QUALITY MANAGEMENT SYSTEM FOR LICENSED MENTAL HEALTH COUNSELORS AND OTHER BEHAVIORAL HEALTH PROFESSIONALS IN THE MILITARY HEALTH SYSTEM
|
|
|
- Sharleen McKenzie
- 7 years ago
- Views:
Transcription
1 QUALITY MANAGEMENT SYSTEM FOR LICENSED MENTAL HEALTH COUNSELORS AND OTHER BEHAVIORAL HEALTH PROFESSIONALS IN THE MILITARY HEALTH SYSTEM Presentation to the Institute of Medicine Robert C. Saunders, Ph.D., Research Scientist
2 Outline Provide examples of structure, process, and outcomes in high-performing quality management systems Identify some challenges associated with these measures and future directions in measurement 2
3 Structural Measurement NCQA s MBHO Accreditation Program Survey and site-review Plans are evaluated on 5 Standards Quality Management & Improvement Utilization Management Credentialing & Re-credentialing Members Rights & Responsibilities Preventive Health Elements/factors, rated on a 5-point scale Population-based approach QIA evaluation and Preventive Health functions are unique to MBHO Accred. 3
4 Accreditation Example QI7: Clinical Practice Guidelines Element A: Adopting Guidelines Adopt guidelines on at least 2 conditions Establishing clinical basis for guidelines Reviewing & updating at least every 2 yrs Distributing to appropriate providers Element B: Performance Measurement Annually measured performance against at least 2 important aspects of each guideline Similar process for other standards 4
5 Structural Measurement (cont) Patient-Centered Medical Home Recognition Program Uses a review process similar to that for accreditation, but focused at the practice-level and generally off-site Next version of standards (2011) will address behavioral health & primary care integration Evidence of good care management/planning for 3 conditions, one must be in behavioral health NCQA contracts with HRSA, Military Health Service, Navy Minnesota s Diamond Project Placing care management in primary care settings Depression care management fee 5
6 PCMH 2011 (6 standards/25 elements) 1. Access/Continuity Access Medical Home Responsibilities CLAS Practice Team 2. Identify/Manage Patient Populations 3. Plan/Manage Care Care Management Medication Management/ E-Prescribing 4. Self-Care Support 5. Track/Coordinate Care Test/Referral Tracking Facilities 6. Performance Measurement/ Quality Improvement Measures of Performance Patient Experience Quality Improvement Reporting 6
7 Process Measurement HEDIS measures are an important component of Health Plan accreditation and quality improvement activities Behavioral health measures in HEDIS Antidepressant medication management Follow-up care for children prescribed ADHD medications Follow-up after hospitalization Mental health utilization NOT used for MBHO Accreditation Identification and Initiation & Engagement in treatment for AOD dependence treatment 7
8 % meeting criteria Data Example Commercial Health Plans, AMM Acute Phase Source: NCQA, State of Health Care 2009 Most HEDIS BH performance measures are low-and-flat AMM Continuation Phase Calendar Year 8
9 Moving Forward on Process At NCQA Re-evaluation of the BH measures this year (3-year cycle) NCQA is developing measures under federal contracts on: Schizophrenia in ambulatory settings (Medicaid) Inpatient psychiatric hospital care Exploring opportunities to measure quality for depression and PTSD Minnesota s Diamond Project Measures for periodic screening, follow-up 9
10 Process Measurement Challenges Claims-based v. chart-based v. survey Availability, accuracy, detail, cost, ease Timing of measures New episodes/cases v. caseload Professional turf/responsibility issues Reimbursement/policy issues Efficacy v. effectiveness research A lot of the former (controlled research), not a lot of the latter (in real world practice) Often not strong links or body of research connecting process to outcomes 10
11 Challenges (Cont.) NCQA explored PCP-perceived barriers to use of standardized screening with the PHQ-9 for depression PCP s didn t consider follow-up necessary Don t believe they are responsible for ensuring completed referrals Who s available for referrals? Ethics of screening/assessment when services not available Perception that documentation takes time 11
12 Outcomes Measurement Generally not collected on a routine basis When collected, it is often in a way that cannot be aggregated or used for management/improvement HOS is one example that does collect this Agreement on measurement tools There s not a HbA1c for most mental health conditions Where there is agreement, seldom routine use, data capture, use, and/or feedback 12
13 Moving Forward on Outcomes Moving to individual-level collection and analysis, especially with EMR/EHR s Collection and feedback of clinical outcomes in close to real time with clinicians Contextualized Feedback System (Bickman & Riemer; New York State OMH) 13
14 Follow-up Questions Robert C. Saunders
HEDIS/CAHPS 101. August 13, 2012 Minnesota Measurement and Reporting Workgroup
HEDIS/CAHPS 101 Minnesota Measurement and Reporting Workgroup Objectives Provide introduction to NCQA Identify HEDIS/CAHPS basics Discuss various components related to HEDIS/CAHPS usage, including State
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
Behavioral Health Quality Standards for Providers
Behavioral Health Quality Standards for Providers TABLE OF CONTENTS I. Behavioral Health Quality Standards Access Standards A. Access Standards B. After-Hours C. Continuity and Coordination of Care 1.
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business Quality Management Program 2012 Overview Quality Improvement
Arkansas Blue Cross and Blue Shield Patient Centered Medical Home Provider Manual
Arkansas Blue Cross and Blue Shield Patient Centered Medical Home Provider Manual 2015 This document is a guide to the 2015 Arkansas Blue Cross and Blue Shield Patient- Centered Medical Home program (Arkansas
NCQA PCMH 2011 Standards, Elements and Factors Documentation Guideline/Data Sources
NCQA PCMH 2011 Standards, Elements and Factors Documentation Guideline/Data Sources Key: DP = Documented Process N/D = Report numerator and denominator creating percent of use RPT = Report of data or information
Fixing Mental Health Care in America
Fixing Mental Health Care in America A National Call for Measurement Based Care in Behavioral Health and Primary Care An Issue Brief Released by The Kennedy Forum Prepared by: John Fortney PhD, Rebecca
To precertify inpatient admissions or transitional care services, call 1-866-688-3400 and select option #1.
Security Health Plan provides coverage of various mental health/aoda (alcohol and other drug abuse) benefits to individual and employer group members. These benefits are managed by Security Health Plan.
Michigan Engagement Center
Michigan Engagement Center Quality Improvement Activities Provider Key Updates The ValueOptions Michigan Engagement Center is committed to being a center for excellence in developing and coordinating quality
Cenpatico Quality Improvement Program Description 2014
Cenpatico Quality Improvement Program Description 2014 Table of Contents Section Page I. Introduction... 1 II. Quality Improvement Program Authority... 2 III. Quality Improvement Program Scope... 2 IV
Idaho Health Home State Plan Amendment Matrix: Summary Overview. Overview of Approved Health Home SPAs
Idaho Health Home State Plan Amendment Matrix: Summary Overview This matrix outlines key program design features from health home State Plan Amendments (SPAs) approved by the Centers for Medicare & Medicaid
Blue Choice PPO SM Behavioral Health Services (Mental Health & Chemical Dependency)
SM (Mental Health & Chemical Dependency) In this Section The following topics are covered in this section: Topic Page Integrated Program I 2 Program Components I 2 Focused Outpatient Management Program
Integrating Behavioral Health into the Patient Centered Medical Home: The Massachusetts Experience
Integrating Behavioral Health into the Patient Centered Medical Home: The Massachusetts Experience Megan E. Burns, MPP Judith L. Steinberg, MD, MPH Michael H. Bailit, MBA F. Alexander Blount, EdD Disclosures
Overview. Consider the materials presented in this webinar during your initial PCMH planning sessions
p. 1 Overview NCQA PCMH 2014 Standards Strategy to create a PCMH work plan Quality improvement planning A word about renewals Summary Consider the materials presented in this webinar during your initial
UW Medicine Integrated Mental Health Care. Laura Collins MSW, Darcy Jaffe ARNP Jürgen Unützer, MD, MPH, MA
UW Medicine Integrated Mental Health Care Laura Collins MSW, Darcy Jaffe ARNP Jürgen Unützer, MD, MPH, MA Why Behavioral Health Care in Primary Care? 1. Access to care: Serve patients where they are 2.
Welcome to Magellan Complete Care
Magellan Complete Care of Florida Provider Newsletter Welcome to Magellan Complete Care On behalf of Magellan Complete Care of Florida, thank you for your continued support and collaboration. As the only
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida Medicare Quality Management Program Overview Quality Improvement (QI) Overview At Coventry, we
504 Lavaca Street Suite 850 Austin, Texas 78701 PROVIDER NEWSLETTER
504 Lavaca Street Suite 850 Austin, Texas 78701 PROVIDER NEWSLETTER PROVIDER REPORT www.cenpatico.com Welcome to the first Cenpatico provider report for 2013. We re excited to share with you details on
Patient-Centered Medical Home (PCMH) 2014
Patient-Centered Medical Home (PCMH) 2014 Part 1: Standards 1-3 All materials 2014, National Committee for Quality Assurance Agenda Part 1 Content t of PCMH 2014 Standards d and Guidelines Standards 1
FY 14-15 ADULT MEDICAID CLIENT SATISFACTION REPORT
FY 14-15 ADULT MEDICAID CLIENT SATISFACTION REPORT September 2015 This report was produced by Health Services Advisory Group, Inc. for the Colorado Department of Policy & Financing. 3133 East Camelback
Learning Objectives: Identify the critical elements for providing effective integrated behavioral health care within the PCMH
Learning Objectives: Understand the role of behavioral health integration for effectively addressing NCQA PCMH Recognition Standards and responding to the complex healthcare needs of high risk populations
Advancing Health Equity. Through national health care quality standards
Advancing Health Equity Through national health care quality standards TABLE OF CONTENTS Stage 1 Requirements for Certified Electronic Health Records... 3 Proposed Stage 2 Requirements for Certified Electronic
Making the Grade! A Closer Look at Health Plan Performance
Primary Care Update August 2011 Making the Grade! A Closer Look at Health Plan Performance HEDIS (Healthcare Effectiveness Data and Information Set) is a set of standardized measures designed to track
Lessons on the Integration of Medicine and Psychiatry
Lessons on the Integration of Medicine and Psychiatry Edward Post, MD, PhD Associate Professor of Internal Medicine, University of Michigan VA Health Services Research & Development Center of Excellence,
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
Oregon Standards for Certified Community Behavioral Health Clinics (CCBHCs)
Oregon Standards for Certified Community Behavioral Health Clinics (CCBHCs) Senate Bill 832 directed the Oregon Health Authority (OHA) to develop standards for achieving integration of behavioral health
An Administrative Orientation for Providers for Oscar Health Insurance
An Administrative Orientation for Providers for Oscar Health Insurance Objectives Overview of ValueOptions Overview of ValueOptions & Oscar Partnership Overview of Operational Areas Clinical Operations
Enhancements. PCMH 2014 Standards. Barbara Proffitt RN Quality Initiatives Manager. NCQA PCMH Certified Content Expert
Enhancements to the NCQA PCMH 2014 Standards Barbara Proffitt RN Quality Initiatives Manager NCQA PCMH Certified Content Expert Objectives To provide an overview on the major enhancements to the PCMH NCQA
Table 1 Performance Measures. Quality Monitoring P4P Yr1 Yr2 Yr3. Specification Source. # Category Performance Measure
Table 1 Performance Measures # Category Performance Measure 1 Behavioral Health Risk Assessment and Follow-up 1) Behavioral Screening/ Assessment within 60 days of enrollment New Enrollees who completed
COMPARISON: PPC-PCMH 2008 With PCMH 2011
COMPARISON: PPC-PCMH 008 With PCMH 011 About This Crosswalk The following crosswalk compares Physician Practice Connections Patient-Centered Medical Home (PPC -PCMH ) 008 with NCQA s Patient-Centered Medical
NCQA Patient-Centered Medical Home. Improving experiences for patients, providers and practice staff
NCQA Patient-Centered Medical Home Improving experiences for patients, providers and practice staff PCMH Recognition The patient-centered medical home is a model of care that emphasizes care coordination
Vermont ACO Shared Savings Program Quality Measures: Recommendations for Year 2 Measures from the VHCIP Quality and Performance Measures Work Group
Vermont ACO Shared Savings Program Quality Measures: Recommendations for Year 2 Measures from the VHCIP Quality and Performance Measures Work Group Presentation to VHCIP Steering Committee August 6, 2014
ALWAYS call to verify eligibility and remaining benefits as the member may have seen or is currently seeing other providers.
Billing Requirements Affiliated providers must follow Wisconsin Medicaid and BadgerCare Fee-For Service Billing requirements effective October 1, 2003 for all BadgerCare/Medicaid services billed to Security
Ohio s Community Behavioral Health Center Health Homes: A New Service Delivery Model
Ohio s Community Behavioral Health Center Health Homes: A New Service Delivery Model 1 C E N T E R F O R E V I D E N C E - B A S E D P R A C T I C E S A T C A S E W E S T E R N R E S E R V E U N I V E
Department of Health Services. Behavioral Health Integrated Care. Health Home Certification Application
Department of Health Services Behavioral Health Integrated Care Health Home Certification Application (Langlade, Lincoln, and Marathon Counties) December 18, 2013 1 Behavioral Health Integrated Care Health
Florida Medicaid: Mental Health and Substance Abuse Services
Florida Medicaid: Mental Health and Substance Abuse Services Beth Kidder Assistant Deputy Secretary for Medicaid Operations Agency for Health Care Administration House Children, Families, and Seniors Subcommittee
Primary Care-Mental Health Integration (PC-MHI) Functional Tool
Primary Care-Mental Health Integration (PC-MHI) Functional Tool The purpose of this tool is to outline the essential elements of a fully functional Primary Care-Mental Health Integration (PC-MHI) program
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
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,
Washington Common Measure Set on Healthcare Quality. Behavioral Health Measure Selection Workgroup Meeting #2 September 14, 2015
Washington Common Measure Set on Healthcare Quality Behavioral Health Measure Selection Workgroup Meeting #2 September 14, 2015 Today s Meeting Agenda 1. Welcome, Member Introductions 2. Review: Public
2015 HEDIS/CAHPS Effectiveness of Care Report for 2014 Service Measures Oregon, Idaho and Montana Commercial Business
2015 HEDIS/CAHPS Effectiveness of Care Report for 2014 Service Measures Oregon, Idaho and Montana Commercial Business About HEDIS The Healthcare Effectiveness Data and Information Set (HEDIS 1 ) is a widely
Mid-Hudson Adherence to Antipsychotic Medications for People Living With Schizophrenia
Adherence to Antipsychotic Medications for People Living With Schizophrenia 83 81 71 70 68 68 66 71 A. Behavioral Health 880 151 396 134 325 41 317 65 63 The percentage of recipients living with schizophrenia,
Article Writing - Episodes of Care
Provider Stakeholder Group November 4th, 2015 1 Update on Episodes of Care strategy Primary Care Transformation updates Primary Care Transformation TAG process PCMH payment streams and supports Health
Appendix 2. PCMH 2014 and CMS Stage 2 Meaningful Use Requirements
Appendix 2 PCMH 2014 and CMS Stage 2 Meaningful Use Requirements Appendix 2 PCMH 2014 and CMS Stage 2 Meaningful Use Requirements 2-1 APPENDIX 2 PCMH 2014 AND CMS STAGE 2 MEANINGFUL USE REQUIREMENTS Medicare
How To Get A Pcmh
A Comparison of the National Patient-Centered Medical Home Accreditation and Recognition Programs David N. Gans, MSHA, FACMPE, Senior Fellow Industry Affairs, Medical Group Management Association Englewood,
Patient Centered Medical Homes
Patient Centered Medical Homes Paul Kleeberg, MD, FAAFP, FHIMSS CMIO Stratis Health North Dakota e-health Summit November 20, 2013 REACH - Achieving - Achieving meaningful meaningful use of your use EHR
Achieving PCMH Recognition: Lesson s Learned from the Field. November 20, 2012
Achieving PCMH Recognition: Lesson s Learned from the Field November 20, 2012 Objectives 1. Identify the key components of a medical home model of care. 2. Learn what the patient-centered medical home
Integrating Behavioral Health and Primary Care. Overview
Integrating Behavioral Health and Primary Care Department of Family Medicine & Public Health Sciences Overview 1) Healthcare system & spending 2) Why behavioral health? 3) Patient-Centered Medical Home
Degree of Integration
Integrated Primary Care and Behavioral Health Services at Community Clinics and Health Centers: RESULTS OF THE 2012 BEHAVIORAL HEALTH SERVICES ADVOCACY AND NETWORKING SURVEY FACT SHEET: Integrated Behavioral
Patient Centered Medical Home (PCMH): Communication and Care Coordination
Patient Centered Medical Home (PCMH): Communication and Care Coordination Phillip Roemer, MD Assistant Professor of Medicine General Internal Medicine Feinberg School of Medicine Northwestern University
Psychosocial Rehabilitation Program Services
Psychosocial Rehabilitation Program Services 2013 Overview Objectives Definitions What it is not What it is Who can provide What to focus on Populations of Service Documentation Requirements 2 Objectives
PCMH : A WINDOW TO 2014
Colorado Community Health Network Spring Conference PCMH : A WINDOW TO 2014 Presented by: Bonni Brownlee, MHA CPHQ CPEHR NCQA PCMH Certified Content Expert Senior Clinical Consultant Audience Poll: Where
10/18/2015. Collaborative Family Healthcare Association 12th Annual Conference 1
Session # 5680745 Friday, October 16 th, 2015, H2b, Period 2 What's With All the Numbers?: Quality Indicators within Integrated Behavioral Health Programs Lesley Manson, PsyD Director of Integrated Training
Building Your ACO and Healthcare IT s Role
Building Your ACO and Healthcare IT s Role TM a QSI company NextGen Healthcare Collaborative Care Solutions Update Healthcare at the Speed of Light Where do you fit in the American healthcare ecosystem?
SMD# 13-001 ACA #23. Re: Health Home Core Quality Measures. January 15, 2013. Dear State Medicaid Director:
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 SMD# 13-001 ACA #23 Re: Health Home Core Quality
Integrating Primary Care and Behavioral Health Services: A Compass and A Horizon
Integrating Primary Care and Behavioral Health Services: A Compass and A Horizon A curriculum for community health centers Developed for the Bureau of Primary Health Care Managed Care Technical Assistance
2014 Quality Management Program Behavioral Health Provider Summary
2014 Quality Management Program Behavioral Health Provider Summary Table of Contents MBHP Overview..... 3 Who We Are MBHP Vision MBHP Mission MBHP Values Quality Management Program......8 Overview Quality
2014 Quality Improvement Program Description
2014 Quality Improvement Program Description Table of Contents BACKGROUND AND HISTORY 2 MISSION STATEMENT 3 AUTHORITY 3 SCOPE 3 QI ACTIVITES TO FULFILL THE SCOPE 4 PURPOSE 6 GOALS 7 OBJECTIVES 7 DELEGATION
Behavioral Health Management of Substance Use Disorder Services
Behavioral Health Management of Substance Use Disorder Services Arlene González-Sánchez, Commissioner Robert Kent, General Counsel SAMSHA: New York State should remain consistent with SAMSHA policy philosophy
Health Home Service Certification Application and Pre-Assessment of Readiness SAN JUAN AND CURRY COUNTY ONLY
Health Home Service Certification Application and Pre-Assessment of Readiness SAN JUAN AND CURRY COUNTY ONLY This application is required for those New Mexico community mental health services providers
Patient-Centered Medical Home: How Are California School-Based Health Centers Relating to This New Model of Care? September, 2013
Patient-Centered Medical Home: How Are California School-Based Health Centers Relating to This New Model of Care? September, 2013 Prepared In Collaboration With Introduction Patient-centered medical home
Continuity of Care Guide for Ambulatory Medical Practices
Continuity of Care Guide for Ambulatory Medical Practices www.himss.org t ra n sf o r m i ng he a lth c a re th rou g h IT TM Table of Contents Introduction 3 Roles and Responsibilities 4 List of work/responsibilities
Andrew C. Bledsoe, MBA, CHPA, PCMH CCE Executive Director. Northeast KY Regional Health Information Organization. www.nekyrhio.org
Andrew C. Bledsoe, MBA, CHPA, PCMH CCE Executive Director Northeast KY Regional Health Information Organization www.nekyrhio.org NCQA Program Setup Standards Six Standards Outline Program Elements Six
Welcome to Crozer-Keystone Health Network Primary Care
Welcome to Crozer-Keystone Health Network Primary Care A Guide to Your CKHN Patient-Centered Medical Home: What you can expect from us... What we will need from you......so you can gain the full benefits
Quality Improvement Program
Quality Improvement Program Section M-1 Additional information on the Quality Improvement Program (QIP) and activities is available on our website at www.molinahealthcare.com Upon request in writing, Molina
Managed Medical Care for Persons with Disabilities and Behavioral Health Needs
January 2015 RDA Report 6.56 Olympia, Washington Managed Medical Care for Persons with Disabilities and Behavioral Health Needs Preliminary Findings from Washington State David Mancuso, PhD and Barbara
Patient-Centered Medical Home (PCMH) 2014
Patient-Centered Medical Home (PCMH) 2014 Part 1: Standards 1-3 All materials 2015, National Committee for Quality Assurance Agenda Part 1 Content of PCMH 2014 Standards and Guidelines Standards 1 3 Documentation
Population Health Management For Behavioral Health. MHA s 2015 Annual Conference June 3, 2015
Population Health Management For Behavioral Health MHA s 2015 Annual Conference June 3, 2015 Goals of the Affordable Care Act Improve the health of populations Lower per capita costs Improve the patient
CHIPRA Quality Demonstration Grant. QTIP - Hobbs
CHIPRA Quality Demonstration Grant Kristine Hobbs, LMSW Lynn Martin, LMSW Let the practices set their own priorities with the goal of moving each practice toward integration ALL kids are their kids Find
Integrating Self Management Supports in Primary Care
Integrating Self Management Supports in Primary Care Support for this product was provided by a grant from the Robert Wood Johnson Foundation in Princeton, New Jersey, 2009 Objectives: To describe key
Horizon Behavioral Health SM Provider Orientation. July 2014
Horizon Behavioral Health SM Provider Orientation July 2014 Objectives Overview of Horizon Behavioral Health Overview of Operational Areas Overview of ProviderConnect and NaviNet Claims Processing and
Treating Depression to Remission in the Primary Care Setting. James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health
Treating Depression to Remission in the Primary Care Setting James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health 2007 United Behavioral Health 1 2007 United Behavioral Health Goals
Ambulatory Services Recommendations. Public Health and Health Planning Committee December 12, 2013
Ambulatory Services Recommendations Public Health and Health Planning Committee December 12, 2013 Guiding Tenets Recommendations developed with consideration for: Patient Safety and Quality Transparency
Program Agenda and Faculty
Best Practices in Depression Treatment: HEDIS and Beyond NCQA Overview William Tulloch, MA Director, Customer Resources, NCQA Healthcare Effectiveness Data Information Set (HEDIS) is a registered trademark
BCBSM Physician Group Incentive Program. Patient-Centered Medical Home and Patient-Centered Medical Home-Neighbor Domains of Function
BCBSM Physician Group Incentive Program Patient-Centered Medical Home and Patient-Centered Medical Home-Neighbor Domains of Function Interpretive Guidelines 2014-2015 V1.0 5.0 Extended Access Goal: All
Follow-Up Care for Children Prescribed ADHD Medication (ADD)
Follow-Up Care for Children Prescribed ADHD Medication (ADD) The percentage of children newly prescribed attention-deficit/hyperactivity disorder (ADHD) medication who have at least three follow-up care
QUARTERLY CONTRACT MONITORING REPORT (QCMR) CLIENT MOVEMENT REPORT INTEGRATED CASE MANAGEMENT SERVICES
CLIENT MOVEMENT REPORT 1. 2. 3. 4. 5. 6. Beginning Active Caseload (First Day of Quarter) New Enrollees to Transfers to During Quarter Transfers From Terminations From Ending Active Caseload (Last Day
Patient-Centered Medical Home and Meaningful Use
Health Home Series: Patient-Centered Medical Home and Meaningful Use Presenters: Christine Stroebel, MPH, PCIP/NYC REACH Natalie Fuentes, MPH, PCIP/NYC REACH Alan Silver, MD, MPH/IPRO March 27, 2012, 2:00
Depression Support Resources: Telephonic/Care Management Follow-up
Depression Support Resources: Telephonic/Care Management Follow-up Depression Support Resources: Telephonic/Care Management Follow-up Primary Care Toolkit September 2015 Page 29 Role of the Phone Clinician
NCQA Standards Workshop Patient-Centered Medical Home PCMH 2011. Part 1: Standards 1-3
NCQA Standards Workshop PCMH 2011 Part 1: Standards 1-3 Agenda: Part 1 Overview Content of PCMH 2011 Standards 1 3 Documentation examples* * Examples in the presentation only illustrate the element intent.
Partnering with Health Homes and Accountable Care Organizations. Considerations for Mental Health and Substance Use Providers
Partnering with Health Homes and Accountable Care Organizations Considerations for Mental Health and Substance Use Providers JANUARY 2011 PARTNERING WTH HEALTH HOMES AND ACCOUNTABLE CARE ORGANIZATIONS
Diabetes Care 2011-2012
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
Ohio Health Homes Learning Community Meeting. Overview of Health Homes Measures
Ohio Health Homes Learning Community Meeting Overview of Health Homes Measures Tuesday, March 5, 2013 Presenter: Amber Saldivar, MHSM Associate Director, Informatics Analysis Health Services Advisory Group,
Quality Improvement Program Description
2015 Quality Improvement Program Description Approved by the Board of Directors: March 19, 2002; April 22, 2003; April 20, 2004; April 26, 2005, April 25, 2006, February 27, 2007, March 25, 2008, March
The Wyoming Pay for Participation Program for Medicaid Health Management
The Wyoming Pay for Participation Program for Medicaid Health Management 2010 Medicaid Congress James Bush, M.D. State Medicaid Medical Officer Wyoming Department of Health Wyoming Medicaid- EqualityCare
Question & Answer Guide. (Effective July 1, 2014)
Joint Commission Primary Care Medical Home (PCMH) Certification for Accredited Ambulatory Health Care Organizations Question & Answer Guide (Effective July 1, 2014) A. ELIGIBILITY/DECISION-RELATED Question:
GAINING NCQA RECOGNITION AS A PATIENT-CENTERED MEDICAL HOME THE ROLE OF COMMUNITY RESOURCE CONNECTIONS
GAINING NCQA RECOGNITION AS A PATIENT-CENTERED MEDICAL HOME THE ROLE OF COMMUNITY RESOURCE CONNECTIONS WHITE PAPER - SEPTEMBER 2013 WHITE PAPER GAINING NCQA RECOGNITION AS A PATIENT-CENTERED MEDICAL HOME:
CAHPS : Assessing Health Care Quality From the Patient s Perspective
P R O G R A M B R I E F CAHPS : Assessing Health Care Quality From the Patient s Perspective The Agency for Healthcare Research and Quality's (AHRQ s) mission is to produce evidence to make health care
Quality Improvement in Mental Healthcare: The Measures Matter
Quality Improvement in Mental Healthcare: The Measures Matter Richard Hermann, MD, MS Associate Professor of Medicine and Psychiatry Tufts University School of Medicine Center for Quality Assessment &
Medical Homes- Understanding the Model Bob Perna, MBA, FACMPE WSMA Practice Resource Center
Bob Perna, MBA, FACMPE WSMA Practice Resource Center Bob Perna, MBA, FACMPE Senior Director, WSMA Practice Resource Center E-mail: rjp@wsma.org Phone: 206.441.9762 1.800.552.0612 2 Program Objectives:
NCQA Standards Workshop Patient-Centered Medical Home PCMH 2011. Part 2: Standards 4-6
NCQA Standards Workshop PCMH 2011 Part 2: Standards 4-6 Agenda: Part 2 Content of PCMH 2011 Standards 4 6 Documentation examples* * Examples in the presentation only illustrate the element intent. They
AETNA BETTER HEALTH OF MISSOURI
Aetna Better Health of Missouri 10 South Broadway, Suite 1200 St. Louis, MO 63102 800-566-6444 AETNA BETTER HEALTH OF MISSOURI HEDIS Quick Reference Billing Guide 2014 Diagnosis and/or procedure codes
Turning on the Care Coordination Switch in Rural Primary Care Practices
Turning on the Care Coordination Switch in Rural Primary Care Practices AHRQ Master Contract Task Order #5 HHSA2902007100016I (9/07-11/09) Care Management Plus research at OHSU is supported by funding
Chapter 18 Behavioral Health Services
18 Behavioral Health Services INTRODUCTION The State of Arizona has contracted the administration of the AHCCCS mental health and substance abuse services program to the Arizona Department of Health Services
Job # BH-84 Re-opened 06/11/15 Psychiatric Mental Health Nurse Practitioner Adult Behavioral Health Program Recruitment is open until filled Revised
Yamhill County HUMAN RESOURCES / COUNTY EMPLOYMENT Location: 434 NE Evans Street Mailing Address: 535 NE 5 th Street McMinnville, Oregon 97128 (503) 434 7553 Fax EMPLOYMENT OPPORTUNITY Job # BH-84 Re-opened
Collaborative Care: Evidence-Based Mental Health Care in Primary Care Settings
Collaborative Care: Evidence-Based Mental Health Care in Primary Care Settings Anna Ratzliff, MD, PhD Assistant Professor Associate Director for Education, Division of Integrated Care & Public Health Department
2014 Quality Management Program Highlights
2014 Quality Management Program Highlights March 2015 1 Table of Contents Quality Management Program Overview..... 3-4 Quality Committees. 5 Data Monitoring... 6 QM/UM Plan Highlights.. 7 Access to and
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
MOLINA HEALTHCARE OF CALIFORNIA
MOLINA HEALTHCARE OF CALIFORNIA MAJOR DEPRESSION IN ADULTS IN PRIMARY CARE HEALTH CARE GUIDELINE (ICSI) Health Care Guideline Twelfth Edition May 2009. The guideline was reviewed and adopted by the Molina