1 / 14

West Virginia Medical Home Initiative Through the Health Improvement Institute

West Virginia Medical Home Initiative Through the Health Improvement Institute. AAFP Southeast Family Medicine Forum Briefing and Overview August, 2008. Medicaid Transformation Grants.

dayo
Download Presentation

West Virginia Medical Home Initiative Through the Health Improvement Institute

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. West Virginia Medical Home Initiative Through the Health Improvement Institute AAFP Southeast Family Medicine Forum Briefing and Overview August, 2008

  2. Medicaid Transformation Grants Centers for Medicare & Medicaid Services (CMS) initiative under DRA providing grants to states for innovative improvement of Medicaid program WV DHHR received 5 awards Each award is focused on a different aspect of Medicaid Redesign Each grant has 24 month timeline

  3. Advanced Medical Home Medicaid Transformation Grants • Five CMS grants awards: • Personal Responsibility • Health System Improvement • Applied Technology • Stronger Medicaid Program • Enhanced Medication Management

  4. Health System Improvement Grant focused on: Improving primary care delivery system Creating patient-centered medical homes Launching Health Improvement Institute to help facilitate enhancement of primary care system of care Activities in this area are coordinated by project management team

  5. THE PREVALENT SYSTEM OF CARE DELIVERY Practice working in a vacuum 20-55% Compliance with Evidence Based Guidelines 45% Internet traffic is patients seeking self management info Less than 18% use IT for patient care 40% waste & inefficiency Reimbursement Piecemeal Fee for Service Delays & Waits for access 1-12 weeks 3:1 Staffing Ratio

  6. The Potential-The Pioneers CareSouth Carolina Source: Ann Lewis, CEO CareSouth Carolina Time with doctor has gone from 8.2 minutes to 12.5 minutes Total visit time has gone from 90 minutes to 42 minute average HbA1c for their population of focus came down from 11 to 8 Encounters and revenue for behavioral health services skyrocketed (in Medicaid cost based reimbursed and Medicare is 60% of the cap for behavioral counseling services) There are several key clinical indicators where they have reversed the health disparities and outcomes for minority populations are better Third available appointment has gone from 140 to 0 days Went from breakeven/deficit spending to 7% positive margin Total average aggregate costs of care for people with Diabetes 30-70% less than all other providers Grew from 16,000 patients to 40,000

  7. PLANNED CARE IN THE NEW ENVIRONMENT Guidelines In exam room With PDAs EMR eliminate All paper Registry used For Master Scheduling Community Resources Part of care team Reimbursement Aligned to support Planned care Group Visits Used 25% 17% visits by Email Open Access No shows decrease to 2-5% Continuous Flow minimize On-site time Care Team Work Spread 8:1 Ratio M.D. N..P. N.P. R.N. R.N. M.A. DIETICIAN EXTERNAL TEAM

  8. Diabetes Outcome MeasuresOctober 2005 – September 2006 All MCI diabetes patients n = 8631

  9. CMS Profit = $8.00 / test Yields $100,000 / yr.

  10. Transformational change:In the Health Care Delivery System For Medicaid patients with Diabetes receiving these services 2000-2002 Source: South Carolina Office of Budget and Control 2004

  11. West Virginia Health Improvement Institute Stakeholder Advisory Group Meet Quarterly Virtual Engagement On-Going Steering Committee Provider Education Self Management Adoption of HIT Measurement/ Reimbursement/ Reporting Pilots Pilots Pilots Measures& Pilots Innovation Community 150+ Practices

  12. Medical Home Learning Community Recruitment Cohort WV Health Improvement Institute Demonstrations Results • 120-150 Practice • Teams • Team-based learning around a care team • Learn elements of Medical Home • Test practice changes • Share ideas, successes and failures with each other • Monitor and report common measures of performance • Evolve the practice into a patient-centered medical home • Measurement and • Reimbursement • Workgroup • Measures for monthly reporting Payer Pay for Performance Demonstration • Performance measures • Clinical outcomes measures • New reimbursement models • Economic indicators reflected in Medicaid claims and health status of overall Medicaid populations • Increased successful adoption of EHRs • New care models to spread to providers across the state • Medical Home penetration • Self-Management • Workgroup • Coaching and technical assistance • Topic-specific webcasts Self-Management Demonstration • Adoption of Electronic • Health Records • Workgroup • Coaching and technical assistance Electronic Health Records Demonstration • Provider Training and • Support Workgroup • Coaching and technical assistance • Measures for monthly reporting • Topic-specific webcasts • Monthly team calls • Virtual short-cycle learning sessions

  13. Communication Vehicles Quarterly Meetings www.wvhealthimprovement.org Newsletter

  14. Roger Chaufournier rchaufournier@spreadinnovation.com301-529-7858

More Related