Confidential to Kaiser Permanente Patient Centered Care Works!
Marci Nielsen, PhD, MPH Chief Executive Officer, PCPCC The Patient-Centered Medical Home and Health System Transformation: Texas Health Home Summit
A Change in Paradigm TodayFuture Treating Sickness / EpisodicManaging Population Fragmented CareCollaborative Care Specialty DrivenPrimary Care Driven Isolated Patient FilesIntegrated Electronic Record Utilization ManagementEvidence-Based Medicine Fee for ServiceShared Risk/Reward Payment for VolumePayment for Value Adversarial Payer-Provider Relations Cooperative Payer-Provider Relations “Everyone For Themselves”Joint Contracting 14
Health IT Infrastructure PCMH and Accountable Care: Two Sides of the Same Coin Accountable Care PCMH PCMH PCMH PCMH PCMH Hospitals Public Health Shared Services Care Coordination Care Managers Specialists 15
HIT Infrastructure: EHRs and Connectivity Primary Care Capacity: Patient Centered Medical Home Operational Care Coordination: Embedded RN Coordinator and Health Plan Care Coordination $ Value/ Outcome Measurement: Reporting of Quality, Utilization and Patient Satisfaction Measures Value-Based Purchasing: Reimbursement Tied to Performance on Value Supportive Base for ACOs, PCMH Networks, and Bundled Payments Trajectory to Value-Based Purchasing It is a journey, not a fixed model of care 16 Source: THINC - Taconic Health Information Network and Community
Role of The Collaborative (PCPCC) 17 Lead from the front Challenge Challenge the status quo Drive Drive the marketplace information Disseminate timely information networking & educational opportunities Provide networking & educational opportunities