West Virginia was awarded a series of Medicaid Transformation grants by the Centers for Medicare and Medicaid Services. A key design element of the grants was the belief that a vehicle was needed to bring key stakeholders together to leverage collaboration and resources while fostering alignment across the health care system. This was the impetus for forming the Health Improvement Institute.
A second design element was the premise that quality would be improved by rapid adoption of the medical home model by primary care providers in West Virginia. A series of four workgroups were launched in April 2008 with the goal of shaping the environment in the State for rapid adoption of the Medical Home model as outlined by the February 2007 Joint Principles consensus document on the Medical Home. Those workgroups are the Adoption of Health Information Technology, Measurement/ Reporting/ Reimbursement, Provider Outreach and Education, and Self-Management Workgroups. In September 2008 an Innovation and Evaluation Work Group was added. A Coordinating Council was also formed of the work group chairs to assure alignment across all groups. We anticipate launching a Mental Health System Work Group in the coming months.
Adoption of Health Information Technology
This work group is being chaired by Bob Coffield, an attorney active in the formation of strategies for HIT in West Virginia. This work group is very focused on the issue of how to accelerate the adoption of electronic health information technology by providers in West Virginia in support of the medical home model. There are many initiatives underway relative to information technology in the State of West Virginia. The focus of this group is on physician practice adoption of technology.
The Charter of the Adoption of Health Information Technology Work Group is to:
- Conduct an environmental scan of the penetration of electronic health information systems in West Virginia
- Model the costs for the State of West Virginia to fully saturate the provider community with information technology systems supporting the medical home
- Make recommendations on a strategy to accelerate the adoption of electronic health records in West Virginia
- Recommend Pilots that the Health Improvement Institute can pilot that would lead to a pathway of rapid adoption by the provider community
- Lead the application process for the CMS EHR Demonstration Grant Opportunity (completed)
Coordinating Council
This work group is comprised of all the chairs of the other 5 workgroups, with some additional membership from the Bureau of Medical Services.
The Role of the Coordinating Council is to:
- Ensure effective communication and coordination is achieved across all groups
- Ensure that demonstration projects are aligned with the vision and goals of the Institute
- Be a resource to the Bureau of Medical Services as it supports the Medicaid Transformation Grant process
- Provide input to priority opportunities for the Institute
Innovation and Evaluation
This work group is being led by James Becker, MD. Dr. Becker is with the Bureau for Medical Services.
The Charter of the Innovation and Evaluation Work Group is to:
- Promote and coordinate the development and support of pilot and demonstration programs for the Health Improvement Institute
- Serve as a vehicle to triage requests for pilots and demonstrations that arise from outside of the existing Work Group structures
- Foster innovation in the field centered on improving quality for Medicaid recipients and all West Virginians
- Focus on opportunities for the Medicaid population for focused pilot projects that address some of the more pressing needs of the population
- Provide strategic input to the evaluation process for the Institute
- Ensure that all pilots have sound evaluation methodologies associated with their proposed execution strategies
- Monitor the environment for the purposes of seeking extramural grant funding opportunities for innovative initiatives in order to augment the resources of the Institute
Measurement/Reporting/Reimbursement
This work group has been integrated with an already existing work group on Chronic Care collaboration with payers led by Carl Callison of Mountain State Blue Cross Blue Shield. The group will recommend draft measures and reporting requirements for the Medical Home as well as pilots for testing alternative reimbursement models.
The Charter of the Measurement/ Reporting/ Reimbursement Work Group is to:
- Recommend to Medicaid a core set of measures proposed to be reported by providers to assess progress with adoption of the medical home model and improvement in quality
- Ensure proposed measures are aligned with other initiatives in the State (Payer; HCA; Professional Societies)
- Recommend an overall philosophy to align reimbursement systems that will accelerate and support the medical home model
- Model the economics of proposed changes
- Recommend pilots and proposed evaluation methodology
Provider Outreach and Education
This work group is being chaired by Helen Matheny, CEO of the West Virginia Medical Foundation. The focus of this work group is on developing strategies to provide education and assistance to primary care providers in West Virginia in order to migrate them to the Medical Home model.
The Charter of the Provider Education Work Group is to:
- Develop a profile of the primary care providers in the State of West Virginia that will be the focus of the provider training programs on the Medical Home
- Recommend a communication plan to providers on the Medical Home and on Medicaid Redesign
- Inventory existing programs and resources available to assist providers toward becoming recognized as a Medical Home; including liaison with the professional societies and organization to foster collaboration
- Recommend a curriculum for providers and care teams on the Medical Home model and on Medicaid Redesign
- Recommend a portfolio of training options for providers and their care teams
- Develop provider training modules
- Recommend mechanisms for technical assistance for provider care teams
- Provide support to the Health Improvement Learning Community
Self-Management
This work group is being chaired by Perry Bryant, Executive Director of West Virginians for Affordable Health Care. The focus of this work group is to identify mechanisms with which to make Medicaid beneficiaries aware and accessible to resources to assist their ability to improve their self-management capacity. The group will provide a vehicle for channeling self-management resources to needed individuals.
The Charter of the Self Management Work Group is to:
- Conduct an environmental scan and catalogue Self-Management resources in the State of West Virginia
- Assess mechanisms to coordinate Medical Homes with external partners
- Make recommendations on how to provide access to all Medicaid members for self-management support
- Develop proposals for pilots that lead to enhanced self-management capacity of Medicaid beneficiaries
- Recommend a communication plan explaining the Medical Home model to beneficiaries and coordinating this messaging with the Provider Education Work Group
