The Michigan Primary Care Transformation (MiPCT) Project Succeeding in 2014: What it Will Take
MiPCT Team-Based Care Recap 16 MiPCT Team-Based Care Recap
MiPCT Team-Based Care Evergreen” Themes 16 MiPCT Team-Based Care Evergreen” Themes Care managers work in close proximity to PCP team In PCP office as much as possible Work with PCP team to meet their needs Regular communication via huddles, medical meetings, etc. Ensure Care Management coverage Focus on MiPCT patients (across participating payers) Manage high-complexity, high-cost patients Patients selected based on risk score plus PCP input Focus on evidence-based interventions Medication reconciliation Care transitions In-person contact with patients whenever possible Comprehensive care plan for complex patients
Success = Improvements in Population Health + Cost + Patient Experience
Reduction in Unnecessary and Non-Value-Added Costs How do we make a dent in cost? -Preventing unnecessary ED and inpatient visits by providing care upstream before a crisis - Making sure your patients know about your extended access and how to reach you after hours - Using resources more wisely 5
2014 Priorities Target the Right Patients Combine data with clinical judgment Introduce palliative care opportunities when appropriate Diabetes Management Expanded Access Make sure patients know how to contact the practice’s 24/7 access
MiPCT: Beyond 2014…
Preparing for Sustainability Physician Organizations have made a significant investment in care management Working hard for payers to support the model financially We need your help!
CMS – Looking for Solutions (desperately) Areas of promise – what we’re doing! Good directional signs CMS Quarterly Payment Proposal (for 2015) Commercial Payer Sustainability Statement Potential for Demo Extension Question on the table - Can primary care redefine care delivery? This is our best (last?) chance to provide the answer If successful, can lead to new funding models
How can YOU help shape the future?
It’s Time to Put on Your Cape!
Thank You!