Strengthening Primary Care for Patients April 9, 2013 Kaiser Permanente Center for Total Health Washington, D.C.

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Presentation transcript:

Strengthening Primary Care for Patients April 9, 2013 Kaiser Permanente Center for Total Health Washington, D.C.

Restricted The Primary Connection Michael W. Cropp, M.D., M.B.A President & CEO, Independent Health Buffalo, New York

Restricted 3 The Primary Connection Patient Experience

Restricted The Primary Connection Quality 4

Restricted The Primary Connection Efficiency 5

Restricted The Primary Connection Efficiency Comparison 6

Restricted The Primary Connection Quality Comparison 7

Alliance of Community Health Plans (ACHP) Making Health Care Better April 9, 2013 Scott Smith, MD Associate Medical Director of Operations Kaiser Permanente Colorado

Confidential to Kaiser Permanente Continuity

Confidential to Kaiser Permanente Access

Confidential to Kaiser Permanente Quality

Confidential to Kaiser Permanente Patient Centered Care Works!

Marci Nielsen, PhD, MPH Chief Executive Officer, PCPCC The Patient-Centered Medical Home and Health System Transformation: Texas Health Home Summit

A Change in Paradigm TodayFuture Treating Sickness / EpisodicManaging Population Fragmented CareCollaborative Care Specialty DrivenPrimary Care Driven Isolated Patient FilesIntegrated Electronic Record Utilization ManagementEvidence-Based Medicine Fee for ServiceShared Risk/Reward Payment for VolumePayment for Value Adversarial Payer-Provider Relations Cooperative Payer-Provider Relations “Everyone For Themselves”Joint Contracting 14

Health IT Infrastructure PCMH and Accountable Care: Two Sides of the Same Coin Accountable Care PCMH PCMH PCMH PCMH PCMH Hospitals Public Health Shared Services Care Coordination Care Managers Specialists 15

HIT Infrastructure: EHRs and Connectivity Primary Care Capacity: Patient Centered Medical Home Operational Care Coordination: Embedded RN Coordinator and Health Plan Care Coordination $ Value/ Outcome Measurement: Reporting of Quality, Utilization and Patient Satisfaction Measures Value-Based Purchasing: Reimbursement Tied to Performance on Value Supportive Base for ACOs, PCMH Networks, and Bundled Payments Trajectory to Value-Based Purchasing It is a journey, not a fixed model of care 16 Source: THINC - Taconic Health Information Network and Community

Role of The Collaborative (PCPCC) 17  Lead from the front  Challenge  Challenge the status quo  Drive  Drive the marketplace information  Disseminate timely information networking & educational opportunities  Provide networking & educational opportunities

Delivery Reform Payment Reform Public Engagement Benefit Redesign Transformation requires …

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