April Month in Review: Focus on Primary Care Innovators

Focus on Primary Care Innovators 
Friday, April 28

Dear Colleagues and Friends: 

I am thrilled to have joined the Primary Care Collaborative (PCPCC) as its new President and CEO as of April 3rd and look forward to working with you to advance primary care to make it more robust and patient centered.   

I am honored to lead the organization that successfully put the patient-centered medical home (PCMH) on the map and excited about all the innovation across the country to re-invent primary care. At this critical time in U.S. health policy, we need to work across stakeholder groups to build upon the gains we have made in elevating primary care — not retreat from those successes —  and figure out which of the many new primary care models being tested can further enhance healthcare value.

In that spirit, the Collaborative’s annual conference — to be held October 11 and 12th in Washington, DC — will bring together varied leaders who are innovating to advance primary care and seek to understand what they are achieving in terms of the Quadruple Aim — better care, better health, lower costs, and greater joy for clinicians and staff in delivery of care.

We’ll be examining these innovative models against the PCPCC’s yet-to-be-released 2017 Shared Principles for Advanced Primary Care. A decade after the Collaborative published the original Joint Principles for the PCMH, we are augmenting them to reflect changes in how primary care has evolved and lay out our aspirations for its future. These principles, developed by diverse stakeholders across healthcare, build on and go beyond the PCMH.

This spring you will receive:

  • A copy of the yet-to-be-released 2017 Shared Principles and be given the opportunity to sign on to them;
  • More information about PCPCC’s annual conference, including an agenda and speakers. In the meantime, please mark your calendars and plan to attend the conference October 11-12th.

These are just a few of the many ways we are partnering with stakeholders across the healthcare system and in particular with our executive members. If your organization is not currently an executive member, we hope you will join us to take advantage of the many educational, convening and advocacy opportunities we make exclusively available to them. There is no better time to connect with the Collaborative.

Ann Greiner, MCP

President & CEO

Inside Executive Membership:

April Monthly Briefing Focused on Payment Reform to Support Behavioral Health Integration  

Change Payment, Change Care:
Paying for Comprehensive Primary Care That Includes Integrated Behavioral Health

For our monthly briefing, executive members had the opportunity to participate in a special webinar about how payment reform can facilitate the integration of behavioral health into primary care. Lead author Benjamin Miller, PsyD, presented the major findings from his recent article in American Psychologist: "Payment Reform in the Patient-Centered Medical Home: Enabling and Sustaining Integrated Behavioral Health Care.
Following Miller's presentation, leaders affiliated with the American Psychological Association, the American Psychiatric Association, and the American Academy of Child & Adolescent Psychiatry reacted to the paper and provided their valuable perspectives. Executive members then engaged in an insightful conversation, discussing challenges and sharing best practices.

Webinar Recording Available
Current executive members can access the archived webinar. Contact us to request a copy. If your organization is not currently an executive member, and you're interested in joining us, please contact us for more information.  


Benjamin Miller, PsyD, Director, Eugene S. Farley, Jr. Health Policy Center, Department of Family Medicine, University of Colorado School of Medicine
Dr. Miller is a principal investigator on several federal grants, foundation grants, and state contracts related to comprehensive primary care and mental health, behavioral health, and substance use integration.

Doug Tynan, PhD, Director of Integrated Health Care and Acting Director of the Center for Psychology & Health, American Psychological Association
Dr. Tynan is a psychologist with extensive experience in primary and integrated care. 

Mark Borer, MD, Child & Adolescent Psychiatrist, Integrative Care Consultant, and Representative of the American Academy of Child & Adolescent Psychiatry
Dr. Borer specializes in psychopharmacology, family therapy, and collaborative care. His private practice, Psychiatric Access for Central Delaware, P.A., is in Dover, DE.

Louis Beckman, MD, American Psychiatric Association
Dr. Beckman is a collaborative care psychiatrist and Assistant Professor of Clinical Psychiatry at the Georgetown University School of Medicine.


SAVE THE DATE for Oct. 11-12!
PCPCC Annual Conference to Focus on
New Shared Principles & Innovations in Primary Care

Later this year, we will release new Shared Principles of Primary Care to guide the evolution of varied care delivery and payment models to further the robustness, centrality and patient-centeredness of primary care for the new era.

These Shared Principles - developed by stakeholders representing all aspects of health care - are designed to move the United States toward a vibrant future of person-centered, team-based, community-aligned primary care that will help achieve the goals of better health, better care, and lower costs. The Shared Principles will empower us to speak with one united voice as we work toward the ideal vision of advanced primary care that includes appropriate payment, investment, training, workforce and other resources to support it.
Conference panel presentations and plenaries will focus on innovative primary care models that exemplify these aspirational Principles. Our 2017 Annual Conference will bring the new Shared Principles to life through real world examples. Conference attendees will hear first-hand about innovations happening around the country, as well as receive a timely update on key changes in the federal and state legislative and regulatory areas that affect primary care.
Mark your calendar for #PCPCC2017! We will host an insightful and engaging conference at the Westin City Center in Washington, DC, October 11-12. Stay tuned for details!

Welcome New Executive Member OPEN MINDS
OPEN MINDS is a nationally-recognized market intelligence, executive education, and business solutions firm specializing in sectors of the health and human service industry serving individuals with complex support needs including mental health; addiction treatment; children & family services; intellectual & developmental disabilities; chronic disease management; long term care; social services; correctional health care, reentry & diversion; and juvenile justice.

As many care providers transition to integrated care models, value-based reimbursement and population health, OPEN MINDS provides up-to-the-minute market intelligence and “on-the-ground” expertise on the realities of integrating consumer behavioral health management into primary care delivery. This support includes assisting organizations with custom research, developing and implementing business plans or financial models for new integrated programs, and developing innovative collaborations and productive partnerships with the payers, health systems, and care management organizations that are driving the value-based care market.

Practice Transformation Corner

CMS Quality Payment Program Aligns With TCPI 
Did you know that the Transforming Clinical Practice Initiative (TCPI) aligns with the CMS Quality Payment Program (QPP)? As part of the TCPI, our Collaborative provides technical assistance to practices and practice transformation networks on adopting person and family engagement (PFE) strategies to improve clinical quality. Many of the activities and metrics incorporated in the TCPI can be used for credit under the QPP Merit-based Incentive Payment System (MIPS). The TCPI has adopted six person and family engagement metrics, which may eventually be adopted as quality measures in MIPS, and easily crosswalk to MIPS measures.

Practices working to improve person and family engagement can get "credit" for both MIPS quality improvement and TCPI PFE metrics for many Quality Improvement (QI) activities. Examples of the alignment of the TCPI and MIPS measures are listed below. (Access a more detailed list of the aligned measures here on our website.)
  1. TCPI PFE Metric 1: Support for Patient & Family Voices = MIPS-eligible QI: Engage patients and families to guide improvement in the system of care
  2. TCPI PFE Metric 2: Shared Decision-making = MIPS-eligible QI: Engagement of patients, family and caregivers in developing a plan of care; and use of evidence-based decision aids to support shared decision-making
  3. TCPI PFE Metric 3: Patient Activation = MIPS-eligible QI: Leveraging a QCDR to standardize processes for screening and implementation of fall screening and assessment programs
  4. TCPI PFE Metric 4: E-tool Use = MIPS-eligible QI: Engagement of patients through improvements in patient portal; and use of telehealth services that expand practice access
  5. TCPI PFE Metric 5: Health Literacy = MIPS-eligible QI: Use of tool sets or other resources to close healthcare disparities across communities
  6. TCPI PFE Metric 6: Medication Management = MIPS-eligible QI: Evidence-based techniques to promote self-management into usual care; and implementation of medication management practice improvements
Need help with the Quality Payment Program? As a TCPI Support & Alignment Network, we provide virtual support on PFE measures including coaching calls, onsite training, webinars, and tool development and can help you find help on QPP participation. Contact us for more information.
CMS Quality Payment Program Update:

MIPS Participation Letters On the Way 
The Centers for Medicare & Medicaid Services is now reviewing claims and notifying practices regarding which clinicians need to participate in MIPS, the Merit-based Incentive Payment System. MIPS is an important part of the new Quality Payment Program.

In late April through May, practices will receive a letter from the Medicare Administrative Contractor that processes Medicare Part B claims. This letter will tell the participation status of each MIPS clinician associated with the Taxpayer Identification Number or TIN in a practice.

Clinicians should participate in MIPS for the 2017 transition year if they bill more than $30,000 in Medicare Part B allowed charges a year AND provide care for more than 100 Part B-enrolled Medicare beneficiaries a year.

The Quality Payment Program intends to shift reimbursement from the volume of services provided toward a payment system that rewards clinicians for their overall work in delivering the best care for patients. It replaces the Sustainable Growth Rate formula and streamlines the “Legacy Programs” Physician Quality Reporting System (PQRS), the Value-based Payment Modifier (VM), and the Medicare Electronic Health Records (EHR) Incentive Program. Learn more about the Quality Payment Program.

Recent News of Note
6 Steps to Improving the Patient, Family Engagement Process
Patient EngagementHIT | 04/25/17

AAFP Submits Physician-Focused Alternative Payment Model: 6 Things to Know
Becker’s | 04/25/17

AAP: After-Hours Care Should Meet Medical Home Standards
MedPage Today | 04/24/17 (requires log-in, which is free)

Keep Primary Care Close to Home for All Americans
The Hill | 04/18/17

Making Health Care Markets Work: Competition Policy for Health Care
Brookings, Robert Wood Johnson Foundation, et al. | 4/12/17

Substantial Physician Turnover and Beneficiary “Churn” in a Large Medicare Pioneer ACO
The Commonwealth Fund | 04/12/17

Medical Home Recognition Revised to Address Physician Feedback
Medical Economics | 04/10/17

State Policy Capacity and Leadership for Health Reform
Milbank Memorial Fund | 04/10/17

How Patient-Centered Medical Homes Can Help Trim Hospitals' ER Costs
Health Data Management | 04/10/17

NCQA Revamps Patient-Centered Medical Home to Ease Adoption
HealthIT Analytics | 04/07/17

Upcoming Events
Charting the Future of Primary Care: Building Teams to Manage Complexity
May 4-6 | Boston, MA
Webinar: Involving Patient and Family Advisors as Teachers in Medical Education
May 10 | hosted by the Institute for Patient- and Family-Centered Care

PCPCC Executive Member Monthly Briefing
May 23 | Webinar hosted by the PCPCC
Webinar: QI Basics for Advisors
May 23 | hosted by PFCCpartners

Webinar: Care Coordination in Behavioral Health: PFE In Action
May 24 | Webinar

Our Annual Conference will be held Oct. 11-12 in Washington, DC.

For additional events, click here.

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Primary Care Collaborative · 601 13th Street, NW, Suite 430 North · Washington, DC 20005 · USA

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