1. The Michigan Primary Care Transformation (MiPCT) Project
PO Sustainability Webinar
December 6, 2016

2. Agenda Welcome (Jean Malouin, Sue Moran)
SIM PCMH Update (Phillip Bergquist)
48 Month Incentive Update (Amanda First)
Demonstration Final Period and Wrap-Up Period and 2017 Overview (Diane Marriott, Jean Malouin)
Upcoming Meetings (Diane Marriott)
ADT Working Group (December 7th) at noon
PGIP (December 9th) MiPCT Session from 1:15 to 2pm
Open Discussion (All)

3. SIM PCMH Update

4. 48 Month Incentive Update

5. 48 Month Incentive Update
PO deadline to review draft scores is today, Dec 6th
Payment will be made in December
Overall performance increased for several metrics:
Readmissions
Asthma ED visits, Adults and Children
Breast Cancer Screening
Well child visits
All registry metrics except for Hypertension BP<140/90

6. Demo Final Quarter and Wrap-Up 2017

7. Demo Final Quarter and Wrap-Up 2017 Close Out Activity Overview
Incentive Payouts
54 and 60 month periods
Final PO/Practice Quarterly Reports due 1/31/17
PHI MiPCT Data Destruction
Aggregated/Summary information may be retained
PHI may retained through Dec 31, 2017 but then must be destroyed
Guidance and attestation template will be distributed midyear to prepare
Mipct.org website will still be accessible and updated throughout 2017

8. Demo Final Quarter and Wrap-Up 2017 Transition to 2017 Partnerships with SIM PCMH Initiative and CPC+
Several paths to securing ongoing funding for our MiPCT participating payers
All have a common overarching structure, aim and model: Promoting a synergistic and consistency and collaboration
Common elements:
Defined pathways for Medicare, Medicaid and commercial funding
Ongoing participation in a single, state-wide model
Continued support for you via MiPCT in partnership with the State and payers (e.g., MiPCT Central Operations, MDC, CMRC, etc.)

9. Demo Final Quarter and Wrap-Up 2017 What Will Change
The SIM introduces the new role of Care Coordinators who will partner with Care Managers
Greater use of G and CPT codes for care management
Medicare is expanding codes for 2017
BCBSM and Priority will continue to use codes
Though Medicaid will pay on a PMPM basis, they will require submission of codes
CPC+ transformation expectations offer an opportunity to move to the next level of care

10. Demo Final Quarter and Wrap-Up 2017 How Payments Will Be Made in 2017
Medicare participation:
CPC+
Utilization of CMS Care Management and Behavioral Integrated Health codes
Medicaid participation:
SIM PCHM/MiPCT Partnership
Both CPC+ and non-CPC+ practices are eligible
Commercial participation (BCBSM, Priority):
Continuation of G/CPT submission for both CPC+ and non-CPC+ practices

11. Upcoming Meetings

12. Upcoming Meetings/Deadlines
ADT Working Group (December 7th) at noon
PGIP (December 9th) MiPCT Session from 1:15 to 2pm
4 Q 2016 PO Reports due January 31, 2017

13. Open Discussion

14. APPENDIX – Acronym Glossary

15. Decoding the Acronyms: What They Mean
SIM
The State Innovation Model, a CMS demonstration ( ) that was awarded to the State of Michigan.
There are several pillars of the SIM (PCMH, Community Health Regions or CHIRS, IT, Payment Reform). The MiPCT is partnering with the State to support the PCMH Initiative of the SIM
MiPCT practices as well as PCMH practices in five SIM regions were eligible to participate
This is the gateway for Medicaid continued funding.

16. Decoding the Acronyms: What They Mean
CPC+
The Comprehensive Primary Care Plus program, a new CMS initiative that will begin in 2017 and be in place for five years in partnership with BCBSM and Priority in Michigan.
Practices had to apply for the CPC+ by September 15, and be selected to participate for the January 1, launch date.
CMS announced that in 2017, CPC+ will reopen applications for practices and payers for 2018 participation. Additional details will be released by CMS.
Practices can participate in both the SIM PCMH Initiative and CPC+
This is one gateway to Medicare funding for care management.

17. Decoding the Acronyms – What They Mean
MACRA (Medicare Access & CHIP Reauthorization Act)
QPP: Quality Payment Program (created by MACRA)
MIPS: Merit-based Incentive Payment System
APM: Alternative Payment Model
Advanced APM: APMs that meet additional criteria for financial risk-bearing
ACI: Advancing Care Information
CPIA: Clinical Performance Improvement Activity