Shield PCMH Assessment Projects Phase 1 and Phase 2 May 10 2012 Shelley Vrungos PhD Research Analyst MSI Program MSI Patient Satisfaction Survey Results Q3 JanMar 2012 98 know their medical home provider ID: 741830
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Slide1
MSI Program Findings and Blue Shield PCMH Assessment Projects: Phase 1 and Phase 2
May 10, 2012
Shelley Vrungos, Ph.D
.
Research Analyst
MSI Program
Slide2
MSI Patient Satisfaction Survey Results: Q3 (Jan-Mar 2012)
98% know their medical home provider
99% report no problems discussing health care
98% report no problems obtaining needed
rx
97% report no difficulties scheduling appointments
87% provided educational materials on condition
67% report specialist went over results
60% report visiting MH in last 3 mos.Slide3
Level of Patient Satisfaction
P
roximity of medical home provider (4.5)
Medical home coordination of referrals (4.2)
Overall satisfaction with health since assignment to medical home(4.4)
Overall satisfaction with MSI program (4.8)Slide4
MSI Balance Scorecard
Performance Measures
Reporting Interval (Frequency)
Range Criteria
BSC Target
BSC Baseline
FY1011
Year-End Q1FY11-12Q1-Q2FY11-12Q1-Q3FY11-12Preventable inappropriate Emergency Room visits by MSI clientsQuarterly < 45% ▲ 46-53% >54%45%51%50%49% 50%50%Percent of MSI Members with at least one Medical Home Visit per yearQuarterly >70%▲ 60-69% <59%57%57%60%61%71% 68%Slide5
PCMH Assessment Project: Phase 1Purpose:
Assess medical home “readiness” of MSI primary care practices using NCQA PCMH standards
Enhanced Access and Continuity
Identify and Manage Patient Populations
Plan and Manage Care
Provide Self-Care Support and Community Resources
Track and Coordinate Care
Measure and Improve PerformanceSlide6
PCMH Assessment Project Method
NCQA Assessment tool used to evaluate practices on PCMH 6 standards areas
132 Clinics and provider sites completed
assessments
- Low Non-completion rate (14%)
Sites received PCMH score breakdown, gap analysis and recommendations Slide7
Summary of MSI Network PCMH Scores
PCMH Assessment Summary Results
Level achieved
# unique sites
% of MSI network
Level 0(<35 pts)
69
52%Level 1 (35-59 pts)
10
8%
Level 2(60-84 pts)
34
26%
Level 3(85-100 pts. )
19
14%
Total Sites
132Slide8
Breakdown of scores by Must Pass Elements
PCMH Must Pass Elements
% Passed
% Not Passed
Standard 1 Enhance Access & Continuity: Access office hours
97%(127)
3%(4)
Standard 2: Identify & Manage Patient Population: Use data for Population Management64% (87)34% (44)
Standard 3: Plan & Manage Care: Care management
84% (110)
17% (21)
Standard 4: Self care support: Support Care Processes
77% (101)
23% (30)
Standard 5: Track & Coordinate Care: Referral tracking & follow-up
88% (115)
12% (16)
Standard 6: Measure & Improve Performance: Implement continuous quality improvement
61% (80)
39% (51)Slide9
PCMH Implementation Project: Phase 2
Awarded $
100,000
from Blue Shield of CA Foundation to augment implementation of patient-centered services within LIHP network
Develop set of PCMH implementation tools and conduct targeted training
on these tools
with
medical home sitesPost-assessment to determine levels of enhancement in PCMH servicesAlign QOL based on level of PCMH recognition achieved at post-test Slide10
Main Project Objectives
Develop set
of
PCMH
implementation tools to assist MSI provider sites in augmenting
PCMH services
Conduct targeted trainings on these PCMH tools to enable successful implementation of patient-centered enhancements
Form a PCMH Learning Collaborative where providers can share best practices to help them successfully implement and sustain PCMH changesPost-assessment to evaluate level of PCMH readiness Slide11
PCMH Training goalsGroup training
sessions: overview
of
fundamental areas
that drive
successful PCMH
transformationWebinar-based trainings: comprehensively review NCQA standards and needed documentation to meet PCMH recognition.Technical assistance calls to help practices understand appropriate evidence of PCMH readiness and how to successfully implement patient-centered augmentations within their practices. Slide12
Project Contact Informationsvrungos@ochca.com
Please Fill out sheet with contact info for key contact person at your site
THANK YOU FOR PARTICIPATING IN THIS IMPORTANT PROJECT!!!!Slide13
Questions?