1. Point of Care Tool to Manage Patient Populations
St. Joseph Hospital Affiliated Physicians
St. Joseph Heritage Healthcare
Point of Care Tool to Manage Patient Populations
Cory Rayyes, R.N., MBA
Chief Operating Officer
St. Joseph Hospital Affiliated Physicians

2. Overview St. Joseph Hospital Affiliated Physicians
California based risk sharing IPA
Contracts
Aetna
BlueCross
Blue Shield
Cigna
Pacificare
Hospitals: St. Joseph Hospital & CHOC

3. Overview 180 Primary Care Physicians 500 Specialty Physicians
80,000 Patients enrolled with our network
PCP Compensation
Capitation based on Age/Sex
Reward program based on P4P parameters
Specialty Compensation
80% of Network Capitation based
20% FFS

4. Process of Care Traditional Acute/Episodic Care
Population Based/Chronic Care
Need additional tools for the physicians to be able to switch from traditional care to a new chronic care model
Access to data
Data needs to be timely and accurate
Need both claims based and chart based data

5. Data Registry
SJHAP working with Intelligent Healthcare (IHC) developed a disease registry in 2002.
Data sources
Claims Physician and Hospital
Pharmacy – Health Plan PBM’s
Lab Value data
Currently manual feeds monthly
Moving to live lab feeds in June

6. Data Registry Reasons for Development Track populations of patients
Improve P4P scores
Measure outcomes for network and individual physicians
Improve outcomes for our population
Improve gaps in care for patients with chronic conditions