Michigan Primary Care Association

Michigan Primary Care Association Improving Outcomes Finance & Quality through Integrated Information Conference June 2-3, 2016 Shanty Creek Resorts Bellaire, MI

Definition and Purpose HRSA s Health Center Controlled Networks (HCCNs) are networks controlled and acting on behalf of health centers as defined and funded under Section 330(e)(1)(C) of the Public Health Service Act and must consist of at least 3 collaborator organizations. Purpose: The purpose is to ensure access to health care for the medically underserved populations through the enhancement of health center operations, including health information technology.

Mission The mission of the HCCNs is to improve operational effectiveness and clinical quality in Health Centers through the provision of management, financial, technology and clinical support services. HCCN initiatives are typically focused in functional areas requiring high-cost and/or highly specialized trained personnel, procurement of large infrastructure systems or in functional areas where operational mass drives economies of scale.

History HCCNs arose out of the health centers need to operate more efficiently by working together to form a business structure that would enable them to maximize the purchasing power of their limited dollars by sharing the costs of services.

Activities Below are the examples of core areas and functions that HCCNs provide, based on the needs of the health centers. Information Systems: IT department and infrastructure development Clinical: Health Education, Clinical Guidelines, Continual Quality Improvement/Clinical Systems Improvement, Research Finance: Billing/Revenue Management, Accounting, Policies and Procedures, External Audit Administrative: Accounting, Policies and Procedures, External Audit

Goals Aim: Improve health care quality through Health IT Specifics goals: To advance adoption and implementation of electronic health records (EHRs) To promote participation of eligible providers in the CMS EHR incentive program commonly known as Meaningful Use To improve quality of care through achieving: Healthy People 2020 goals on quality measures reported in UDS Recognition by health centers as Patient- Centered Medical Homes

Michigan Primary Care Association Michigan Primary Care Association got its beginnings in 1978 as the Michigan Association of Rural Health Care (MARHC), a networking organization of Health Centers and stakeholders interested in fostering primary care in rural underserved communities across the state. MARHC changed its name to Michigan Primary Care Association (MPCA), which incorporated in 1981. Today 39 Health Center organizations provide quality, affordable, comprehensive primary and preventive health care for more than 615,000 Michigan residents at over 250 sites located in both rural and urban communities across the state.

Michigan Primary Care Association MPCA Mission MPCA's mission is to promote, support, and develop comprehensive, accessible, and affordable community-based health care services to everyone in Michigan. MPCA Vision To build a healthy society in which all residents have convenient and affordable access to quality health care. MPCA will be a leader in influencing health care policy, legislation, and regulation fostering comprehensive, community governed, quality care that ensures excellent health and quality of life for all residents of the United States.

Current: MQIN Implementation Date: December 1, 2012 End of Funding Cycle: July 31, 2016 Membership: 22 Health Centers HRSA Focus Areas: 1. EHR Adoption 2. PCMH 3. Meaningful Use 4. Quality Improvement

Percent of MQIN Members with ONC Certified EHR MQIN Support 76% 90% 100% Development of assessment tool to compare platforms TA from VirtualCHC Discounted pricing through VCHC Baseline (Fall 2012) Fall 2013 Current (Spring 2015) Peer feedback on product features, functions and staff satisfaction

Percent of MQIN Members Reporting 100 % Eligible Providers Receiving EHR Incentive Payments 60% 15% Baseline (Fall 2012) Fall 2014

Percent of MQIN Members with PCMH Recognition Health Centers with PCMH Recognition* Baseline Comparison 21% 69% 77% 86% Baseline (Fall 2012) Fall 2014 Spring 2015 Current (Spring 2016) MQIN Support Conference May 2014 Customized TA Quality First Healthcare Consulting Newsletters with tips, links, reminders, key dates Supported network of PCMH leaders Expertise and TA upon request All MI Health Centers 69%

Number of MQIN Members Meeting or Exceeding 1 Healthy People 2020 Goal Meeting 4 Goals 6 6 6 Meeting 5 Goals Meeting 6 Goals Meeting 7 Goals 100% Achieved 1 3 Meeting 8 Goals Source: UDS 2014 MQIN Support of QI QI Consultant QI Director s Network Comparative data reports Dashboard templates QI Plan reviews Educational opportunities Webinars In-person Listserve/Network calls

Michigan Data Warehouse and Reporting Tool - MQIN Related Goals EHR Platforms able to directly connect Baseline - 1 Current: 3 SuccessEHS eclinicalworks NextGen Aggregation and reporting capacity Able to report from three EHR Platforms utilizing a customized tool on three clinical measures

New Funding Cycle August 1, 2016 July 31, 2019 Award based on number of member organizations Due date: HRSA EHB March 1 st Four Core Objectives 1. Health IT Implementation and Meaningful Use 2. Data Quality and Reporting 3. Health Information Exchange (HIE) and population Health Management 4. Quality Improvement

MQIN Membership Participating Health Centers: 37 Health Centers 254 sites Amount Requested: $1,125,00,000 Next Steps : Funding announcement - expected before Aug 1 st Getting Staff and Health Centers ready for the grant requirements.

Health IT Implementation & Meaningful Use Certified EHR Implementation and Optimization: Support the adoption, use, and optimization of certified EHRs. Advance Meaningful Use Assist with meeting Stages 1, 2, and 3 Meaningful Use requirements. Response/TA Strategies: EHR/EDR User Groups- 3 EHR and 2 EDR user groups Virtual CHC- Group discounts and vendor negotiations MU assistance- Staff expertise and strategic partnerships (M-CEITA, Medicaid EHR Incentive program office), HIPAA training and Security Risk Assessment help.

Quality Improvement Clinical Quality Improvement Support use of health IT to enhance performance on clinical quality measures Operational Quality Improvement Support use of health IT to support health center operational excellence. Advance PCMH Status Assist health centers in using health IT to advance their respective PCMH recognition and implementation efforts. Response and TA Strategies: CMO Network, Clinician Network, QI Directors Network, Lean and PCMH certified staff- personalized TA Trainings and educations on a regular basis Strategic partnership (GLPTN, Consultants)

Health Information Exchange & Population Health Management Health Information Exchange Support secure health information exchange among unaffiliated providers or entities. Population Health Management Support population health management activities leveraging health information across different care settings. Responses and TA Strategies: MQIN representation on MiHIN board Extensive partnerships with substrate HIEs (Ex; GLHC) Needs assessment interviews with Health Centers

Data Quality and Reporting Data Quality Provide strategies to enhance data validity for reporting, aggregation, and analysis. Health Center and Site Level Data Reports Support enhanced data reporting at the health center site and clinical team levels. Health Data Integration Support the integration of health data across all service types provided by the health center. Responses and TA Strategies: Data driven staff with ability for data aggregation and analysis Exploration and purchase of analytical tool that best serves the data needs of the Health Centers and MQIN

Governance MQIN Leadership Committee Operate under structure and by-laws of MPCA Leadership representatives: Executive Officer Financial Officer Operations Officer Medical Officer Information Systems/Technology Quality Improvement Transformation Leader New HIT Sub-Committee The primary function of the Michigan Quality Improvement Network Leadership Committee is to provide guidance to the Network to support systems and processes that provide optimal organizational results in clinical outcomes, operations, financial sustainability and patient satisfaction.

MQIN Guiding Principles Interoperability Technology-enabled quality improvement strategies Health information exchange usage Alignment of clinical quality measures Support clinical and financial integration Innovation

Consistent leadership and a shared, member-inspired vision create powerful synergy among these four entities. Health Center Leadership Vision for the Future of Health Centers in Michigan All four entities share a common Health Center membership. Broad Membership Shared Membership Shared Membership Shared Customers With leadership, vision and members in common each entity s core purpose represents a key dimension to the backing and services Health Centers need to thrive. Michigan Primary Care Association Promote, support, and develop comprehensive, accessible, and affordable community-based health care services to everyone in Michigan. Virtual CHC Provide secure, reliable application services for health information and management technology which allows Health Centers to focus on their patients instead of administering technology Michigan Quality Improvement Network Improve the quality of care at Health Centers through adoption and meaningful use of health information technology, technologyenabled quality-improvement strategies and innovative models of care. Michigan Community Health Network Foster network integration to leverage the power of Health Centers working together in negotiations with payer partners and the deployment of shared infrastructure and services. Each entity contributes a unique set of services, support and representation to Health Centers which all serve to advance the shared vision. MPCA Core Contributions Collective Advocacy Community Development Capital and Funding Development Shortage Designations Health Center Governance Support Health Workforce Assistance Enabling Services Support Health Center Program Assistance Health Center Finance & Operations Health Center Compliance VCHC Core Contributions Centrally Hosted Practice Management and Electronic Health Record Technology Solutions Financial Software Solutions Productivity Applications Telecommunications and Connectivity Communications and Health Information Technology Consulting MQIN Core Contributions Evidence-Based Models of Care Patient Centered Medical Home Integrated Care Meaningful Use of EHR/EDR Data-Driven Quality Improvement Health Information Exchange Health Informatics Metrics and Measures Alignment Population Health Management MCHN Core Contributions Integration and Alignment of Member Practices and Goals Joint Payer Negotiation Joint Legal Review for Reimbursement Arrangements Shared Infrastructure Investment and Development Shared Services Development Group Purchasing All four entities work together, sometimes cumulatively and sometimes in subset partnerships, to collaborate on shared contributions. Shared Contributions / Collaborative Work Peer Communication and Collaboration Networks Education and Training Technical Assistance Medicaid Program Reimbursement Health Center Assessment Michigan Primary Care Association www.mpca.net May 2016

Michigan Community Health Network (MCHN) members Many of the services provided by MQIN will be supportive of the needs of MCHN members For those MCHN member who decide NOT to be MQIN members, will not be eligible for discounted services Potential utility to optimize performance and reporting to be shared between networks Synchronicity

Membership No cost to join Must be an Section 330 funded FQHC or Look alike Sign Memorandum of Agreement Defines expectations of MPCA and MQIN members

Questions? Contact Faiyaz Syed MD, MPH Associate Director of Clinical Services fsyed@mpca.net or 517-827-0887 Our mission is to promote, support and develop comprehensive, accessible and affordable community-based primary health care services to everyone in Michigan.