Children’s Healthcare Access Program (CHAPs)

1. Children’s Healthcare Access Program (CHAPs) Thomas H. Peterson, M.D. PCPCC Stakeholders Collaborative March 30, 2010

3. CHAP Commitments First Steps Board Strategy Financial Support • Priority Health •  payment for primary care services, incentives • Reporting • Measure results • CHAP Staff • Same day transportation • Patient education • No-show avoidance • Clinical • Social services referrals • Physicians •  access •  throughput • Attend meetings Collaboratives Patient-Centered Care Triple Aim Outcomes 3

4. Outcomes Year 1 (Independent Evaluator) • Tracked 17,000 kids in private practices, FQHC, and DeVos Children’s Hospital Pediatric Clinic • Overall results Year 1: • ER use decreased by 9% • Inpatient use decreased by 16% • Most dramatic progress at: • DeVos--15% decrease in ED use—same-day app’ts. • FQHC --9% decrease in ED use, 22% decrease in admissions • Open scheduling, evening hours, increased throughput • Increased clinical time for providers + visits/hour • Improved quality metrics • Different payment strategies 4

5. Lessons Learned (So Far) • Change is hard, but possible • Leadership is critical • So is collaboration • Incentives matter, but they just set the table—professional pride quickly takes over • Good news travels 5

6. What Incentives Contributed? • Economics • Direct increases in payment • Bonus payment for improved performance • Community Collaborative • Transparency—reporting, provider meetings • Professional pride 6

7. Strategic Challenges • Incorporating CHAPs competencies into health plan operations (Foundations won’t support forever) • Spread of payment improvements to entire Medicaid network