PMI Resdults Cycle 1 2004-2005

1. PMI Resdults Cycle 1 2004-2005

2. Practice Management Improvement (PMI) Initiative • Twelve-month quality assurance collaborative designed to increase knowledge of practice management improvement among SBHC team members and demonstrate SBHC improvement in: • Facilities • Business Operations (productivity, coding) • Human Resources • Care Management (CQI, coding, charting) • Practice Compliance (CQI, coding, charting)

3. Practice Management Improvement (PMI) Initiative • First Cycle 2004-2005 (Beta Test) • Six school-based health centers from 4 states (California, New York, Texas, West Virginia)

4. PMI Objectives • Increase SBHC team’s knowledge and understanding of practice management and practice management improvement • Complete a situational analysis of the SBHC practice environment. • Internal and external practice environments • SCORE Model (facilities, business operations, human resources, care management, and practice compliance) • Internal and External S.W.O.T. analyses

5. PMI Objectives • Utilize SBHC situational analysis and recommendations to establish a mission statement for the SBHC • Develop a SBHC practice improvement plan/strategy with short and long term objectives that support the SBHC mission

6. PMI Objectives • Code and document SBHC evaluation/ management office visits and preventive health visits appropriately. • Code and document SBHC mental health visits appropriately. • Use ICD 9 codes and other CPT codes appropriately to maximize SBHC reimbursement and to correctly report the services done in SBHCs.

7. PMI Objectives • Utilize NASBHC’s CQI Tool to assess and improve the delivery of care related to the sentinel conditions • Implement a multifaceted approach for measuring the SBHC’s productivity across core components

8. PMI Activities • 4 Learning sessions • 2 Site visits (pre and post score model, chart review, and coding compliance review) • 1 Site visit (SWOT analysis, mission statement, outline practice management improvement plan) • Workplan for each objective • Quarterly progress reports • Monthly conference calls • Storyboards • Reunion

9. LS2 Situational Analysis Implementation of LS IV Work plan Objectives LS4 Implementation of LS III Work plan Objectives Situational Analysis LS1 L3 PMI Timeline MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN SCORE MODEL SCORE MODEL Implementation of LSI Work plan Objectives Implementation of LS II Work plan Objectives Nat’l Convention LS = Learning Session

10. Objective #1 - Increase SBHC team’s knowledge and understanding of practice management and practice management improvement • All team members at the participating site increased their knowledge and understanding of practice management and improvement

11. Objective #2 -Complete a situational analysis of the SBHC practice environment All participating sites completed • Analysis of internal and external practice environments, • SCORE Model (facilities, business operations, human resources, care management, and practice compliance), and • Internal and External S.W.O.T. analyses

12. Objective #3 - Utilize SBHC situational analysis and recommendations to establish a mission statement for the SBHC • All participating sites utilized their SWOT analysis and recommendations to establish or update their SBHC’s mission statement • Mission statement(s) of sponsoring and/ or collaborating organizations reviewed to access alignment and differences with SBHC’s mission

13. Objective #4 - Develop a SBHC practice improvement plan/strategy with short and long term objectives that support the SBHC mission • 83% of participating sites developed a practice improvement plan/strategy with short and long term objectives to support the SBHC mission • All participating sites completed work plans related to learning session objectives

14. Objective #5 - Code and document SBHC evaluation/ management office visits and preventive health visits appropriately. • All participating sites demonstrated improvement from pre to post chart reviews /coding compliance audits in appropriate documentation and coding of evaluation and management visits and preventive health visits.

15. Objective #6 -Code and document SBHC mental health visits appropriately. • All participating sites demonstrated improvement from pre to post chart reviews /coding compliance audits in appropriate documentation and coding of mental health visits

16. Objective #7 - Use ICD 9 codes and other CPT codes appropriately to maximize SBHC reimbursement and to correctly report the services done in SBHCs. • All participating sites demonstrated improvement from pre to post chart reviews /coding compliance in appropriate documentation and coding of mental health visits.

17. Objective #7 - Use ICD 9 codes and other CPT codes appropriately to maximize SBHC reimbursement and to correctly report the services done in SBHCs. • All participating sites demonstrated improvement from pre to post chart reviews /coding compliance in appropriate documentation and coding of mental health visits.

18. Objective #8 - Utilize NASBHC’s CQI Tool to assess and improve the delivery of care related to the sentinel conditions • All participating sites demonstrated improvement from pre to post chart reviews in screening, identification, and treatment of the sentinel conditions contained in NASBHC’s CQI tool.

19. Objective #9 - Implement a multifaceted approach for measuring the SBHC’s productivity across core components • All participating sites demonstrated improvement from pre to post situational analysis (SCORE model and interviews) in their systems and/or practices related to documentation and reporting of productivity and value added services.

20. Pre and Post OverallPMI SCORE Model Rating

21. PMI Score Model RatingsPre and Post Facilities

22. PMI Score Model RatingsBusiness Operations

23. PMI Score Model RatingsHuman Resources

24. PMI Score Model RatingsCare Management

25. PMI Score Model RatingsPractice Compliance

26. PMI Score Model RatingsBusiness Operations

27. Pre and Post OverallPMI SCORE Model Rating

28. SUMMARY

29. NASBHC involvement elevates status of SBHC within sponsoring organization (from stepchild to focal point) SBHC practice management improvements carry over to sponsoring and collaborating organizations’ systems overall NASBHC’s PMI (score model, chart audit instruments) are being integrated/adopted by some state and local SBHC organizations PMI Outcomes

30. Increase in all SCORE Model ratings from baseline to completion of cycle Improvement in ICD and CPT coding All sites are collecting data on productivity, including value added services PMI Outcomes