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PEBB Vision 2007: Stakeholder input on primary care approach - August 2, 2004

PEBB Vision 2007: Stakeholder input on primary care approach - August 2, 2004. Key participant observations - overall approach. Make sure there is sound evidence to support each criterion; e.g., health risk assessment Make sure each criterion can be realistically assessed

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PEBB Vision 2007: Stakeholder input on primary care approach - August 2, 2004

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  1. PEBB Vision 2007:Stakeholder input on primary care approach - August 2, 2004 BD att 6

  2. Key participant observations - overall approach • Make sure there is sound evidence to support each criterion; e.g., health risk assessment • Make sure each criterion can be realistically assessed • Test each criterion for possible unanticipated consequences • Avoid one-size-fits-all solutions; identify “basic rules,” allow local models, different parallel rural and urban pilots • Focus on selected conditions likely to stimulate clinical behavior change BD att 6

  3. Key participant observations - member-oriented • Develop and communicate a better understanding of PEBB members: risks, needs, demographics • Make sure criteria reflect needs and capabilities of PEBB members (e.g., connectivity) • Member expectations, preferences, and “entitlement” are barriers to providing evidence-based medical care • Need to align patient incentives with provider incentives BD att 6

  4. Key participant observations - system-oriented • Technology - especially EMR – state-of-the-art still evolving; don’t focus on technology, per se, but on desired outcomes • Add criteria on outpatient credentialing,patient safety (e.g. medication management) • Understand and leverage the existing experience and infrastructure in the marketplace, including delivery systems, OHP plans and providers • Make the RFI or RFP simple and minimally burdensome BD att 6

  5. Some questions for further feedback: • In the context of PEBB’s 2007 Vision, do you have any specific feedback on the August 2 criteria? • Which to eliminate? • Others to add? • Which are most important? • Which should be considered “basic rules” • If PEBB asked in an RFP, would you be able to document your current performance on the August 2 criteria? BD att 6

  6. Some questions for further feedback: • Do you have ideas about how PEBB could encourage movement towards these criteria in your environment? • Front-end financing tied to performance? • Bonus payments? • Recognition programs? • Other... BD att 6

  7. Some questions for further feedback: • What should be the scope of a pilot? • Number of lives • Number of physicians or other providers • Geographic scope • Health conditions • Can you suggest other ways PEBB can… • encourage “system-ness”? • encourage “patient-centeredness”? BD att 6

  8. Thanks for your participation Please relay any suggestions to: David Lansky at dlansky@facct.org Next forum - specialist and hospital criteria - September 2nd, 1 – 3 pm, WESD BD att 6

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