The Launch Webcast was Recorded!
Title: WV Medical Home Performance Incentive Pilot Launch Call
Date: Friday, January 8, 2010
Recorded Webinar link: http://wvmedia.wvhealthimprovement.org/MedHomePilot_08Jan10/index.htm
Want to become an NCQA-Recognized Medical Home?
Main contact: Sandi Bauer (sbauer@spreadinnovation.com)
If so, consider joining the Medical Home Performance Incentive Pilot. The purpose of the pilot is to gain experience with implementation of the medical home model in West Virginia and to determine whether the model demonstrates improvement in clinical process and outcomes measures as well as a reduction in overall cost of care. The pilot is divided into two phases. The first phase is the provider training phase; the second phase is the data collection phase to determine impact.
For phase 1, up to 50 providers are being recruited to participate. Each provider is being asked sign a participation agreement and commit to participation as follows:
- Provide a list of all patients in his/her panel, along with the designation of the payer source, to the WVHII staff. This information will be summarized for each payer so that coverage can be verified and the patient designated for inclusion in the subsequent data analysis. WVHII will execute Business Associate Agreements with each practice/ payer.
- Participation the provider and members of the care team in 2 learning session webcasts of 2.5 hours duration each. The first of these will be scheduled during early November, the second in March.
- Attend a one day face to face learning session along with up to 3 other members of his/her care team. The session will be scheduled in January and will last from 9:30 am until 4:00 pm. CME and nursing CEU’s will be available.
- Participation by at least one member of the team on monthly teleconferences of one hour each
- Reporting monthly on the set of measures endorsed by all the WV payers (copy attached)
- Sharing learning and outcomes in a spirit of transparency
- Application for Level 1 NCQA recognition status within 9 months, using diabetes as one of the areas of focus for adults; pediatric obesity as an area of focus for children
- Attempt to track the incremental cost of the changes being made in the practice to evolve to the medical home model. This will assist in decisions about future reimbursement changes.
In return, each physician will be provided with:
- Training on the medical home principles and how to apply them in practice
- Technical assistance and coaching on making these practice changes
- Assistance with installing the open source CDEMS registry if no other registry or EMR is in place
- Payment of the NCQA application fee
- A $5000 stipend to cover lost revenue during the face to face learning session
- Opportunity to share in an incentive pool to which payers will be contributing based on savings experienced through the medical home implementation.
For Phase 2, the payors will use a standard methodology to determine if savings have been achieved, while participants continue to report outcomes. Each payer will contribute 50% of the savings realized, up to 5% of total claims cost, to an incentive pool. Providers will receive a portion of that incentive pool based on their own performance on the clinical outcomes reported as well as utilization of ED visits and hospital admissions. Payers participating in the pilot include Mountain State Blue Cross, PEIA, and UniCare. Efforts will be made to also engage Medicare under a new demonstration project scheduled to begin in 2010.
Click here to apply