Www.chcwm.com CHCWM/Priority Health Oncology Medical Home March 6, 2013.

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Presentation transcript:

CHCWM/Priority Health Oncology Medical Home March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families Cancer and Hematology Centers of Western MI Single Specialty Private Practice Centered in Grand Rapids Multiple offices and clinics north to Reed City, South to Hastings, including Lakeshore cities of Holland, Muskegon, Ludington, Manistee 15 physician, 16 physician extenders, 280 employees 5000 New patients per year 80,000 annual visits Exclusive partner for Spectrum Health and Trinity Health W. MI March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families Program Components 1)Payment Methodology Reform 2)Treatment by Pathway 3)Medical Home Status 4)Advanced Symptom Management 5)QOPI Certification 6)Advanced Care Planning March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families 1) Payment Methodology Reform Drug revenue goes to break even New billable codes: -Monthly case management fee -Payment for treatment planning -Payment for advance care planning -Payment for telephone management March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families 2) Treatment by Pathway Calls for treatment pathway for lung, colon, breast -New order forms are being created to reflect data requirements -Phase II (date TBD) - Online order entry system -NSCLC Example  Pathway teams include: -Dr. Santos, -Dr. Vander Woude, -Dr. Lakhani, -Dr. Kakarala, -Dr. Gribbin March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families 3) Medical Home Status Become a certified medical home For practice: standardizing work across providers and sites Features: -“Call Me First” -Same day availability for urgent patients -Enhanced patient education program -EMR with rapid communication between specialist and PCP March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families 4) Advanced Symptom Management Managing the phones: 24/7/365 Provide evidence based advice for symptom management -New phone triage templates going into effect March 11 Reduce ER visits and direct admits by providing outpatient alternatives to ER visit A self-learning system March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families 5) QOPI Certification The Quality Oncology Practice Initiative Practice is a member of QOPI project and will become certified in the next 12 months QOPI team includes: Dr. O’Rourke and Dr. Batts March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families 6) Advanced Care Planning (ACP) Goal: To initiate discussion with patient and family about: -Choosing a healthcare advocate -Identifying end of life preferences -Completing an Advanced Directive Pilot results support this being acceptable and valuable to our patients ACP team includes: Dr. Alguire and Dr. Porter March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families 6) Advanced Care Planning: Late Stage Cancer Program Program consists of: -Behavioral Oncology service Focus on the meaning of having an incurable disease and discuss goals and desires for remainder of life -Advance Care Planning service -Social Work service Focus on resources for end of life Orderable item in Touchworks Information provided to patient at scheduling March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families Expected Outcomes Medical Oncology becomes convener of the team Optimum evidence-based care delivered in a standardized fashion Develop evidence where it does not exist ER and admissions decreased Quality improves and cost becomes standardized March 6, 2013

Dedicated to help, healing and hope for cancer patients and their families Implementation and Timing Advanced Cancer Planning: Available to order now Breast, Colon and Lung pathways: March 11 Phone Triage (two phases): -1) Daytime: March 11 -2) After-hours and weekend: July 1 QOPI Certification: Application Fall 2013, for Spring 2014 certification approval Oncology Medical Home Priority Health pilot completion: February 2014 March 6, 2013