1. The Michigan Primary Care Transformation (MiPCT) Project PO Open Forum Webinar July 29, 2014 1

2. Post-Demonstration MiPCT Proposed Components Maintained via Payer Support: –Care Management Funding –Central Administration, including Support Services, Policy Analysis, Communication, Multipayer Coordination and Governance Data and Reporting Training and Education Recruitment of Additional Payers Practice Growth Over Time: Manage practice participation growth over time to reach State goals 2 1/1/12 1/1/15 Ongoing “MiPCT V.2” Original Demonstration Period Potential CMS Year Extension

3. Payer Updates Priority Health 3 Continue to pay G and CPT codes for CM – No member liability (even if member has an HSA) – CM billing to be adjudicated and paid real time (no longer batched retrospectively) – For all lines of business, with potential exception of Medicaid Priority which is still in determination – Also for specialty providers (e.g. oncology, cardiology) Will pay new CMS Chronic Care code for non-face-to-face care coordination (level to be finalized but expected to be about $42PMPM) – Coordination with G and CPT codes in development – Potential for this to be an alternative to CPT code non-face-to-face reimbursement

4. Payer Updates Priority Health, cont. 4 In addition, related incentives at two levels: – $3.25 PMPM to practices who attest to having a CM in the office Practice must provide CM to a minimum of 2% of Priority Health patients CM does not have to be employed by the practice Practice must submit examples of care plans – $1 PMPM if practice has PCMH (but no onsite Care Manager) Priority will continue streamlined MiPCT administrative funding for MiPCT support services to practices and POs

5. Payer Updates Medicaid 5 $7.50 PMPM equivalent to continue for 2015 – Not dependent on demonstration period extension by CMS – Differential rates for forward years in exploration Aged Blind and Disabled (ABD) population Temporary Assistance to Needy Families (TANF) and Healthy Michigan populations

6. Other Updates 6 In-Person PO Leader Visioning Session in fall 2015 Care Management revenue modeling in development Comments on CMS proposed language for monthly chronic care management code due to dbechel@umich.edu by August 2dbechel@umich.edu CMS decision on demonstration period extension still in process Applications for practices who want to participate in patient and family advisor training are due Aug 1 (provides four Practice Learning Credits)

7. Questions and Discussion 7