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Project Management POAC Update Michigan Primary Care Transformation Project March 2013

Project Management POAC Update Michigan Primary Care Transformation Project March 2013 . Followups from December Meeting. High Deductible Health Plan Population Magnitude Less than 2.5% of total current membership Fungal Outbreak Follow-Up Discussion with CMS Project Officer – Outcomes

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Project Management POAC Update Michigan Primary Care Transformation Project March 2013

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  1. Project Management POAC UpdateMichigan Primary Care Transformation ProjectMarch 2013

  2. Followups from December Meeting • High Deductible Health Plan Population Magnitude • Less than 2.5% of total current membership • Fungal Outbreak Follow-Up • Discussion with CMS Project Officer – Outcomes • No exclusions to date for any state to date • Would consider potential to exclude only if we could provide evidence that MiPCT practices were differently and substantially effected than non MiPCT practices • Incentive and Clinical Metric sets (attached) and at http://mipctdemo.wordpress.com/resources/mipct-documents-and-presentations/

  3. Baseline Data

  4. Baseline Data • Risk Group DCG Min and Max Bands • Very High 701 to 9999+ • High 226 to 700 • Medium 76 to 225 • Low 21 to 75 • Very Low 0 to 20

  5. Baseline Data

  6. Baseline Data

  7. March 2013 Progress Update • Patient Advisory Council Nomination Process extended until 3/11/13 • Nomination link can be found at: https://jodyooo.wufoo.com/forms/patient-advisory-council-nomination-form/ • Member List Increases • Exciting News: New Payer Addition! • Increased Numbers of BCBSM Lives

  8. March 2013 Progress Update, cont. • MDC Dashboard Releases and Enhancements • Most Recent Release (Feb 2012) • BCBSM data included • PMPM variable not shown as QA testing revealed greater variability than expected (likely due to time period adjustments) but additional testing is in process to confirm and resolve) • Includes data from Jan 2010-July 2012 • Next Release: (End of April) • To include Medicare, Medicaid, BCBSM Jan 2010-Dec 2012 data • May Release • Above with BCN Jan 2010-Dec 2012 data • Additional MDC Reports • ED utilization (March) • Inpatient utilization (May)

  9. March 2013 Progress Update, cont. • Key Metrics • Financial Outflows “New Money” being provided to POs and practices • Provider Characteristics • Number of PAs, NPs, Physicians • CMs (CCM, HCM, MCM) • CMs (full time/part time) • Geography • Large/Mid/Small practice • IPA, PHO, PO classification • Utilization • ACS ED and overall ED visits • ACS inpatient and overall inpatient stays • Readmission within 30 days • Town Hall and Success Story Updates

  10. March 2013 Progress Update, cont. • Key Metrics, cont. • Patient Membership • Total and by PO; by Practice (Adult; Ped; Total combined) • By Payer • ByMajor Chronic Condition/Dxand Risk Level • Cost • PMPM Overall and by payer • PMPM by PO • Risk level • Average Overall and by payer and PO • Percent very high, high, etc. (overall, by payer, by PO) • Cost by diagnosis (for Major Chronic Conditions) • Town Hall and Success Story Updates

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