TEACHING HEALTH CENTER CONSORTIUM Comparative Analysis

1. TEACHING HEALTH CENTER CONSORTIUM Comparative Analysis Linda Thomas-Hemak MD December 2013

2. Comparative Analysis Understanding of PCMH Principles

3. Core PCMH Principles • Team Approach • Information System Support • Quality Improvement • Population Management • Treatment of Mental Health issues • Self-Management Support • Use of Guidelines • Coordination of Care • Patient centered care

4. THC-1 vs. traditional-1

5. THC-1 vs. traditional-2

6. THC-1 vs. traditional-3

7. 2012 THC-1 vs. 2011 THC-1

8. 2012 THC-1 vs. THC-2

9. Comparison Across Time: Percent Change

12. Comparison Across Training Venues for thc track residents

13. Comparative Analysis Correlation analysis of PCMH survey results

15. Correlation between time spent at jermyn and Medical Home Competency Negative Correlation Positive Correlation -1 0 +1 Patient Centered Care Coordination of Care Team Approach Self Management Support Quality Initiatives Use of Guidelines Overall Score Population Management Information System Support Treat Mental Health Issues

17. Correlation between time spent at jermyn and Medical Home CompetencyNovember 2011 Negative Correlation Positive Correlation -1 0 +1 Coordination of Care Patient Centered Care Use of Guidelines Quality Initiatives Treat Mental Health Issues Information System Support Self Management Support Team Approach Population Management Overall Score

18. Comparative Analysis quality and Patient safety surveys

19. Quality and safety surveys • We conducted a survey to assess the understanding of Quality and Patient safety amongst the first year residents that included both THC and Traditional track residents in September 2011 • The data was aggregate and did not look at differentiating the THC vs. Traditional track residents • The same survey was re-administered in September 2012 to the same group of residents who had transitioned to Year-2 of their training

20. Results: Quality and safety survey • The comparison showed an improvement of 8% over time. The limitation of these results being that the results do not allow us to compare the effectiveness of THC vs. Traditional tracks • The researchers have identified this limitation and will focus on this during the next surveys

21. Comparative Analysis CONSORTIUM MODELS FOR THC IMPLEMENTATION

22. WCGME THC Consortium – Initial Development 2011

23. Chart 1: WCGME THC Consortium Resident FTE Cost Center Funding Relationships for 2012 with Teaching Health Center Expansion Year 1 Medicare GME Fund HRSA Teaching Health Center Fund Veteran Administration Hospital GME Fund 10.7FTE 8.5 FTE 10.3FTE 5 VA Funded FTE Established 12 THC FTE 4 FTE THC Expansion Regional Hospital Community Medical Center Moses Taylor Total Participating Hospital Affiliates’ Funded FTE Slots 1 FTE Northeast PA Community Health Center FQHC*** (NEPACHC) The Wright Center for Graduate Medical Education, a 501(c)3, not-for-profit ACGME/AOA Accredited Sponsoring Institution and GME Consortium: 2012 Projection of 64 FTE IM Residency Program The Wright Center Medical Group, P 13.5 FTE 16 FTE 13.5FTE Continuity Group C Resident Group C The Wright Center Medical Group, PC (WCMG) 43 Hospital Funded FTE (4 FTE > FY2011) 2 FTE Wright Center Primary Care Mid-Valley* (WCPC-M) 4 FTE * Established WCMG Internal Medicine Learning Environments ** 2011 Established THC FQHC-Based Learning Environments *** New 2012 FQHC and M&FHS Based Learning Environments in the Planned THC Expansion Continuity Group D Resident Group D Resident Group A Continuity Group A 1/3 FTE Female Health Maternal and Family Health Services (M&FHS)*** 2 FTE Scranton Primary Health Center** (SPHCC) 2 FTE Wayne Memorial Community Health Center FQHC** (WMCHC) • Continuity Groups A-D defined as groups of individual THC residents having Ambulatory Continuity Training Education in 2:1 ratio between a designated WCPC and FQHC site • 2011 Established Continuity Groups • 2012 Proposed Expansion Continuity Groups 4 FTE Wright Center Primary Care Scranton* (WCPC-S) Continuity Group B Resident Group B 1/3 FTE Oral Hygiene*** 1/3 FTE Primary Care Psych*** The combined venues for curriculum expansion to benefit all THC track residents = 1 Expansion FTE = 2 Individual THC track Residents with Ambulatory Continuity experience defined as Group D 2011 Established THC site FY2012 FTEs 2012 Proposed Expansion THC site FTEs

24. WCGME THC Consortium 2012 Training Model

25. WCGME THC Consortium – Regional Family Medicine 2013

26. WCGME THC Consortium – National Network for Family Medicine Residency Training 2013

27. WCGME THC Consortium – Interdisciplinary Model for All Regional Residency Training