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The Role of Managed Care in the Medical Home

Providing a Lifeline for Primary Care Practices

Tuesday, December 13, 2011
12:00-1:30 p.m. (EST)

About the Webinar

Program Objectives

Webinar Will Answer These Questions

Attend from your desktop or conference room. Invite your whole team to attend at one low price.

Rates: $249 per location (special rate for solo practitioners and the military. Please call 301-354-1769 for promo code)

The skyrocketing rise of healthcare costs is an ongoing dilemma – one that is gaining increased attention from lawmakers, employers, payers, physicians and consumers as it threatens the stability of the U.S. economy. One of the reasons attributed to the high cost of care is that the primary care system is not meeting the needs of consumers.

Today, it is estimated that nearly one in five Americans, or 60 million individuals, lack adequate access to primary care due to a shortage of primary care physicians in their communities. All stakeholders agree the systems needs an overhaul to contain costs, improve the delivery of care and make changes to the reimbursement system to reward quality vs. quantity.

One of the models gaining attention as a possible solution is the implementation of the Patient Centered Health Care Home (PCHCH). The model provides a positive way for payers and providers to work together to meet the needs of members by increasing access to services, supporting care coordination across the continuum, improving patient accountability through information and active decision-making, and driving efficiency and effectiveness. The model also provides the pathway to change the reimbursement system to one that bestows incentives to providers who deliver care in a more coordinated and efficient manner.

Our next webinar will bring together a team from the Health Plan of Michigan to discuss the success they have seen in improving care for their members as well as raising satisfaction levels for primary care physician practices as they have transitioned to the patient-centered health care home.

By attending this training session you will be able to:

Describe the value the payer and provider gain through the PCHCH.
Learn about the quality metrics providers and payers can generate that demonstrate improvement in member healthcare status.
Explain how incentives are improving providers’ morale and strengthening relationships with payers.
Discuss the improvements in preventive care as well as improvements in care coordination for patients with chronic medical conditions as a result of the care provided through the PCHCH.

About the Webinar

Primary care is critical to promoting health, improving care and reducing overall system costs, but it has been historically underfunded and undervalued in the U.S. According to the American College of Physicians, primary care practice is on the verge of collapse. This is because very few young physicians are choosing primary care and many of those already in practice are leaving due to heavy workloads, increasing demands and poor reimbursement rates. In an effort to revive primary care practice, health plans are investing in primary care practices through implementation of the medical home. Plans are supporting practices through IT technical support, practice transformation, care coordination, clinical guidelines and enhanced payment.

According to URAC, the accreditation organization that has developed the Patient Centered Health Care Home Practice Achievement Program, the Patient Centered Health Care Home is defined as a quality-driven, interdisciplinary clinician-led team approach to delivering and coordinating care that puts patients, family members, and personal caregivers at the center of all decisions concerning the patient’s health and wellness. A PCHCH provides comprehensive and individualized access to physical health, behavioral health, and supportive community and social services, ensuring patients receive the right care in the right setting at the right time.

The Patient Centered Health Care Home also:

Utilizes population-based tools to support and monitor wellness and care goals for each patient, aimed at preventing illness and improving individual well-being, clinical outcomes and quality of life.
Empowers patients to be active participants in their care, through patient-friendly education and informed shared decision-making that is based on cooperation, trust, and respect for each individual’s health care knowledge and health literacy, values, beliefs, and cultural background.
Is accountable for coordinating, providing, and monitoring a patient’s needs, including prevention, wellness, medical and behavioral health treatment, care transitions, and social and community services where appropriate through the creation of an appropriate individual plan of care.
Optimizes value for patients, payers, and society at large, driven by a commitment to care excellence and customer service.
Provides a rewarding place to work, offering a high level of job training and satisfaction for all members of the team and allowing team members to optimize their training and experience.

To learn how health plans and primary care providers are workings together to enhance the patient experience and improve the delivery of care gather your team on December 13, 2011, from 12:00-1:30p.m. (ET) to participate in a live webinar where our faculty will share their experience and outcomes in this promising model.

Program Objectives

Describe the value the payer and provider gain through implementation of the Patient Centered Health Care Home.
Learn about the quality metrics providers and payers can generate to demonstrate improvement in member healthcare status.
Explain how incentives are improving provider’s morale and strengthening relationships with payers.
Discuss how the through a team effort data is produced to demonstrate improved outcomes in preventative care as well as in care for patients with chronic medical conditions as a result of the care provided through the PCHCH.

Our Webinar Will Answer These Questions

What is the benefit to the health plan for investing in the transition of their primary care practices to the patient centered medical home?
What value does the primary care physician gain from the patient centered healthcare home?
What outcomes can both sides expect to achieve as a result of the collaboration?
What incentives are awarded to the practices who implement the patient centered healthcare home?
What are the metrics that need to be achieved to qualify for the incentives?
How have patients, providers and payer satisfaction levels changed with the implementation of the patient centered healthcare home.

Faculty

Thomas Raskauskas, MD, FACOG, CHCQM, is the Chief Medical Officer, Health Plan of Michigan, the largest managed care Medicaid HMO in Michigan, with 290,000 enrollees. Recently he was selected to be a member of the Steering Committee overseeing the Michigan Medicare Demonstration Project, a three-year grant to start in 2012 and covering 1.9 million citizens in Michigan. Dr. Raskauskas is Board Certified in Obstetrics and Gynecology, and he is certified in Health Care and Quality Management by the American Board of Quality Assurance and Utilization Review Physicians.

Diane Lecerf, MBA, is the Deputy Director of Quality Improvement for the Health Plan of Michigan. She has over 20 years of experience in healthcare quality improvement. Diane directs HPM’s quality improvement, disease management, health outreach, performance reporting, and accreditation compliance activities. She currently supports HPM’s medical home program. Diane participated as practice coach in a three-year, multi-state Medicaid medical home project. Prior to joining HPM, Diane worked in management consulting and with managed care organizations in a variety of quality improvement and accreditation activities. She has experience assisting organizations in achieving accreditation with the National Committee for Quality Assurance (NCQA), URAC, JCAHO, and the Accreditation Association for Ambulatory Healthcare (AAAHC).

Dr. Souha Sultan-Hakim MD
Pediatric Center Of Jackson
Jackson, MI

Moderator:
Anne Llewellyn RN-BC, MS, BHSA, CCM, CRRN
Editor in Chief, Case Management Products
Dorland Health, a Division of Access Intelligence

Who Should Attend

Physicians
Nurse Practitioners
Physician Assistants
Pharmacists
Nurse Case Managers
Social Workers

Quality Improvement Professionals
Behavioral Health Professionals
Managed Care Directors
Benefit Design Professionals
Practice Management Professionals
Patient Centered Medical Home Consultants

Purchase Options

Live Webcast Registration – $249 (per-site fee)
Webcast Recording on CD-ROM – $249
Live Webcast and CD-ROM – $299
special rate for solo practitioners and the military. Please call
301-354-1769 for promo code

About URAC

URAC has developed its Patient Centered Health Care Home (PCHCH) programs to educate and guide health care practices, and their sponsoring health plans, insurers and pilot programs through transformation into truly patient-centered health care homes. Learn more »

Questions?

For questions regarding the Webinar or to register by phone, contact Hope Kabik at 301-354-1769.

If you are having any technical difficulties or need assistance meeting these requirements, please contact our Technical Support Center at 1-866-709-8255.

For content questions regarding this Webinar, contact Anne Llewellyn at 954-254-2950 or email allewellyn@dorlandhealth.com.

*Dorland Health does not offer any refunds for the webinar. All sales are final.

How Does the Webinar Work?

The live audio is delivered to your location over the telephone or your computer speakers. The Power-Point presentations are presented over the Internet and are available to print out before the program. This is like a talk-radio program with visuals on the Web. You and your team will be able to have a live Q&A with all the speakers.

More details on webinar equipment and connections