1. The Michigan Primary Care Transformation (MiPCT) Project The Way Forward: Sustainability and Continuity in 2015 and Beyond 1

2. The Exciting News! 2 The MiPCT has been extended by CMS through 2016! (i.e. until 12/31/2016) Announced on 9/24/14; Ongoing consultation with CMS Project Officers re: operational requirements We’ll share in this presentation what is known about extension

3. How are We Doing? Recap and MiPCT Results to Date 3

4. MiPCT Participants (2014) 358 practices 37 POs 1,800 physicians 1.1 million patients ▫ Medicare ▫ Medicaid managed care plans ▫ BCBSM ▫ BCN ▫ Priority Health (7/13)

5. MiPCT Statewide Progress to Date Over 400 Care Managers hired and trained ▫ Building caseloads of targeted high-risk patients Building infrastructure in partnership with participating Physician Organizations and practices ▫ Ongoing Care Manager training, coaching, mentoring ▫ Learning collaboratives (team-based care, billing) ▫ 2014 - developing Palliative Care expertise ▫ Best-practice sharing Multi-payer claims database ▫ Dashboards, member lists, activity reports ▫ Now incorporating clinical (registry) data 5

6. State Evaluation Conducted by: Michigan Public Health Association (MPHI)

7. Status ActivityStatus Cost, quality and utilization analysis MiPCT practice level analysis underway Comparison data supplied by all payers through December 2013 Being processed – expected Delivery to MPHI: November PO SurveyComplete Care Manager SurveyThree time points available, additional survey planned Practice/Staff SurveyStill open for response Patient Survey Mail/phone follow-up Using claims data to randomly select respondents We could use your help to encourage response 7

8. 3 rd Care Manager Survey Data were collected via Survey Monkey ® June 9 - June 26, 2014 421 Care Managers were emailed invitations to participate 50% completed the survey (N=209) Data cleaning and analysis was performed using SPSS v19.0 8

9. 9 Care Manager Survey Results

10. Number of Encounters (face-to-face and phone) Completed During an Average Shift 10 Maximum1525 Percentiles 901112 7598109 507677 255555 Minimum1111 Complex CMs Hybrid CMs Moderate CMs All CMs

11. Physicians Support MiPCT 11

12. Staff Support MiPCT 12

13. The MiPCT Experience…

15. “I would like to see care management in my practice continue”

16. National Evaluation Conducted by: Research Triangle Institute (RTI)

17. How will CMS define success? 17 The tie to budget neutrality and ROI

18. 18 Quarterly Trend Comparison: Medicare PMPM Payments

19. 19 Quarterly Trend Comparison: Payments to PC and Specialty Physicians

20. 20 Quarterly Trend Comparison: Hospital Admissions

21. Key Quality Data Recap 21

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28. Questions/Discussion