Bridges to Excellence in Diabetes Quality Journey
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1 Bridges to Excellence in Diabetes Quality Journey Pay for Performance Summit - San Francisco, CA February 20, 2013 Dr. Michael Massey, Vice Chair -HTPN Best Care Committee and Physician Champion of Ambulatory Care Ashley Reid MHA, Director of Strategic Initiatives
2 BHCS Overview 340 Access Points 30 Owned/Operated/Ventured/ Affiliated Hospitals 26 Ambulatory Surgery Centers 83 Satellite Outpatient Clinics (Imaging/Pain/Rehabilitation) 205 HealthTexas Locations 1 Free-standing Emergency Medical Center 3 Senior Health Centers 3 Retail Pharmacies Baylor Research Institute 3 Philanthropic Foundations 2
3 FY12: Key Statistics 2012 Patient Encounters 1.7M Hospital Visits 421,609 New Patients 117,723 Gross Revenue $615M Physicians 602 Physician Extenders 100 Employees 2,535 HTPN Care Sites Primary/Specialty Care Primary Care Baylor Senior Health Centers Community Health Centers Family Practice Residency Specialty Care Physiatric Medicine Centers Pulmonology Critical Care Liver Outreach Heart Failure Outreach Kidney Outreach Hospitalist Programs MRI Center
4 National Recognition 60 Practices, 271 Physicians and 59 Non-Physician Providers Acclaim Award Honoree: 2011 and
5 On the Road to Becoming High Performing 5
6 How Do We Spread Quality Initiatives Effectively? Physician Committees Best Care, Disease Management, Ambulatory Electronic Health Record Monthly Operations Meetings Regional Round Tables, Specialty Section Meetings, Annual All-Physician Spring Forum Physician Champions Physician Pulse Website Webinars & s 6
7 Quality / Cost Initiatives Government Physician Quality Reporting System (PQRS) Meaningful Use E- Prescribing Value Based Payment Modifier Primary Care Incentive Payment Commercial Shared Savings Bridges to Excellence Generic Prescribing New payment systems reward physicians for reducing total cost of care, improving quality, and eliminating hospitalizations and ED visits (population management) Physician incentive payments are becoming a larger portion of physicians annual income. 7
8 8
9 Improving Quality throughout HTPN Physician Pay-for-Performance Compensation Plan includes diabetes measures, preventive services scores, and patient satisfaction scores Administrative P4P compensation is aligned with physician P4P metrics Physicians are provided with education to help improve quality audit scores, including one-on-one physician champion coaching Patient engagement with quality measures through the HTPN Patient Portal 9
10 Culture of Transparency 10
11 Physician Dashboard
12 Physician Dashboard Quality
13 Physician Dashboard Quality - All Measures
14 Physician Dashboard Quality Drill-through
15 Embedded Diabetes Protocols in the EHR 15
16 Embedded Diabetes Protocols in the EHR 16
17 Care Coordination: A Team Based Approach to Care 10 Health Coordinators (MA Certification & 3 plus years clinical experience) 3 RN Health Coaches: Certified Diabetes Educator Advanced Asthma Certification Case Management Experience Currently supporting 54 clinics and 250 physicians 11 Protocols (Diabetes & APS) Inpatient Review Implement Pediatric Support in FY13 Special Project Support LDL Review and physician alert (LDL > 100 and no medication change within last year) Diabetic Smoking Status (ensure proper documentation into EHR) Diabetic Aspirin Therapy (review patient record and prompt PCP review contact patient with PCP recommendation) Project RED 17
18 Bridges to Excellence Diabetes Care Recognition Program 18
19 BTE Diabetes Recognition at HTPN # HTPN Physicians: IM, FP, Endo Quarterly EHR data submission through approved BTE data aggregator for all eligible clinicians.
20 BTE Diabetes Care: Incentive Payments Upon recommendation from the Best Care Committee, HTPN submitted Diabetes data for all Internal Medicine, Family Medicine, and Endocrinology physicians to become recognized as Bridges to Excellence in Diabetes providers. Quarterly notification of results sent to practices and physicians. Certificates given at the practice level. Disease Management Physician Champions work with physicians who were not recognized to improve scores. Current Incentives: BCBSTX offers $100/BCBSTX Diabetic patient and $500 one time bonus for recognition prior to 12/31/12. Aetna TRS offers $100/TRS diabetic member (as of July 2013)
21 Future Quality Initiatives Focus on Coronary Artery Disease and Depression Apply for BTE Recognition in Cardiac Care and Asthma 21
22 Let s Not Forget To remember the importance of our relationship with the patient (That trust is key to improving care). To improve quality and service while protecting the care team. To create a Checklist culture but not one that causes a checklist to block your view of the patient. 22
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