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North Carolina’s Partnership with Physicians. Improving the Quality of Children’s Healthcare. Marian F. Earls, MD NASHP Annual Conference August 8, 2005. Medicaid Infrastructure: Community Care of NC (CCNC).

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North Carolina’s Partnership with Physicians

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North carolina s partnership with physicians

North Carolina’s Partnership with Physicians

Improving the Quality of Children’s Healthcare

Marian F. Earls, MD

NASHP Annual Conference

August 8, 2005


Medicaid infrastructure community care of nc ccnc

Medicaid Infrastructure:Community Care of NC (CCNC)

  • Physician – driven: Clinical Directors and Physicians Advisory Group (PAG) set policy and develop quality initiatives.

  • Now 15 networks encompassing 92/100 counties in North Carolina.

  • Medical Management Committee (MMC) at network level is decision-making body.


Medicaid infrastructure community care of nc ccnc1

Medicaid Infrastructure:Community Care of NC (CCNC)

  • Quality Projects include: asthma, developmental screening & surveillance (ABCD), diabetes, ED utilization, Mental Health-Primary Care Integration, Physician Advantage List (PAL-pharmacy).

  • Policy change July 2004, requiring use of formal standardized screening tool at well-visits according to ABCD project schedule.


Abcd project relationships

ABCD Project Relationships

  • Health Check (EPSDT) Coordinators – co-faculty in physician practice trainings; helped pilot ABCD brochures to families.

  • DMA Managed Care Consultants - co-faculty in physician practice trainings; assisted practices in implementation.

  • Early Intervention – shared logos; co-faculty/networking at trainings; sought physician input for referral procedures.

  • Participation in training video and workbook production and dissemination.


Abcd invitations to help develop state initiatives

ABCD: Invitations to Help Develop State Initiatives

  • Healthy Development Learning Collaborative (NC &VT–CCHI & VCHIP)

  • Medical Home (Public Health, Early Childhood Comprehensive Systems Grant)

  • Medical Home Learning Collaborative (CCHI)

  • Mental Health-Primary Care Integration (CCNC)

  • Linking PCP’s to Childcare and Early Education (Division of Child Development, Resource & Referral Centers, Smart Start)


Nc pediatric society

NC Pediatric Society

  • Long-standing relationships with Medicaid and Public Health through Open Forums.

  • Promoted and provided venue to widely communicate about the ABCD project.

  • Mental Health/School Health Committee: multi-agency membership, change in Medicaid policy in February 2001 to allow private mental health providers to directly enroll as Medicaid providers, enabling co-location models in primary care practices.


Challenges for providers

Challenges for Providers

  • Over-riding long held assumptions about working with a bureaucracy.

  • Being available (meetings/calls) to nurture the relationship.

  • Willingness to integrate quality initiatives into the office flow.


Benefits for providers

Benefits for Providers

  • Opportunity to shape policy.

  • Established relationship when new issues for providers arise.

  • Facilitation of care coordination for the office in the community.

  • Improved office efficiency and family satisfaction.

  • Removal of bureaucratic barriers (local and state).


Pearls

PEARLS

  • Begin with the needs and interests of providers.

  • Involve AAP and AFP Chapters early.

  • Identify physician champions.

  • Ensure physician buy-in by physician to physician communication.


Pearls1

PEARLS

  • Align goals with community/state partners.

  • Provide actual networking opportunities.

  • Begin with a pilot, then replicate.

  • Collect data/show evidence/share experience, then replicate. (Note: ABCD State Advisory Group initiated after pilot established and producing data.)

  • Start locally, and then move state-wide.


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