Strengthening Primary Care for Patients April 9, 2013 Kaiser Permanente Center for Total Health Washington, D.C.
Dec 15, 2015
Strengthening Primary Care for Patients
April 9, 2013Kaiser Permanente Center for Total Health
Washington, D.C.
Restricted
The Primary Connection
Michael W. Cropp, M.D., M.B.A
President & CEO, Independent Health
Buffalo, New York
Restricted 3
The Primary Connection Patient Experience
2009 2010 2011 201265%
70%
75%
80%
85%
90%
PCMH/The Primary ConnectionPatient Experience of Care
Patient Experience
PCMH Baseline
7/1/2012 The Pri-mary Connection
Program Starts
Restricted
The Primary Connection Quality
4
2009 2010 Q3 2011 Q3201275.0%
76.0%
77.0%
78.0%
79.0%
80.0%
PCMH/The Primary ConnectionComposite Quality Score
Quality Sc...
PCMH Baseline
7/1/2012 The Pri-mary Connection
Program Starts
Restricted
The Primary Connection Efficiency
5
2008 2009 2010 Q3 2011 Q320120.97
0.98
0.99
1.00
1.01
1.02
1.03
1.04
1.05
PCMH/Primary ConnectionEfficiency Index
Efficiency Index
PCMH Baseline
7/1/2012 The Pri-mary Connection
Program Starts
Alliance of Community Health Plans (ACHP)Making Health Care Better
April 9, 2013
Scott Smith, MDAssociate Medical Director of OperationsKaiser Permanente Colorado
Confidential to Kaiser Permanente
Continuity
2006 2007 2008 2009 2010 2011 201240%
50%
60%
70%
80%
90%
100%
54%
80%82%
84% 84% 83% 83%
Confidential to Kaiser Permanente
Access
2006 2007 2008 2009 2010 2011 20120
2
4
6
8
10
12
14
16 15
12
9
3 3 34
YEAR
DA
YS
Confidential to Kaiser Permanente
Quality
2007 2008 2009 2010 2011 201240%
50%
60%
70%
80%
90%
100%
Mammography HypertensionColon Cancer Screening
Marci Nielsen, PhD, MPHChief Executive Officer, PCPCC
The Patient-Centered Medical Home and Health System
Transformation:Texas Health Home Summit
A Change in ParadigmToday Future
Treating Sickness / Episodic Managing Population
Fragmented Care Collaborative Care
Specialty Driven Primary Care Driven
Isolated Patient Files Integrated Electronic Record
Utilization Management Evidence-Based Medicine
Fee for Service Shared Risk/Reward
Payment for Volume Payment for Value
Adversarial Payer-Provider Relations
Cooperative Payer-Provider Relations
“Everyone For Themselves” Joint Contracting14
Health IT Infrastructure
PCMH and Accountable Care:Two Sides of the Same Coin
Accountable Care
PCMH
PCMH
PCMH
PCMH
PCMHHospitals
Public Health
Shared ServicesCare Coordination
Care Managers
Specialists
15
HIT Infrastructure: EHRs and Connectivity
Primary Care Capacity: Patient Centered Medical Home
Operational Care Coordination: Embedded RN Coordinator and Health Plan Care Coordination $
Value/ Outcome Measurement: Reporting of Quality, Utilization and Patient Satisfaction Measures
Value-Based Purchasing: Reimbursement Tied to Performance on Value
Supportive Base for ACOs, PCMH Networks, and Bundled Payments
Trajectory to Value-Based PurchasingIt is a journey, not a fixed model of care
16 Source: THINC - Taconic Health Information Network and Community
Role of The Collaborative (PCPCC)
17
Lead from the front Challenge the status quo Drive the marketplace Disseminate timely
information Provide networking &
educational opportunities