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MiCCSI What’s in the wind, next steps? One Approach Many Steps.

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Presentation on theme: "MiCCSI What’s in the wind, next steps? One Approach Many Steps."— Presentation transcript:

1 MiCCSI What’s in the wind, next steps? One Approach Many Steps

2 Payment Redesign Continue to Support Care Management The Mi-CCSI Board of Directors approved the formation of a group of partner organizations and others to: Explore developing specific clinical model elements that build on the concepts of MiPCT and COMPASS Review the best way of paying for that model See “Executive Summary” document for details

3 Formation of the QI Council QI Council: Expedite development of a model to build pricing around Medical and behavioral conditions to be included Personnel to be included in the care team Tasks and activities of the care team that would be considered “new work” and part of care management Measure sets (HEDIS plus a handful others) and how to report on progress and outcomes, as well as cost

4 Clinical Model Sub-committee Sub-committee role: Review evidence and establish consensus

5 Mi-CCSI—All rights reserved The “CASE” for Case Review Studies are mixed on the effectiveness of the medical home or care management as deployed thus far It appears that care managers need additional structure, input and clinical-behavioral guidance to provide relevant input to treating PCPs Evidence is low to moderate on impact on cost savings and QOL for a “care management” only approach Other elements required, including improved identification methods, better assessments (including social determinants) and regular review of complex patients by physicians and other clinical consultants This model has been used effectively by health plans and in other clinical settings and models for some years 5

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7 7 Billing and Coding Sub-committee Research available and established codes Establish clarity and understanding of new codes See “Billing and Coding Guideline”

8 Formation of a financial template for input 8

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