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December 14, 2010 Vol I, Issue 7
News from New York's Hudson Valley
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Overview
We believe that revolutionary health care transformation is essential to a healthy, sustainable community. Use of health information technology as a tool, care coordination as a process, and realigned payments as an incentive are essential to achieve transformation immediately. We want to share these ideas and lessons learned to build a better health care community that is patient-centered, coordinated, accessible, low-cost and high quality. To learn more about the Hudson Valley Initiative read on. Early success in the Hudson Valley:
- EHR adoption rate of 38 percent (46 percent among primary care providers)
- More than six years of experience with health information exchange (HIE)
- Medical Home recognition of 236 primary care providers
- Robust health plan involvement
- Measurable gains in quality and safety are within reach
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Patient-Centered Transformation:
Hudson Valley helps establish national benchmarks
Hudson Valley is among a handful of communities selected to be part of developing the first national patient satisfaction benchmarks for ambulatory care providers, reports Lisa M. Kern, MD, M.P.H., of Weill Cornell Medical College. On Dec. 15, she and her colleagues will submit data, collected during late 2009 and early 2010, to the Agency for Healthcare Research and Quality, which will publicly post the aggregated results as national benchmarks. Those contributing data will be able to mine the information for detailed comparisons across various subgroups (e.g., age, diagnosis, etc.). Moreover, Kern and her colleagues will be able to look at Hudson Valley-specific satisfaction data and compare that data before and after medical home implementation. (A follow-up survey is slated for the first quarter of 2011.) "The Hudson Valley is contributing to rigorous evaluation of health care, which will benefit patients and providers," says Kern. "This is an excellent example of how the Hudson Valley is a step ahead of many other communities." Grant support for this research comes from the Commonwealth Fund.
THINC Quality Committee retreat focuses on dedicated care manager program
Last month, Taconic Health Information Network and Community's (THINC) Quality Committee held a full-day retreat largely devoted to discussing the particulars of the dedicated care manager program. A. John Blair, III, MD, president of Taconic IPA, presented a detailed overview of the program design, and Martín Sepúlveda, MD, IBM Fellow & vice president, integrated health services, offered IBM's support for embedded care coordination. Susan Stuard, executive director of THINC, provided a review of accomplishments to date and a proposal for ongoing health plan involvement. Tricia Barrett, vice president, product development at the National Committee for Quality Assurance, also spoke. Her topic: The Value Imperative and the Promise of Integrated Care. The Centers for Medicare and Medicaid had two representatives in attendance: Jody Blatt, senior research analyst, and Suzanne M. Goodwin, Ph.D., social science research analyst.
As states push ahead with primary care initiatives, physician leadership matters
Family physicians are--and should be--heavily involved in health care reform efforts on the state level, said speakers at the American Academy of Family Physicians State Legislative Conference. Mary Takach, RN, M.P.H., a program manager for the National Academy of State Health Policy, told the audience that states are pushing ahead with primary care initiatives, "a trend that is not likely to abate, regardless of what happens with federal health care reform." Accordingly, physicians' "input and their advocacy at the state level is hugely important," she said. (AAFP News Now) |
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Writing the Valley:
Stuard to CMS: Keep smaller practices in mind when developing ACO regs
In November, the Centers for Medicare and Medicaid Services asked for comments to help it develop rules for accountable care organizations. Susan Stuard, executive director of Taconic Health Information Network and Community (THINC), addressed a number of issues in her comments, including the needs of smaller practices. "Solo providers and those practicing in small groups will need access to infrastructure dollars. They may need the ability to work collaboratively in a community-based effort in order to have sufficient size and patient volume. These small groups (and perhaps federally qualified health centers as well) should not be required to bear any downside risk initially and should be given a longer time to demonstrate savings." Her comments on quality standards also touched on these issues: "[S]maller practices and solo providers will need the ability to report on required measures directly out of their EHRs in order to be successful."
An Agency for Healthcare Research and Quality survey suggests physician practices are struggling with health information exchange. Preliminary results from the 2010 AHRQ Medical Office Survey on Patient Safety Culture indicate that the 470 medical offices surveyed had problems with accuracy, completeness or timeliness of patient data at least half the times they exchanged information electronically in the past year. The survey also looked at implementation status of five electronic tools in the medical offices. Eighty-two percent of respondents reported their offices had fully implemented electronic appointment scheduling; 59 percent indicated they have electronic access to patients' test or imaging results; 51 percent said they had implemented electronic health records; 41 percent said they had implemented electronic ordering of medications; and 37 percent had fully implemented electronic ordering of tests, imaging or procedures. (CMIO)
Be prepared for transformation: Sign up for ACO Insights
In 2011, Taconic Health Information Network and Community (THINC) will launch ACO Insights, an initiative to provide education and technical assistance about accountable care organizations in the Hudson Valley. The first ACO Insights Webinar will be held in February. To learn more about these free webinars and other programs, sign up here.
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Profile in Change:
Paul Grundy, MD, M.P.H.
Paul Grundy, MD, M.P.H., global director, IBM Healthcare Transformation; president, Patient-Centered Primary Care Collaborative; board member, Taconic Health Information Network and Community (THINC)
Connector: Why are initiatives such as the Center for Medicare & Medicaid Innovation Center significant?
Grundy: With the rollout of CMS' Innovation Center on Nov. 16, there was an absolute, laser-like focus on better care, better quality, better service and healthier communities, and a focus on really rebuilding the infrastructure to allow that to happen.
The key is having a platform that allows care to be managed in a more effective way; to have a place, a hub where information can be actionable, as the President described in his June 8 talk. This platform, centered on the patient, is often thought of as advanced primary care, or a patient-centered medical home. It returns the family doctor to the center of care.
Connector: How does what's happening in the Hudson Valley vis-à-vis advanced primary care fit into the national picture?
Grundy: IBM is excited and pleased to be part of this very important initiative where we have our largest concentration of lives.
It's particularly significant that Hudson Valley leaders are working in close collaboration with other stakeholders, including buyers of health care and government agencies. Recently, CMS officials visited to look at what's happening in the Valley, to see the community's success in grappling with these issues. They are paying attention to the ongoing effort in the Hudson Valley to transform the community with better, more coordinated and more comprehensive care.
This is a better health care proposition, one that will fundamentally transform health care delivery by providing better care at lower cost. We're pleased that such a large number of physicians in the Hudson Valley have stepped up to medical-home level of care.
Connector: What role do employers have in supporting advanced primary care transformation?
Grundy: The biggest points of pain for our nation are uncontrolled health care cost and poor quality of care. It's the same for employers, who are the biggest purchasers of health care. It's immensely important for us, and it should be immensely important for every community. We need to encourage the delivery of more coordinated, accessible care-and stop episodic "partialist" care that's unsafe, unsound, uneconomical and unsustainable.
That's got to be a responsibility of everyone in the community, including the employers. It's critical for companies who really are hurting to stand up, speak up and be heard in their communities-to address some of these fundamental issues that are causing our society so much pain. This is key. This is our survival. |
Last month, the Centers for Medicare & Medicaid Services launched the much-anticipated Center for Medicare and Medicaid Innovation. CMS Administrator Don Berwick also announced the launch of the new CMS Innovation Center to test new payment methods in demonstration projects via new health care delivery models that emphasize primary care, such as the patient-centered medical home and accountable care organizations. The initiatives affirm the Administration's commitment to care coordination as a value-driving element of advanced primary care, according to Susan Stuard, executive director of Taconic Health Information Network and Community (THINC). Both she and A. John Blair, III, MD, president of Taconic IPA, note the initiatives dovetail with efforts already underway in the Hudson Valley. For instance, THINC, in partnership with Taconic IPA, seeks to create a model of embedded care management within medical homes. (Medical News Today)
Centers for Medicare & Medicaid Services officials announced they expect to issue proposed regulations for accountable care organizations by mid-January 2011. They also confirmed that Medicare beneficiaries will be informed when they are assigned to an ACO. (SURGistrategies)
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