Medical Home at the University of Iowa Hospitals and Clinics
|
|
- Darrell Stevenson
- 5 years ago
- Views:
Transcription
1 Medical Home at the University of Iowa Hospitals and Clinics Prepared for Iowa Healthcare Collaborative Medical Home Learning Community Presented by Stacey T. Cyphert, Ph.D. Assistant Vice President for Health Policy & Deb Steinbaker, RN, MA, MBA, NE-BC Assistant Director, Primary Care Clinic North September 7, 2011 Presentation Overview IowaCare Background and Context (Cyphert) UIHC s Medical Home (Steinbaker) IowaCare History IowaCare Act (House File 841) passed in 2005 IowaCare is a Section 1115 demonstration waiver that has been renewed through December 31, 2013 Provides a limited benefit package, limited provider network Replaced the loss of $65 million in federal funding from intergovernmental transfers Goals of IowaCare are to: Expand access to health h care coverage for low-income, uninsured adults who are not eligible for Medicaid Provide financial stability for safety net hospitals who have high amounts of uncompensated care Experiment with health care innovations 1
2 IowaCare Members IowaCare covers single adults and childless couples ages 19-64, up to 200% FPL, who do not qualify for Medicaid or other insurance More than 80% of IowaCare members have incomes below 100%FLP Average monthly income for an IowaCare members is $850 Members are required to pay a monthly sliding scale premium if above 150% FPL (up to $85 per month at 200% FPL) 95% of IowaCare members do not pay any premium Family 200% of FPL Size 1 $21,780 2 $29,420 3 $37,060 4 $44,700 5 $52,340 6 $59,980 IowaCare Has Proven to be a Popular Program IowaCare has grown from 5,700 enrollees its first month to over 50,000 today. IowaCare Enrollment Varies By County (At end of July 2011 Total Enrollment was 50,297) Lyon Osceola Dickinson Emmet Winnebago Worth Kossuth Mitchell Howard Winneshiek Allamakee Sioux O Brien Clay Palo Alto Hancock Cerro Gordo 108 Floyd Chickasaw Fayette Clayton Plymouth Cherokee Buena Vista Pocahontas Humboldt Wright Franklin Butler Bremer Woodbury Ida Sac Calhoun Webster Hamilton Hardin Grundy Black Hawk Buchanan Delaware Dubuque , ,187 Jackson Monona Crawford Carroll Greene Boone Story Marshall Tama Benton Linn Jones , Clinton 1,087 Harrison Shelby Audubon Guthrie Dallas Polk Jasper Poweshiek Iowa Johnson Cedar 278 Scott , ,673 2,919 Muscatine Pottawattamie Cass Adair Madison Warren Marion Mahaska Keokuk Washington 1, Louisa 249 Mills Montgomery Adams Union Clarke Lucas Monroe Wapello Jefferson Henry Des Moines , Fremont Page Taylor Ringgold Decatur Wayne Appanoose Davis Van Buren Lee 178 NOTE: IowaCare enrollment grew by 27.8% in FY
3 IowaCare Services IowaCare services include: Inpatient and outpatient hospital services Physician and advanced registered nurse practitioner services, including annual preventive physicals Limited dental services Smoking cessation Extremely limited prescription drug coverage Except for emergency, obstetric, and some routine preventive medical examinations, services must be received from a network provider for IowaCare to pay for them. Examples of medically necessary services for which there is not currently any IowaCare coverage include: Mental health care Skilled nursing home care Home health care Durable medical equipment Outpatient pharmaceuticals IowaCare Provider Network From SFY , the provider network only included: University of Iowa Hospitals and Clinics (UIHC) - Iowa City Broadlawns Medical Center - Des Moines Two FQHCs were added to the provider network in October People s Community Health Center Waterloo Siouxland Community Health Center Sioux City In July 2011 three more FQHCs were added: Community Health Center of Fort Dodge Crescent Community Health Center Dubuque Primary Health Care Marshalltown Additional FQHCs are expected to be added over time. Members receive care based on their county of residence and needs: Members receive primary care from their medical home (or the UIHC if not assigned to a medical home) Secondary and higher levels of service are provided at the UIHC (Polk County residents only may receive secondary services at Broadlawns) IowaCare Providers Are Expected to be a Medical Home As a condition of participation in the IowaCare program, network providers must also qualify as medical homes, pursuant to Iowa Code Chapter 135, division XXII. Per (4) Medical home means a team approach to providing health care that originates in a primary care setting; fosters a partnership among the patient, the personal provider, and other health care professionals, and where appropriate, the patient s family; utilizes the partnership to access all medical and nonmedical health-related services needed by the patient and the patient s family to achieve maximum health potential; maintains a centralized, comprehensive record of all health-related services to promote continuity of care; and has all of the characteristics specified in section Network providers are to execute a contract with the Department of Human Services to be an IowaCare medical home and receive enhanced medical home reimbursements. The contract is to include performance measurements and specify expectations and standards for a medical home. 3
4 IowaCare Medical Home Requirements At a minimum, the Medical Home will: Have National Committee for Quality Assurance (NCQA) Level 1 certification or equivalent certification within 18 months of the start of the contract. Medical homes that achieve a higher level of accreditation from NCQA or equivalent shall be designated as such for purposes of payment. Deliver Provider-Directed Care Coordination Services aimed at managing all aspects of a member s care, ensuring quality of care and safety. Care Coordination is a comprehensive process whereby all necessary medical and complimentary services needed by the IowaCare member are provided at the site or are arranged for by the Medical Home provider. This includes but is not limited to coordination of transportation, services, care from other providers, or assistance with receiving benefits that may be provided by other agencies of state government. Develop a Continuity of Care Document (CCD) for each member that details important aspects of member s medical needs. This document will be updated and maintained by the medical home and will be updated as a means of communication between the referring provider and the consulting provider. Submit a CCD and personal treatment plan prior to each referral. IowaCare Medical Home Requirements (cont.) IME specified minimum standards also include: Provide access to care and information Accessibility 24-hours a day with a health care provider on call On-site triage during regular office hours, same-day services will be provided or arranged if determined appropriate Designate a Care Management/Care Coordination staff person Implement a Disease Management Program Diabetes Disease Management is required during the first year. Subsequent studies will be added based on disease burden. Implement a Wellness/Disease Prevention Program with quarterly reporting on quantities and activities. Demonstrate evidence of acquisition, installation and adoption of an electronic health record (EHR) system Develop a reminder service to inform members of appropriate preventative services. Develop an effective system of facilitating referrals and sharing of clinical information between the medical home and the specialty provider. IowaCare Performance-Based Payment Performance Payment. A performance-based PMPM payment will be paid at the end of the SFY to the Medical Home contingent on meeting Medical Home performance measures and available state funding. The Medical Home shall submit their annual performance report by August 1st or the first business day thereafter. The performance payment shall be paid by October 31 or the first business day thereafter and is in addition to any other IowaCare reimbursement. This payment is based on monthly enrollment figures, not by year end enrollment figures. 4
5 IowaCare Performance-Based Payment Schedule Level of Recognition/Year Initial 18 months of operation No Medical Home recognition Medical Home recognition at level other than highest Medical Home Payment PMPM Performance Based Reimbursement $3.00 $1.00 $4.00 $1.00 $1.00 $2.00 $2.50 $1.50 $4.00 Possible Total Reimbursement PMPM Medical Home recognition at highest level $3.50 $1.50 $5.00 IowaCare Performance-Based Criteria Performance criteria that must be met to obtain the performance incentive payment are as follows: As reported by each Medical Home, at least 65 percent of members enrolled in the pilot, over the age of 50, should have their colon cancer screening status reviewed on an annual basis. Colon checks could be performed by any method with appropriate follow up based on US Preventive Services Task Force (USPSTF) guidelines, including: Fecal occult blood test Flexible sigmoidoscopy Double contrast barium enema Colonoscopy As reported by each Medical Home, at least 75 percent of members enrolled in the pilot should have their body mass index (BMI) measured or calculated and recorded in their medical record, and reported to the Department on an annual basis. BMIs should be reported in aggregate to be aware of the status of the population. IowaCare Performance-Based Criteria (continued) Performance criteria that must be met to obtain the performance incentive payment are as follows: Educational and informational printed material provided to the enrolled members should be culturally and linguistically appropriate to the medical home patient population. Each medical home is to report a list of available languages for printed material, samples of a patient medication list, two examples of patient home-bound instructions, and two examples of patient reminder notices. Additional information should be provided on the current process in place to improve this form of communication to patients. All members referred to UIHC for secondary and/or tertiary care should be tracked via a referral tracking system (either manually [paper based] or electronically maintained). Each Medical Home is to report on their process for ensuring the referral tracking system and to report any known or suspected failures of tracking. As reported by the Medical Home, an active medication list must be maintained for at least 80% of all members enrolled by having at least one entry (or an indication that the patient is not currently prescribed any medication) recorded. 5
6 IowaCare Performance-Based Criteria (continued) Performance criteria that must be met to obtain the performance incentive payment are as follows: All members enrolled in the Medical Home Pilot are entered into the registry according to their chronic condition(s). Only a Diabetes Registry is required during year one. Each center is to report on their process for ensuring entry into the registry and to report any known or expected failures. As reported by the Medical Home, at least 75 percent of all members enrolled in pilot will have their tobacco use status documented. Each Medical Home is to report what percent of members enrolled in the program have annual immunizations or there is documentation that immunizations were offered, education provided to member, and member refused. As reported by each Medical Home, at least 70 percent of all eligible women enrolled should have an age appropriate cervical screen or documentation of need for exam. As reported by each Medical Home, at least 80 percent of all enrolled members with a diagnosis of diabetes have had at least one A1C annually. IowaCare Medical Home Coverage Began October 1, 2010 Other than primary care in medical home counties, secondary and higher levels of care are provided at the UI Hospitals and Clinics (although Broadlawns can provide some limited secondary care for residents of Polk County only). Lyon Osceola Dickinson Emmet Winnebago Worth Kossuth Mitchell Howard Winneshiek Allamakee Sioux O Brien Clay Palo Alto Hancock Cerro Gordo Floyd Chickasaw Non-UIHC Medical Home Fayette Clayton Plymouth Cherokee Buena Vista Pocahontas Humboldt Wright Franklin Butler Bremer UIHC Medical Home Webster Black Buchanan Delaware Dubuque Woodbury Ida Sac Calhoun Hamilton Hardin Grundy Hawk Jackson Monona Crawford Carroll Greene Boone Story Marshall Tama Benton Linn Jones Not in a medical home* Clinton Harrison Shelby Audubon Guthrie Dallas Polk Jasper Poweshiek Iowa Johnson Cedar Scott Pottawattamie Cass Adair Madison Warren Marion Mahaska Keokuk Washington Muscatine Louisa Mills Montgomery Adams Union Clarke Lucas Monroe Wapello Jefferson Henry Des Moines Fremont Page Taylor Ringgold Decatur Wayne Appanoose Davis Van Buren Lee *People not assigned to a medical home are served by the UIHC. Continual Growth in IowaCare Program A Challenge in Operating a Medical Home 22.4% increase in own medical home beneficiaries UIHC s medical home counties have seen an increase in IowaCare enrollment of 1,809 beneficiaries (from 8,077 to 9,866) between October 1, 2010 and July 31, % increase in beneficiaries unassigned to medical homes Counties not assigned to medical homes for which the UIHC is responsible for primary and greater care have seen an increase in IowaCare enrollment of 3,407 beneficiaries i i (from 15,447 to 18,854) 8 between October 1, 2010 and July 31,
7 Deb Steinbaker, RN, MA, MBA, NE-BC Assistant Director Primary Care Clinic North Corporate Goals Short Term NCQA-PCMH Certification at a Level 3 for IowaCare Enrollees Long Term NCQA-PCMH Certification for all other payers including Pediatric population Achieving the Standards 7
8 Building Partnerships With Patients Building Partnerships with Medical Homes The UIHC is also the source for secondary, tertiary and quaternary care for IowaCare beneficiaries so there are many opportunities for interactions. Per Iowa Administrative Code (6)(c), IowaCare beneficiaries must receive a referral from their medical home provider to access the UIHC for any services not available from the medical home. 249J7(7) of the Code of Iowa authorizes the use of clinical transfer and referral protocols to be used by providers. Electronic communication tools have been put in place -- Care Link is in use with FQHC medical homes and have seamless electronic information sharing with Broadlawns. Team Structure Providers (MDs and Extenders) Case Manager RNs MAs Additional Support Staff Pharmacist support pp Social Services support 8
9 IowaCare web page created at UIHC for patients, medical homes and staff Share Key Performance Indicators Internally Teams Administration Tools necessary for success EPIC Reports Phone Contacts Individual and group health coaching EPIC reminder letters My Chart Automated Telephone Reminders Future Cell phone text message reminders? Face Book contacts? 9
10 Care Coordination Navigating the healthcare maze for the patient QUESTIONS? 10
Table of Contents/Links
Iowa Vets Prepared by: Stephan Arndt, Ph.D. Iowa Consortium for Substance Abuse Research & Evaluation University of Iowa With funds from the Iowa Department of Public Health Veterans in Iowa 3 PTSD 6 Depression
More informationIowa County Attorneys Association
Iowa County Attorneys Association Fiscal Year 2018 Salary Survey Inside This Issue: 8/8/17 Profile Full Time County Attorneys Page 2 Profile Part Time County Attorneys Page 4 Assistant County Attorney
More informationIowa Medicaid Managed Care 2014
Iowa Medicaid Managed Care 2014 Topics Marketplace Choice Plan Iowa Wellness Plan MediPASS Meridian HMO Magellan Behavioral Health Accountable Care Organizations Health Risk Assessments Health Homes PACE
More informationOverview of the Indigent Patient Care Program
Overview of the Indigent Patient Care Program Presented to the Board of Regents, State of Iowa December 16, 2004 PRES 0332 11/04 1 Principles Governing UIHC s Care for Patients Regardless of Their Ability
More informationOutcomes for Iowa Medicaid Health Home Program Enrollees
Policy Report October 2014 Outcomes for Iowa Medicaid Health Home Program Enrollees Elizabeth T. Momany Peter C. Damiano Suzanne E. Bentler -2013 Outcomes for Iowa Medicaid Health Home Program Enrollees
More informationLICENSING STANDARDS AND PROCEDURES
Comm. 204 (Rev. 3/18) Child Care Centers and Preschools LICENSING STANDARDS AND PROCEDURES WELCOME TO CHILD CARE PROVIDERS On an average day in Iowa, more than 100,000 children are cared for in more than
More information2018 SSNHA General Grant Application
2018 SSNHA General Grant Application Applicant Information 1. Applicant Name (Name of non-profit organization, local government, etc.) 2. Applicant Type: Non-Profit Organization Governmental (City, County,
More informationTransforming the Future of UI Health Care
Transforming the Future of UI Health Care 1 Because things are the way they are, things will not stay the way they are. Bertolt Brecht 2 Where were we in this transformation process? What challenges are
More informationPolicies and Practices in Iowa Hospitals Relating to Human Sterilization
Policies and Practices in Iowa Hospitals Relating to Human Sterilization Nelle S. Noble, M.D. REGULATIONS IN Iowa hospitals regarding tubal ligation vary widely. To ascertain the facts questionnaires were
More informationLICENSING STANDARDS AND PROCEDURES
Comm. 204 (Rev. 8/17) Child Care Centers and Preschools LICENSING STANDARDS AND PROCEDURES WELCOME TO CHILD CARE PROVIDERS On an average day in Iowa, more than 75,000 children are cared for in more than
More informationMargaret C. Tyler University of Iowa. Peter C. Damiano University of Iowa. Elizabeth T. Momany University of Iowa. Health Policy
Health Policy 3-1-2004 Evaluation of the Iowa Medicaid Managed Care Plans: The Consumer s Perspective. Results from the 2003 Survey of Iowa Medicaid Managed Care Enrollees. Final Report to the Iowa Department
More informationIHCP bulletin INDIANA HEALTH COVERAGE PROGRAMS BT OCTOBER 13, 2015
IHCP bulletin INDIANA HEALTH COVERAGE PROGRAMS BT201573 OCTOBER 13, 2015 FSSA announces FFY 2016 hospice rates The Centers for Medi & Medicaid Services (CMS) released new federal hospice rates for federal
More informationSTATE OF IOWA ACTION PLAN FOR DISASTER RECOVERY #2 (Including Amendments #1 through #19 and Technical Modifications #1 through #10)
STATE OF IOWA ACTION PLAN FOR DISASTER RECOVERY #2 (Including Amendments #1 through #19 and Technical Modifications #1 through #10) Utilizing Supplemental CDBG Disaster Recovery Funding from the Consolidated
More informationCARROLL COUNTY Carroll Carroll Community and New Opportunities Free Medical Clinic Highway 30 East Carroll, Iowa 51401
ADAIR COUNTY Greenfield Greenfield United Methodist Church Free Clinic United Methodist Church 108 SW 5th St Greenfield, Iowa 50849 CARROLL COUNTY Carroll Carroll Community and New Opportunities Free Medical
More information2016 SNAPSHOT REPORT. July for Indiana Community Foundations
2016 SNAPSHOT July 2017 REPORT The 2016 GIFT Snapshot Report is a compilation of data from Indiana community foundations entered into the CF Insights database. for Indiana Community Foundations 2016 data
More informationADAPT Utilizing Innovative Member Engagement Programs to Educate, Involve and Empower your Members
ADAPT Utilizing Innovative Member Engagement Programs to Educate, Involve and Empower your Members PRESENTED BY: Augusta Kairys, Senior Vice President, Medecision Kimberly Tuck, Plan President & CEO, Home
More informationTransportation I H C P A n n u a l. S e m i n a r
Transportation I H C P 2 0 1 7 A n n u a l S e m i n a r VERMILLION CareSource Transportation Vendors CareSource partners with two vendors for transportation: Ride Right (northern Indiana) LCP (southern
More informationState of Indiana Floodplain Management Work Plan FFY
State of Indiana Floodplain Management Work Plan FFY 2005-2009 Prepared by: Gregory Main CFM, NFIP State Coordinator and Debbie Smith, Floodplain Management Supervisor, Indiana Department of Natural Resources,
More informationPatient-Centered Medical Home Program Update
Patient-Centered Medical Home Program Update Allison Scripps, MS, RD, CDE Director, Quality Care Partnership David Moroney, MD Medical Director, Network Innovation August 26, 2016 Becoming Agents of Change
More informationIC Chapter 2. Indiana Board of Veterinary Medical Examiners
IC 25-38.1-2 Chapter 2. Indiana Board of Veterinary Medical Examiners IC 25-38.1-2-1 Board of veterinary medical examiners Sec. 1. (a) The Indiana board of veterinary medical examiners is established.
More informationAmerican Indian and Alaska Native Total Population 2010
The 00 Decennial Census publishes regional population demographics for ethnicity, race and age groups. This profile will feature county trends and statistics for s American Indian and Alaska Native Alone
More informationKentucky Health Information Exchange
Kentucky Health Information Exchange (KHIE) Kentucky e-health Historical Overview March 8, 2005 Legislation (Senate Bill 2) to create a secure interoperable statewide electronic health network Kentucky
More informationRoad Funding in Indiana
On Local Government Road Funding in Indiana Larry DeBoer Purdue University October 2015 1 Funding Sources, Indiana Highway Expenditures, 2013 (thousands of dollars) Local 402,750 16% Federal 970,770 38%
More informationFlorida Managed Medical Assistance Program:
Florida Managed Medical Assistance Program: Program Overview Agency for Health Care Administration Division of Medicaid Table of Contents Why Are Changes Being Made to Florida s Medicaid Program?... 3
More informationMetro Advisory Council Homeland Security Subcommittee
Metro Advisory Council Homeland Security Subcommittee Final Report Submitted: October 10 th, 2006 Carl Metzger, Chairman Table of Contents I. Subcommittee Overview and Recommendations II. Appendix a. Homeland
More information28% 41,089 49% 87% $12.5 million 43, to 10 p.m. TOP 5 CAUSES OF POISONING SEDATIVES, HYPNOTICS AND ANTIPSYCHOTICS MEDICINE
CHILDREN ADULTS EDUCATORS HEALTHCARE PROFESSIONALS MEDICINE HOUSEHOLD CHEMICALS BITES & STINGS PLANTS & MUSHROOMS DRUGS OF ABUSE 41,089 43,466 FOLLOW UP CALLS made by Iowa s Poison Center PAINKILLERS COSMETICS
More informationMERCY HEALTH NETWORK'S Midwest Rural Telemedicine Consortium
MERCY HEALTH NETWORK'S Midwest Rural Telemedicine Consortium Telemedicine/Telehealth: Pieces in the Elaborate Health Care Puzzle 1. Telemedicine History 2. Incentives for Growth 3. Reimbursement 4. Legislation
More informationMcElroy Trust Grant Application
McElroy Trust Grant Application Letter of Intent Thank you for your interest in applying to the McElroy Trust. We use the Letter of Intent (LOI) as the first step in our process. The process has four goals:
More informationData Report 2015 Indiana Nursing Licensure Survey
Data Report 2015 Indiana Nursing Licensure Survey May 2016 0 010 0 010 0 0110101010 0110 0 010 011010 010 0 010 0 0110110 0110 0110 0 010 010 0 010 0 01101010 0110 0 010 010 0 010 0 0 N U R S E S 0 010
More informationGeorgia Trauma Commission. Six Immediate Goals
Georgia Trauma Commission Six Immediate Goals 2009-2010 #56 EMS Vehicles Replaced Seminole County Alabama Model System Processes Identify trauma patients requiring Trauma Center level of care based upon
More informationSUMMARY OF BENEFITS. Advantage (HMO) H
SUMMARY OF BENEFITS January 1, 2017 - December 31, 2017 Cigna-HealthSpring Advantage (HMO) H4454-012 Our service area includes the following counties in Tennessee: Anderson, Bedford, Benton, Bledsoe, Blount,
More informationKentucky Prescription Assistance Program (KPAP)
Kentucky Prescription Assistance Program (KPAP) KENTUCKY ACTED In the Spring 2008 Legislative Session, the General Assembly passed House Bill 406 that appropriated funds to consolidate all programs in
More informationMolina HealthCare of Illinois Provider Newsletter
Molina HealthCare of Illinois Provider Newsletter Molina Healthcare of Illinois now serving HealthChoice Illinois Members 2018 Quarter 1 HealthChoice Illinois is the state s Medicaid managed care program
More informationPre-Announcement. Ohio Common Pleas Court Administrative Judges and Ohio Board of County Commissioners:
Pre-Announcement Ohio Common Pleas Court Administrative Judges and Ohio Board of County Commissioners: Targeted Community Alternatives to Prison (T-CAP) Tentative Release Date: July 17, 2017 This Pre-Announcement
More informationGateway to Practitioner Excellence GPE 2017 Medicaid & Medicare
Gateway to Practitioner Excellence GPE 2017 Medicaid & Medicare Recognizing and Rewarding Excellent Practices Improving the Health of Gateway Members PRACTICE ELIGIBILITY (see PCMH slide #27 for separate
More informationIowa s Comprehensive Nutrition and Physical Activity Plan
Iowa s Comprehensive Nutrition and Physical Activity Plan Table of Contents Introduction 2 The Burden of Obesity in Iowa 4 Nutrition in Iowa 10 Physical Activity in Iowa 12 Iowa Focus Groups 15 Community
More informationNorthwest Region Republican 271, % Democrat 167, % Other 22, % Variance (R) 103, % Erie. Seneca. Richland.
2016 Ohio US Senate Race *Portman (R)... 3,118,567...... 58.03% Strickland (D).. 1,996,908...... 37.16% Other.......... 258,689....... 4.81% Variance (R)... 1,121,659..... 20.87% West Region Republican
More informationMedicaid Update Special Edition Budget Highlights New York State Budget: Health Reform Highlights
Page 1 of 6 New York State April 2009 Volume 25, Number 4 Medicaid Update Special Edition 2009-10 Budget Highlights David A. Paterson, Governor State of New York Richard F. Daines, M.D. Commissioner New
More informationCost Analyses of the Iowa Medicaid Health Home Program
Policy Report October 2014 Cost Analyses of the Iowa Medicaid Health Home Program Elizabeth T. Momany Phuong Nguyen-Hoang Peter C. Damiano Suzanne E. Bentler Dan M. Shane Cost Analyses of the Iowa Medicaid
More informationSouth Dakota Health Homes Care Coordination Innovation
South Dakota Health Homes Care Coordination Innovation Senator Deb Soholt NCSL Health Innovation Task Force December 6, 2016 South Dakota Health Homes Health Homes (HH)- provide enhanced health care services
More information2018 Summary of Benefits
2018 Summary of Benefits H5209-004_MDASB 9-13-17 Accepted 9/18/2018 DHS Approved 09/13/2017 This is a summary of drug and health services covered by Care Wisconsin Medicare Dual Advantage Plan (HMO SNP)
More informationGoals & Challenges for Outpatient Quality Directors. Quality HealthCare Consulting, LLC CEO: Jennifer O'Donnell, MHA, PCMH-CCE
Goals & Challenges for Outpatient Quality Directors Quality HealthCare Consulting, LLC CEO: Jennifer O'Donnell, MHA, PCMH-CCE Objectives Learn a practical way for Quality Directors to align Quality Measures
More informationColorado s Health Care Safety Net
PRIMER Colorado s Health Care Safety Net The same is true for Colorado s health care safety net, the network of clinics and providers that care for the most vulnerable residents. The state s safety net
More informationCommunity Matters. Program Builder Offers Help for Community Development Services. In This Issue
Volume 1, Issue 1 Community Matters Spring 007 Community Matters a Quarterly Publication for Iowa Leaders from Extension Community and Economic Development Program Builder Offers Help for Community Development
More informationVictim Witness Coordinators January 27, 2017
Iowa County Attorneys Association Tom Ferguson, Executive Director Hoover State Office Building, 2 nd Floor Des Moines, Iowa 50319 Phone: 515-281-5428 FAX: 515-281-6771 Attn: ICAA E-mail: tom.ferguson@iowa.gov
More informationPATIENT CENTERED. Medical Home. Attestation. Facility Compliance
2 0 1 7 Attestation PATIENT CENTERED Medical Home of Facility Compliance State of Wyoming, Department of Health, Division of Healthcare Financing Check the Patient Centered Medical Home (PCMH) Programs
More informationState of Mississippi EXPERIENCE AND TRAINING RECORD
State of Mississippi EXPERIENCE AND TRAINING RECORD APPLICATION MUST BE SUBMITTED TO: MS Military Dept., ATT: NGMS-SRP P. O. Box 5027 Jackson, MS 39296-5027 GENERAL INSTRUCTIONS TYPE OR PRINT IN BLACK
More informationHealth Care that revolves around you.
Health Care that revolves around you. MISSION STATEMENT Lone Star Circle of Care is committed to the pursuit of community-wide access to a behaviorally enhanced, patient-centered health care home that
More informationQuality Peer Group UDS Best Practices and Data Sharing 9/9/16. ohiochc.org
1 Quality Peer Group UDS Best Practices and Data Sharing 9/9/16 ohiochc.org Presenters 2 Ashley Ballard Director of Clinical Quality Tiffany Blair Quality Improvement Coordinator Dr. Wymyslo Chief Medical
More informationAn Introduction to MPCA and Federally Qualified Health Centers~ Partners for Quality Care
An Introduction to MPCA and Federally Qualified Health Centers~ Partners for Quality Care AIM Partnership Forum June 5, 2014 Lynda C. Meade, MPA Director of Clinical Services Michigan Primary Care Association
More informationHMO Basic (HMO) / HMO 40 (HMO) / HMO 20 (HMO) Summary of Benefits
/ / Summary of Benefits January 1, 2015 December 31, 2015 Call toll-free 1-800-965-4022 8 a.m. to 8 p.m. daily October 1 to February 15 and 8 a.m. to 8 p.m. weekdays the rest of the year. TTY/TDD 711 HealthAllianceMedicare.org
More informationArkansas Blue Cross and Blue Shield Patient Centered Medical Home Provider Manual
Arkansas Blue Cross and Blue Shield Patient Centered Medical Home Provider Manual 2016 This document is a guide to the 2016 Arkansas Blue Cross and Blue Shield Patient-Centered Medical Home program (Arkansas
More informationEarly Education Matching Grant
Early Education Matching Grant Request for Funding for Eligible Applicants January 2014 outline 1. Statute 2. Requirements 3. Application Process 4. Grant Participation Guiding principles Access School
More information$100 Hospital Ambulatory Surgical Center (ASC) Specialist: $30/visit Chiropractic (Medicare-covered) Podiatry (Medicare-covered)
2009 BENEFIT HIGHLIGHTS HEALTH NET PEARL NEW YORK OPTION 1 Albany, Broome, Cayuga, Chenango, Erie, Franklin, Genessee, Herkimer, Lewis, Livingston, Madison, Monroe, Montgomery, Oneida, Onondaga, Ontario,
More informationHonorees of the Iowa Public Health Association
Honorees of the Iowa Public Health Association Henry Albert Memorial Award was named in honor of the Commissioner of the IDPH from 1926-1930 and recognizes distinguished leadership in public health in
More informationTitle: Financial Assistance Hospital Facilities
Effective Date: 09/09/05; Rev: 04/07, 12/07, 10/10, 08/11, 02/12, 01/16 POLICY: Iowa Health System, d/b/a UnityPoint Health (UPH) Hospitals and Hospital Organizations shall fulfill their charitable missions
More informationPrevention Works. Good Behavior Game. Nurse Family Partnership. Healthy Families America. Communities That Care ...
Prevention Works Good Behavior Game Nurse Family Partnership Healthy Families America Communities That Care Prevention does not scale/sustain: Lack of payment Diverse settings Use of unlicensed professionals
More information2015 Statewide Bridge Sufficiency Rating Report - Condensed
Purdue University Purdue e-pubs Indiana Local Technical Assistance Program (LTAP) Publications Indiana Local Technical Assistance Program (LTAP) 10-2015 2015 Statewide Bridge Sufficiency Rating Report
More informationAn RHC Patient Centered Medical Home Experience
An RHC Patient Centered Medical Home Experience NARHC October 19, 2017 Kate Hill, RN The Compliance Team MACRA Recognition TCT Recognized for it s PCMH Program Today s Objectives Understand the difference
More informationCancer Screening in Primary Care: Lessons from Community Health Centers
Cancer Screening in Primary Care: Lessons from Community Health Centers Dialogue for Action Washington, DC April 11, 2018 Durado Brooks, MD, MPH Managing Director, Cancer Control Intervention American
More informationSelect Summary YOU HAVE CHOICES ABOUT HOW TO GET YOUR MEDICARE BENEFITS TIPS FOR COMPARING YOUR MEDICARE CHOICES
INTRODUCTION TO THE SUMMARY OF BENEFITS FOR January 1, 2015 - December 31, 2015 Central Alabama and Mobile Area SECTION I INTRODUCTION TO THE SUMMARY OF BENEFITS This booklet gives you a summary of what
More informationArkansas Blue Cross and Blue Shield Patient Centered Medical Home Provider Manual
Arkansas Blue Cross and Blue Shield Patient Centered Medical Home Provider Manual 2017 This document is a guide to the 2017 Arkansas Blue Cross and Blue Shield Patient-Centered Medical Home program (Arkansas
More informationOmaha Trade Area Study No. 3: License Plate Survey of Eight Major Shopping Points
University of Omaha DigitalCommons@UNO Publications Archives, 96- Center for Public Affairs Research --967 Omaha Trade Area Study No. : License Plate Survey of Eight Major Shopping Points Donald W. Lea
More informationPPC2: Patient Tracking and Registry Functions
PPC2: Patient Tracking and Registry Functions Element F: Use of System for Population Management At we use our EMR, clinical event manager, and the ad hoc reporting system (Business Objects) for a multi-pronged
More informationFree Clinics in Iowa. Impact of the ACA and Health System Change on the Iowa Safety Net. Peter C. Damiano. Suzanne E. Bentler.
Free Clinics in Iowa Impact of the ACA and Health System Change on the Iowa Safety Net Peter C. Damiano Suzanne E. Bentler Astha Singhal Peter Schumacher The University of Iowa Public Policy Center Last
More informationTransforming a School Based Health Center into a Patient Centered Medical Home
Transforming a School Based Health Center into a Patient Centered Medical Home April 14, 2010 10:15 11:0 am Eugene F. Sun, MD, MBA Chief Medical Officer Molina Healthcare of New Mexico Outline Molina Healthcare
More informationmycountyparks.com SAVE THE DATE: 2017 Initiative Volume 58, Issue No. 6 October 14, 2016 IACCB link on MCP.com
Autumn Sunrise on Lake Pahoja Lyon County Volume 58, Issue No. 6 October 14, 2016 SAVE THE DATE: The IACCB Calendar is also available online via the IACCB link on MCP.com * Oct. 20 District 1 Mtg. Carroll
More informationOutcomes for Iowa Medicaid Chronic Condition Health Home Program Enrollees. Policy Report. SFYs February 2017
Policy Report February 2017 Outcomes for Iowa Medicaid Chronic Condition Health Home Program Enrollees Ss 2012-2015 Elizabeth Momany Assistant Director, Health Policy Research Program* Associate Research
More informationAbout the National Standards for CYSHCN
National Standards for Systems of Care for Children and Youth with Special Health Care Needs: Crosswalk to National Committee for Quality Assurance Primary Care Medical Home Recognition Standards Kate
More informationState of West Virginia Department of Health and Human Resources Bureau for Medical Services
State of West Virginia Department of Health and Human Resources Bureau for Medical Draft Access Monitoring Review Plan Prepared for Public Comment July 13, 2016 Cynthia E. Beane Acting Commissioner Bureau
More informationOverview. Patient Centered Medical Home. Demonstrations and Pilots: Judith Steinberg, MD, MPH March 6, 2009
Patient Centered Medical Home Judith Steinberg, MD, MPH March 6, 2009 Patient Centered Medical Home Payment Reform & Incentive Alignment Transparency and Measurement Quality Improvement Practice Transformation
More informationOptions for cost savings through regionalizing community-based services, and discussion of data needs. Michael Flaum, MD
Legislative Task Force Des Moines, IA Oct 21, 2009 Options for cost savings through regionalizing community-based services, and discussion of data needs Michael Flaum, MD Director, Iowa Consortium for
More informationIowa Medicaid Family Planning 2012
Iowa Medicaid Family Planning 2012 What is Medicaid? A public health program through which a comprehensive range of health services for persons having no income, or a low income, are provided. 1965 amendment
More informationAlbany Medical Center. AMCH PPS Clinical & Quality Affairs Committee. Kallanna Manjunath MD, FAAP, CPE Medical Director AMCH PPS August 26, 2015
Albany Medical Center AMCH PPS Clinical & Quality Affairs Committee Kallanna Manjunath MD, FAAP, CPE Medical Director AMCH PPS August 26, 2015 AMCH PPS: Clinical & Quality Affairs (CQA) Committee Presentation
More informationKentucky Birth Surveillance Registry
Kentucky Birth Surveillance Registry Counting Every Baby because Every Baby Counts National Birth Defect Prevention Annual Meeting February 27, 2012 Sandy Fawbush RN, BSN Mission To develop and implement
More informationExecutive, Legislative & Regulatory 2018 AGENDA. unitypoint.org/govaffairs
Executive, Legislative & Regulatory 2018 AGENDA unitypoint.org/govaffairs Dear Policy Makers and Community Stakeholders, In the midst of tumultuous times, we bring you our 2018 State Legislative Agenda.
More informationQuality Measurement Approaches of State Medicaid Accountable Care Organization Programs
TECHNICAL ASSISTANCE TOOL September 2014 Quality Measurement Approaches of State Medicaid Accountable Care Organization Programs S tates interested in using an accountable care organization (ACO) model
More informationFirstHealth Moore Regional Hospital. Implementation Plan
FirstHealth Moore Regional Hospital Implementation Plan FirstHealth Moore Regional Hospital Implementation Plan For 2016 Community Health Needs Assessment Summary of Community Health Needs Assessment Results
More informationCommunity Healthcare Needs Assessment Summarizing Report
Mercy Medical Center North Iowa Community Healthcare Needs Assessment Summarizing Report Encompasses Fiscal Years 2011-2013 1 INDEX Introduction and Mission Community Served by Hospital Community Assets
More informationHazard Analysis Summary
Hazard Analysis Summary Overview This Request for Proposal (RFP) is not a contract and shall not be interpreted as such. Rather, this RFP only serves as the instrument through which proposals are solicited.
More informationHealthy Aging Recommendations 2015 White House Conference on Aging
Healthy Aging Recommendations 2015 White House Conference on Aging Chronic diseases are the leading causes of death and disability in the U.S. and account for 75% of the nation s health care spending.
More informationCSM Physician Bulletin
CSM Physician Bulletin September 2015 Volume 5, Issue 7 Quality and Clinical Integration Status of Performance for FY 2016 Goals: July and August Results We continue to be a leader in breast cancer screening
More informationIntegration Improves the Odds: Lessons Learned. Monday, December 18 th, 2017
Integration Improves the Odds: Lessons Learned Monday, December 18 th, 2017 Julie Cornell, North America Regional Manager, Global Community Impact INTEGRATION IMPROVES THE ODDS Lessons Learned Webinar
More informationMedical Management. G.2 At a Glance. G.2 Procedures Requiring Prior Authorization. G.3 How to Contact or Notify Medical Management
G.2 At a Glance G.2 Procedures Requiring Prior Authorization G.3 How to Contact or Notify G.4 When to Notify G.7 Case Management Services G.10 Special Needs Services G.12 Health Management Programs G.14
More informationMedical Management. G.2 At a Glance. G.3 Procedures Requiring Prior Authorization. G.5 How to Contact or Notify Medical Management
G.2 At a Glance G.3 Procedures Requiring Prior Authorization G.5 How to Contact or Notify Medical Management G.6 When to Notify Medical Management G.11 Case Management Services G.14 Special Needs Services
More informationAppendix 4 CMS Stage 1 Meaningful Use Requirements Summary Tables 4-1 APPENDIX 4 CMS STAGE 1 MEANINGFUL USE REQUIREMENTS SUMMARY
Appendix 4 CMS Stage 1 Meaningful Use Requirements Summary Tables 4-1 APPENDIX 4 CMS STAGE 1 MEANINGFUL USE REQUIREMENTS SUMMARY 1. Use CPOE (computerized physician order entry) for medication orders directly
More informationNY EPO OA 1-09 v Page 1
PLAN FEATURES Deductible (per calendar year) Member Coinsurance (applies to all expenses unless otherwise stated) Maximum Out-of-Pocket Limit (per calendar year) Lifetime Maximum (per member lifetime)
More informationSUMMARY OF BENEFITS. Cigna-HealthSpring. Advantage SMS (HMO) H January 1, December 31, Cigna H4407_16_32690 Accepted
SUMMARY OF BENEFITS January 1, 2016 - December 31, 2016 Cigna-HealthSpring Advantage SMS (HMO) H4407-011 2015 Cigna H4407_16_32690 Accepted SECTION I - INTRODUCTION TO SUMMARY OF BENEFITS This booklet
More informationMaryland Medicaid Program. Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 31, 2012
Maryland Medicaid Program Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 31, 2012 1 Maryland Medicaid In Maryland, Medicaid is also called Medical Assistance or MA. MA is a joint
More informationChecklist for Ocean County Community Health Improvement Plan Implementation of Strategies- Activities for Ocean County Health Centers: CHEMED & OHI
Checklist for Community Health Improvement Plan Implementation of Strategies- Activities for Lead Organizations Activities Target Date Progress to Date Childhood Obesity (4 Health Centers 1-Educate on
More informationPatient Centered Medical Home The next generation in patient care
Patient Centered Medical Home The next generation in patient care Provider Training Module I OBJECTIVE To explain... What Patient Centered Medical Home is How it works Why it s important Where to begin
More informationHighway Safety Plan - FFY Iowa Department of Public Safety. Governor s Traffic Safety Bureau
Highway Safety Plan - FFY 2017 Iowa Department of Public Safety Governor s Traffic Safety Bureau Roxann M. Ryan, Commissioner Patrick Hoye, Bureau Chief Executive Summary The Governor s Traffic Safety
More informationOur service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete (HMO SNP) H0432-009 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationDual Eligible Special Needs Plans For 2015
Dual Eligible Special Needs Plans For 2015 Introduction: Amerigroup Community Care is offering Dual Eligible Special Needs Plans (D-SNPs) to people who are eligible for both Medicare and Medicaid benefits
More informationPatient-Centered Medical Homes in Rural and Underserved Areas: A Webinar and Peer Discussion for Primary Care Offices
Patient-Centered Medical Homes in Rural and Underserved Areas: A Webinar and Peer Discussion for Primary Care Offices Association of State and Territorial Health Officials (ASTHO) August 17, 2016 Dial-In
More informationUniCare Health Plan of West Virginia, Inc. A true partnership with our provider community
A true partnership with our provider community Medicaid Managed Care Welcome! We would like to thank everyone for taking time out of their busy schedule to be here today! Thank you for the dedicated care
More informationIOWA S CENTER FOR AGRICULTURAL SAFETY AND HEALTH
IOWA S CENTER FOR AGRICULTURAL SAFETY AND HEALTH 2001 Annual Report and Compendium of Agricultural Health and Safety Activities in Iowa Iowa s Center for Agricultural Safety and Health Department of Occupational
More informationHOME DECORATING AND DESIGN Youth Center Thursday, July 26, 2018 Colette Masterson, Assistant Superintendent Brenda Young, Assistant Superintendent
HOME DECORATING AND DESIGN Youth Center Thursday, July 26, 2018 Colette Masterson, Assistant Superintendent Brenda Young, Assistant Superintendent GENERAL GUIDELINES 1. Age of Participants To be eligible
More informationOur service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete ONE (HMO SNP) H0251-004 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationFirst Look at Iowa's Medicaid Expansion: How Well Did Members Transition to the Iowa Health & Wellness Plan from IowaCare
Health Policy 0--0 First Look at Iowa's Medicaid Expansion: How Well Did Members Transition to the Iowa Health & Wellness Plan from IowaCare Suzanne E. Bentler University of Iowa Peter C. Damiano University
More information