chronic Illness in Vermont Don Dickey Joint Fiscal Office January 16, 2007 2 Outline of Presentation Why the focus on chronic illness? Making health care more responsive

More information

What this means for Idaho?

What this means for Idaho? What this means for Idaho? Why now? The 2011 Idaho Legislature approved the Medicaid Cost Containment and Health Care Improvement Act : The current fee-for-service health care delivery system of payment

More information

Appendix A. State Programs Approaches on Building Blocks

Appendix A. State Programs Approaches on Building Blocks Appendix A. State Programs Approaches on Building Blocks Table 1. Eligibility Requirements Program/State Age Diagnosis Eligibility for existing program Children s Medical Services (CMS) Network/Florida

More information

Accountable Care Organizations and Shared Savings Programs (What are they and how do they differ)

Accountable Care Organizations and Shared Savings Programs (What are they and how do they differ) Accountable Care Organizations and Shared Savings Programs (What are they and how do they differ) Presentation to: House Health Care Committee January 30, 2015 Georgia Maheras, Esq. Director, Vermont Health

More information

PHYSICIAN. JOB DESCRIPTION Employees in this job function as professional physicians in a general or specialized area of medicine.

PHYSICIAN. JOB DESCRIPTION Employees in this job function as professional physicians in a general or specialized area of medicine. MICHIGAN CIVIL SERVICE COMMISSION JOB SPECIFICATION PHYSICIAN JOB DESCRIPTION Employees in this job function as professional physicians in a general or specialized area of medicine. There are two classifications

More information

Medicaid Is One of Multiple Payers in Vermont s Health Care Reforms

Medicaid Is One of Multiple Payers in Vermont s Health Care Reforms Aligning Incentives in Medicaid March 2013 Medicaid Is One of Multiple Payers in Vermont s Health Care Reforms Sharon Silow-Carroll Health Management Associates The mission of The Commonwealth Fund is

More information

Arkansas Health Care Payment Improvement Initiative

Arkansas Health Care Payment Improvement Initiative Arkansas Health Care Payment Improvement Initiative Joseph W. Thompson, MD, MPH Arkansas Surgeon General Director, Arkansas Center for Health Improvement Arkansas System Transformation Strategy Workforce

More information

Department of Human Services Health Care Reform Review Committee Representative George Keiser, Chairman March 19, 2014

Department of Human Services Health Care Reform Review Committee Representative George Keiser, Chairman March 19, 2014 Department of Human Services Health Care Reform Review Committee Representative George Keiser, Chairman March 19, 2014 Chairman Keiser, members of the Health Care Reform Review Committee, I am Julie Schwab,

More information

69 th Annual Meeting of the Southern Legislative Conference

69 th Annual Meeting of the Southern Legislative Conference 69 th Annual Meeting of the Southern Legislative Conference Medicaid Behavioral Health Homes Integrating Services- Overview and Implementation Advice Savannah, GA July 19, 2015 Michael S. Varadian, JD,

More information

CMS Innovation Center Improving Care for Complex Patients

CMS Innovation Center Improving Care for Complex Patients CMS Innovation Center Improving Care for Complex Patients ECRI Institute Dr. Patrick Conway, M.D., MSc CMS Chief Medical Officer and Deputy Administrator for Innovation and Quality Director, Center for

More information

Patient-Centered Medical Home. Transform Your Practice

Patient-Centered Medical Home. Transform Your Practice Patient-Centered Medical Home Transform Your Practice 1 The New York ehealth Collaborative (NYeC) Regional Extension Center (REC) The NYeC Regional Extension Center is the physician s trusted advisor in

More information

Concept Series Paper on Disease Management

Concept Series Paper on Disease Management Concept Series Paper on Disease Management Disease management is the concept of reducing health care costs and improving quality of life for individuals with chronic conditions by preventing or minimizing

More information

Pamela Tropiano, RN, CCM, BSN, MPA. CareSource

Pamela Tropiano, RN, CCM, BSN, MPA. CareSource Annual Education Conference September 30 October 3, 2012 Orlando, FL 1.7 Creative Case Management Pamela Tropiano, RN, CCM, BSN, MPA Senior Vice President, Health hservices CareSource Mission: The CareSource

More information

Pennsylvania s Efforts to Transform Primary Care

Pennsylvania s Efforts to Transform Primary Care Pennsylvania s Efforts to Transform Primary Care Ann S. Torregrossa, Esq. Director Governor s Office of Health Care Reform Commonwealth of Pennsylvania Prescription for Pennsylvania Prescription for Pennsylvania

More information

HEALTH REFORM AND THE PATIENT-CENTERED MEDICAL HOME: Policy Provisions and Expectations of the Patient Protection and Affordable Care Act

HEALTH REFORM AND THE PATIENT-CENTERED MEDICAL HOME: Policy Provisions and Expectations of the Patient Protection and Affordable Care Act Safety Net Medical Home Initiative HEALTH REFORM AND THE PATIENT-CENTERED MEDICAL HOME: Policy Provisions and Expectations of the Patient Protection and Affordable Care Act Policy Brief Issue 2 Introduction

More information

Summary: There are four major initiatives underway that address integration of substance abuse care with physical and mental health.

Summary: There are four major initiatives underway that address integration of substance abuse care with physical and mental health. Summary: Section E.306.2(b)(1) requires the Secretary of Administration and the Chief of Health Care Reform to submit a report on current and additional strategies to achieve a more comprehensive health

More information

HealthPartners: Triple Aim Approach to ACO Development

HealthPartners: Triple Aim Approach to ACO Development HealthPartners: Triple Aim Approach to ACO Development Brian Rank, MD Medical Director, HealthPartners Medical Group October 27, 2010 HealthPartners Integrated Care and Financing System 10,300 employees

More information

Project Objective: Integration of mental health and substance abuse with primary care services to ensure coordination of care for both services.

Project Objective: Integration of mental health and substance abuse with primary care services to ensure coordination of care for both services. Domain 3 Projects 3.a.i Integration of Primary Care and Behavioral Health Services Project Objective: Integration of mental health and substance abuse with primary care services to ensure coordination

More information

Minnesota s Integrated Health Partnership

Minnesota s Integrated Health Partnership Minnesota s Integrated Health Partnership Minnesota s IHP program was designed to create a shared risk arrangement to improve care coordination and quality Program applies to all Medicaid beneficiaries,

More information

Evolving Medical Home Payment Models to Be5er Support Triple Aim Goals

Evolving Medical Home Payment Models to Be5er Support Triple Aim Goals Evolving Medical Home Payment Models to Be5er Support Triple Aim Goals May 24, 2012 Mary Takach, MPH, RN Program Director Na:onal Academy for State Health Policy For audio, please turn up your speakers.

More information

Ron Stock MD MA Oregon Rural Health Conference October 24, 2013

Ron Stock MD MA Oregon Rural Health Conference October 24, 2013 Ron Stock MD MA Oregon Rural Health Conference October 24, 2013 Provide a historical context for healthcare reform including the 2010 Patient Protection & Accountable Care Act Connect what is known to

More information

Pushing the Envelope of Population Health

Pushing the Envelope of Population Health Pushing the Envelope of Population Health Timothy Ferris, MD, MPH Senior Vice President, Population Health Management, Partners HealthCare May 15, 2014 DISCLAIMER: The views and opinions expressed in this

More information

Harriet L. Hall, Ph.D., President and CEO Jefferson Center for Mental Health

Harriet L. Hall, Ph.D., President and CEO Jefferson Center for Mental Health Harriet L. Hall, Ph.D., President and CEO Jefferson Center for Mental Health Medicaid expansion state State-run health insurance exchange Colorado Office of Behavioral Health renamed in 2010 to reflect

More information

Are We There Yet? Evaluating Care Coordination Systems

Are We There Yet? Evaluating Care Coordination Systems Are We There Yet? Evaluating Care Coordination Systems Dianne Hasselman, Senior Director, Strategic Programs NAMD Annual Meeting November 4, 2014 Arlington, VA Network for Regional Healthcare Improvement

More information

Title Slide: Healthcare Reform and Multilevel Interventions and Research: Big Changes Go Hand-in-Hand with Big Science

Title Slide: Healthcare Reform and Multilevel Interventions and Research: Big Changes Go Hand-in-Hand with Big Science Title Slide: Healthcare Reform and Multilevel Interventions and Research: Big Changes Go Hand-in-Hand with Big Science Presented by Kelly J. Devers Prepared for the N C I Conference on Multilevel Interventions

More information

Appendix E: Assessment of Primary Care Resources and Supports for Chronic Disease Self Management (PCRS) 1,2,3

Appendix E: Assessment of Primary Care Resources and Supports for Chronic Disease Self Management (PCRS) 1,2,3 Appendix E: Assessment of Primary Care Resources and Supports for Chronic Disease Self Management (PCRS),2,3 Individuals interested in using the PCRS in quality improvement work or research are free to

More information

CHAPTER 7: UTILIZATION MANAGEMENT

CHAPTER 7: UTILIZATION MANAGEMENT OVERVIEW The Plan s Utilization Management (UM) program is collaboration with providers to promote and document the appropriate use of health care resources. The program reflects the most current utilization

More information

MVP/PREFERRED CARE GUIDELINE

MVP/PREFERRED CARE GUIDELINE MVP/PREFERRED CARE GUIDELINE MVP/Preferred Care Clinical Guideline Overview Screening Adolescents for Alcohol and Substance Abuse in Primary Care MVP Health Care/ Preferred Care, as part of its continuing

More information

Objectives: Perform thorough assessment, and design and implement care plans on 12 or more seriously mentally ill addicted persons.

Objectives: Perform thorough assessment, and design and implement care plans on 12 or more seriously mentally ill addicted persons. Addiction Psychiatry Program Site Specific Goals and Objectives Addiction Psychiatry (ADTU) Goal: By the end of the rotation fellow will acquire the knowledge, skills and attitudes required to recognize

More information

Integrating Behavioral Health and Primary Health Care: Development, Maintenance, and Sustainability Cici Conti Schoenberger, LCSW, CAS Behavioral

Integrating Behavioral Health and Primary Health Care: Development, Maintenance, and Sustainability Cici Conti Schoenberger, LCSW, CAS Behavioral Integrating Behavioral Health and Primary Health Care: Development, Maintenance, and Sustainability Cici Conti Schoenberger, LCSW, CAS Behavioral Health Provider Sunshine Community Health Center Why Integrate?

More information

TESTIMONY. March 17, 2014. Rutland, VT

TESTIMONY. March 17, 2014. Rutland, VT Community Solutions to Breaking the Cycle of Heroin & Opioid Addiction TESTIMONY Harry Chen, MD, Commissioner of Health March 17, 2014 Senate Committee on the Judiciary Franklin Conference Center at the

More information

Health Care Affordability Act Catamount Health. Senator James Leddy, Chair Vermont Senate Health & Welfare Committee

Health Care Affordability Act Catamount Health. Senator James Leddy, Chair Vermont Senate Health & Welfare Committee Health Care Affordability Act Catamount Health Senator James Leddy, Chair Vermont Senate Health & Welfare Committee Principles of Health Care Reform in Vermont Established by Coalition 21 (January 2005)

More information

State Innovation Models Initiative:

State Innovation Models Initiative: Department of Health & Human Services Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 FACT SHEET FOR IMMEDIATE RELEASE Contact: CMS Media Relations

More information

Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights

Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Emily Brower Executive Director Accountable Care Programs Emily_Brower@AtriusHealth.org November 2013 1 Contents Overview of

More information

Center for Medicare and Medicaid Innovation

Center for Medicare and Medicaid Innovation Center for Medicare and Medicaid Innovation Summary: Establishes within the Centers for Medicare and Medicaid Services (CMS) a Center for Medicare & Medicaid Innovation (CMI). The purpose of the Center

More information

Risk Adjustment: Implications for Community Health Centers

Risk Adjustment: Implications for Community Health Centers Risk Adjustment: Implications for Community Health Centers Todd Gilmer, PhD Division of Health Policy Department of Family and Preventive Medicine University of California, San Diego Overview Program and

More information

POPULATION HEALTH MANAGEMENT The Lynchpin of Emerging Healthcare Delivery Improve Patient Outcomes, Engage Physicians, and Manage Risk

POPULATION HEALTH MANAGEMENT The Lynchpin of Emerging Healthcare Delivery Improve Patient Outcomes, Engage Physicians, and Manage Risk POPULATION HEALTH MANAGEMENT The Lynchpin of Emerging Healthcare Delivery Improve Patient Outcomes, Engage Physicians, and Manage Risk Julia Andrieni, MD, FACP Vice President, Population Health and Primary

More information

Best Principles for Integration of Child Psychiatry into the Pediatric Health Home

Best Principles for Integration of Child Psychiatry into the Pediatric Health Home Best Principles for Integration of Child Psychiatry into the Pediatric Health Home Approved by AACAP Council June 2012 These guidelines were developed by: Richard Martini, M.D., co-chair, Committee on

More information

A FEDERAL STATE DISCOURSE ON PRIMARY CARE AND BEHAVIORAL HEALTH INTEGRATION. Background Material

A FEDERAL STATE DISCOURSE ON PRIMARY CARE AND BEHAVIORAL HEALTH INTEGRATION. Background Material A FEDERAL STATE DISCOURSE ON PRIMARY CARE AND BEHAVIORAL HEALTH INTEGRATION Background Material 1 The Need for Primary Care and Behavioral Health Integration Individuals with behavioral health needs often

More information

Patient Centered Medical Home: An Approach for the Health Plan

Patient Centered Medical Home: An Approach for the Health Plan : An Approach for the Health Plan By Marissa A. Harper and JoAnn E. Balara Excellence in healthcare consulting The Medical Home Concept Works Recent Medicare demonstration projects on Patient Centered

More information

Health Homes in Medicaid

Health Homes in Medicaid Health Homes in Medicaid Melissa Cuerdon, MSW, LCSW-C and Christa Speicher, MPH Disabled and Elderly Health Programs Group Centers for Medicaid & CHIP Services Centers for Medicare and Medicaid Services

More information

Selection of Medicaid Beneficiaries for Chronic Care Management Programs: Overview and Uses of Predictive Modeling

Selection of Medicaid Beneficiaries for Chronic Care Management Programs: Overview and Uses of Predictive Modeling APRIL 2009 Issue Brief Selection of Medicaid Beneficiaries for Chronic Care Management Programs: Overview and Uses of Predictive Modeling Abstract Effective use of care management techniques may help Medicaid

More information

Substance Abuse Treatment Services Objectives and Performance Measures Progress: First Annual Report

Substance Abuse Treatment Services Objectives and Performance Measures Progress: First Annual Report Report to The Vermont Legislature Substance Abuse Treatment Services Objectives and Performance Measures Progress: First Annual Report In Accordance with Act 179 (2014) Sec. E.306.2 (a)(1) Submitted to:

More information

Standard Life And Accident Insurance Company: PremiumSaver

Standard Life And Accident Insurance Company: PremiumSaver This is only a summary. This plan is supplemental to your group s major medical plan. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document

More information

National Reimbursement Models and Alignment with Washington State Initiatives

National Reimbursement Models and Alignment with Washington State Initiatives September 15, 2008 Presented by Michael Bailit to the Washington Primary Care Coalition Presentation Objectives 1. Set the context for a discussion of PCMH reimbursement models 2. Review the range of PCMH

More information

Costs of Vermont s Health Care System Comparison of Baseline and Reformed System. Initial Draft April 21, 2011

Costs of Vermont s Health Care System Comparison of Baseline and Reformed System. Initial Draft April 21, 2011 Costs of Vermont s Health Care System Comparison of Baseline and Reformed System Initial Draft April 21, 2011 Prepared by Vermont Legislative Joint Fiscal Office www.leg.state.vt.us/jfo Vermont Department

More information

Profile: Incorporating Routine Behavioral Health Screenings Into the Patient-Centered Medical Home

Profile: Incorporating Routine Behavioral Health Screenings Into the Patient-Centered Medical Home 104 A LOOK TO THE FUTURE Profile: Incorporating Routine Behavioral Health Screenings Into the Patient-Centered Medical Home Background Management of chronic diseases can be challenging in primary care,

More information

iq Practice Development Planner

iq Practice Development Planner If you want better control of your current and future finances you need iq Practice Development Planner The unique financial and management planning system for General Practice. Essential for Practices

More information

Imagining Seamless Information Flow: Bridging the HIE Gap and Making Care Coordination Reality AJ Peterson: GM, CareConnect Larry Seltzer: GM,

Imagining Seamless Information Flow: Bridging the HIE Gap and Making Care Coordination Reality AJ Peterson: GM, CareConnect Larry Seltzer: GM, Imagining Seamless Information Flow: Bridging the HIE Gap and Making Care Coordination Reality AJ Peterson: GM, CareConnect Larry Seltzer: GM, CareManager Jerry Dolezal: CIO, Optum BH-Pierce County Agenda

More information

Blue Cross Blue Shield of Michigan

Blue Cross Blue Shield of Michigan Blue Cross Blue Shield of Michigan Provider Delivered Care Management Program Thomas Simmer, MD Sr. Vice President and Chief Medical Officer January 18, 2013 PGIP: Catalyzing Health System Transformation

More information

ADHDInitiative. The Vermont A MULTIDISCIPLINARY APPROACH TO ADHD FOR FAMILIES/CAREGIVERS, EDUCATIONAL & HEALTH PROFESSIONALS

ADHDInitiative. The Vermont A MULTIDISCIPLINARY APPROACH TO ADHD FOR FAMILIES/CAREGIVERS, EDUCATIONAL & HEALTH PROFESSIONALS The Vermont ADHDInitiative A MULTIDISCIPLINARY APPROACH TO ADHD FOR FAMILIES/CAREGIVERS, EDUCATIONAL & HEALTH PROFESSIONALS ACKNOWLEDGEMENTS: This work and its resulting improvements in the care provided

More information

Integration of Mental Health in Quality-Assurance Policies

Integration of Mental Health in Quality-Assurance Policies A HEALTHCARE REFORM ISSUE BRIEF Integration of Mental Health in Quality-Assurance Policies This is one of a series of issue briefs by the Bazelon Center on the integration of mental health in healthcare

More information

NURSE PRACTITIONER PROGRAM THE PENNSYLVANIA STATE UNIVERSITY College of Nursing

NURSE PRACTITIONER PROGRAM THE PENNSYLVANIA STATE UNIVERSITY College of Nursing NURSE PRACTITIONER PROGRAM THE PENNSYLVANIA STATE UNIVERSITY College of Nursing Preceptor Evaluation of Student Clinical Performance: Adult Gerontology Acute Care Nurse Practitioner Option Nursing 863

More information

Recommendations and Next Steps: Reform Health Care Practice

Recommendations and Next Steps: Reform Health Care Practice Incorporate into routine medical practice screening and intervention for risky substance use and diagnosis, treatment and disease management for addiction Develop core competencies for physicians in understanding

More information

A Close Look at Care Coordination within Patient-Centered Medical Homes: West Virginia s Experience

A Close Look at Care Coordination within Patient-Centered Medical Homes: West Virginia s Experience A Close Look at Care Coordination within Patient-Centered Medical Homes: West Virginia s Experience Web Seminar May 9, 2013 Follow this event on Twitter Hashtag: #AHRQIX Using the Webcast Console and Submitting

More information

Second Annual Florida 2008 Electronic Prescribing Report

Second Annual Florida 2008 Electronic Prescribing Report Second Annual Florida 2008 Electronic Prescribing Report FLORIDA CENTER FOR HEALTH INFORMATION AND POLICY ANALYSIS AGENCY FOR HEALTH CARE ADMINISTRATION JANUARY 2009 Better Health Care for All Floridians

More information

10/21/2014. Clinical Innovations in the Patient Centered Medical Home to Improve Diabetes Care

10/21/2014. Clinical Innovations in the Patient Centered Medical Home to Improve Diabetes Care Clinical Innovations in the Patient Centered Medical Home to Improve Diabetes Care Robert A. Gabbay, MD, PhD, FACP Chief Medical Officer & Senior Vice President Joslin Diabetes Center Harvard Medical School

More information

Health Reform and the AAP: What the New Law Means for Children and Pediatricians

Health Reform and the AAP: What the New Law Means for Children and Pediatricians Health Reform and the AAP: What the New Law Means for Children and Pediatricians Throughout the health reform process, the American Academy of Pediatrics has focused on three fundamental priorities for

More information

MaineCare Value Based Purchasing Initiative

MaineCare Value Based Purchasing Initiative MaineCare Value Based Purchasing Initiative The Accountable Communities Strategy Jim Leonard, Deputy Director, MaineCare Peter Kraut, Acting Accountable Communities Program Manager Why Value-Based Purchasing

More information

eprescribing Incentives, Benefits & Challenges Presentation By Director of Government Affairs

eprescribing Incentives, Benefits & Challenges Presentation By Director of Government Affairs eprescribing Incentives, Benefits & Challenges Presentation By Director of Government Affairs eprescribing That s what it says: one tablespoonful, 300 times a day. Presentation Goals Appreciate the benefits

More information

Case Management and Care Coordination:

Case Management and Care Coordination: HEALTH MANAGEMENT CUP recognizes the importance of promoting effective health management and preventive care for conditions that are relevant to our populations, thereby improving health care outcomes.

More information

Talking with Health Care Entities about Value: A Tool for Calculating a Return on Investment

Talking with Health Care Entities about Value: A Tool for Calculating a Return on Investment Talking with Health Care Entities about Value: A Tool for Calculating a Return on Investment Overview Doctors, hospitals, and other health care providers are under increasing pressure to improve quality

More information

Partnerships in Primary and Behavioral Health Care ACO Survival Integrated Care

Partnerships in Primary and Behavioral Health Care ACO Survival Integrated Care Partnerships in Primary and Behavioral Health Care ACO Survival Integrated Care Ensuring Success for ACOs September 22 23 Joyce Wale LCSW Vice President, Institute for Behavioral Healthcare Improvement

More information

Henriëtte van der Horst VUmc Head of Department of General Practice and Elderly Care Medicine

Henriëtte van der Horst VUmc Head of Department of General Practice and Elderly Care Medicine MUS and psychiatry in primary care Henriëtte van der Horst VUmc Head of Department of General Practice and Elderly Care Medicine Double Dutch: two topics Major changes in the mental health care organisation

More information

Care Coordination among DSRIP Partners

Care Coordination among DSRIP Partners Care Coordination among DSRIP Partners John F. Skip Williams, Jr., MD, EdD, MPH Maureen Fahey, RN, MBA Thursday, June 25, 2015 3:00-3:30 pm OVERVIEW OF PRESENTATION New York State DSRIP Overview Brooklyn

More information

Accountable Care Organizations: An old idea with new potential. Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010

Accountable Care Organizations: An old idea with new potential. Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010 Accountable Care Organizations: An old idea with new potential Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010 Impetus for ACO Formation Increased health care cost From

More information

Division of Behavioral Health. Requirements for Program Staff

Division of Behavioral Health. Requirements for Program Staff Division of Behavioral Health Requirements for Program Staff Integrated BH Regulations Training 1 Program Staff Program Staff are professionals who render behavioral health services directly to a recipient.

More information

A Blueprint for Building a Medical Group s Internal Quality and Cost Efficiency Infrastructure

A Blueprint for Building a Medical Group s Internal Quality and Cost Efficiency Infrastructure + A Blueprint for Building a Medical Group s Internal Quality and Cost Efficiency Infrastructure + Disclosures: Timothy Harlan: I have no actual or potential conflict of interest in relation to this presentation.

More information

9/14/2011. Quality, Care, and Coordination Under One Roof: RDs in the Medical Home. How to Set the Table for a Nutritious Meal in the Medical Home

9/14/2011. Quality, Care, and Coordination Under One Roof: RDs in the Medical Home. How to Set the Table for a Nutritious Meal in the Medical Home Quality,, and Coordination Under One Roof: RDs in the Medical Home Laura Pickler, MD, MPH Debra Hook, MPH, RD How to Set the Table for a Nutritious Meal in the Medical Home Laura Pickler, MD, MPH Debra

More information

Co occurring Disorders Treatment Integration. Kitsap County Substance Abuse Advisory Board Cheryl Mogensen MA, MHP, CDP December 10, 2013

Co occurring Disorders Treatment Integration. Kitsap County Substance Abuse Advisory Board Cheryl Mogensen MA, MHP, CDP December 10, 2013 Co occurring Disorders Treatment Integration at KMHS Kitsap County Substance Abuse Advisory Board Cheryl Mogensen MA, MHP, CDP December 10, 2013 Kitsap Mental Health Services Bremerton, Washington Comprehensive

More information

Vermont State Board of Nursing. APRN/RN/LPN Scope of Practice Position Statement and Decision Tree

Vermont State Board of Nursing. APRN/RN/LPN Scope of Practice Position Statement and Decision Tree Vermont State Board of Nursing APRN/RN/LPN Scope of Practice Position Statement and Decision Tree Question: How does an Advanced Practice Registered Nurse (APRN), Registered Nurse (RN) or Licensed Practical

More information

ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION)

ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION) ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION) Hello and welcome. Thank you for taking part in this presentation entitled "Essentia Health as an ACO or Accountable Care Organization -- What

More information

The Medical Home: A Continuing Renovation Job. Paul Kaye, MD Executive VP, Practice Transformation February 22, 2012

The Medical Home: A Continuing Renovation Job. Paul Kaye, MD Executive VP, Practice Transformation February 22, 2012 The Medical Home: A Continuing Renovation Job Paul Kaye, MD Executive VP, Practice Transformation February 22, 2012 DISCLAIMER: The views and opinions expressed in this presentation are those of the author

More information

Implementation of SBIRT onto Electronic Health Records: From Documentation to Data

Implementation of SBIRT onto Electronic Health Records: From Documentation to Data Implementation of SBIRT onto Electronic Health Records: From Documentation to Data John R. McAteer, LCSW-R New York City Department of Health and Mental Hygiene Bureau of Alcohol and Drug Use Prevention,

More information

National Quality Management

National Quality Management National Quality Management National Approval Date: Effective Date: 02/24/2015 Subject Practitioner and Provider Availability: Network Composition and Contracting Plan Originating Dept. National Quality

More information

October 22, 2014 Jill M. Gregoire RN, MSN Quality Assurance/Clinical Operations Director Indian Stream Health Center Colebrook, NH

October 22, 2014 Jill M. Gregoire RN, MSN Quality Assurance/Clinical Operations Director Indian Stream Health Center Colebrook, NH October 22, 2014 Jill M. Gregoire RN, MSN Quality Assurance/Clinical Operations Director Indian Stream Health Center Colebrook, NH Why Stratify Risk for Your Patients? NCQA s Patient-Centered Medical Home

More information

SENATE... No. 2126. The Commonwealth of Massachusetts. Joint, April 30, 2014.

SENATE... No. 2126. The Commonwealth of Massachusetts. Joint, April 30, 2014. SENATE.............. No. 2126 The Commonwealth of Massachusetts Joint, April 30, 2014. BILL #: S993 BILL STATUS: Favorable with Amendment DISSENTERS: None ACCOMPANIED BILLS: None For the committee, JAMES

More information