Date post: | 27-May-2015 |
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Economy & Finance |
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Michigan Primary Care Transformation
Demonstration Project
April 17, 2013 Webinar
Congratulations!
Anchor Bay Clinic
• Karl Emerick, DO
• Kevin Klein, DO
• Raquela LePera, DO
• Thomas Mianecki, DO
• Debra Moses, DO
• Irene Scott, Office Manager
• Angie Siegmon, RN, Care Manager
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Upcoming URAC Audits
Hampton Medical
• Bruce Johnson, DO
• Susan Tam, DO
Country Creek Family Physicians
• Al Juocys, DO
• Shailaja Rastogi, MD
Douglas Hames, MD
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Upcoming URAC Audits
Rosa Parks Geriatrics
Ron Williamson, MD
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URAC Deadline Extended
URAC has given a green light for deadline
extension
5
Care Manager Training
Moderate Care Manager Training
Complex Care Manager Training
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Liability Insurance
All MNO care managers carry full liability coverage
$1,000,000/$3,000,000
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Liability Coverage
Letter from carrier
Letter from MNO endorsing malpractice carrier
Average annual premium $7,000
Approximate 20-30% savings
Dinner meeting on Wednesday, May 22, 2013
from 6:00-7:30pm ay APCC
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Liability Coverage
“Reserve” Plan only available to MNO primary
care physicians in wave one
URAC PCMH accreditation
Annual team training including risk training
Quality scores at 70%
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iExaminer
Project lead
One iExaminer/MiPCT office
Training tool
Appropriate ophthalmoscope
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Diabetes Pilot Project
Project lead
Poor enrollment
Outreach
Assistance
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Shared Visits
Hampton Medical
Anchor Bay Clinic
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Financial Incentives
Year one distribution
Care manager funding
1st Quarter 2013 report
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Billing and Coding Seminars
Throughout May, regional meetings will be held
throughout the state, facilitated by BCBSM, BCN,
and Medicare Advantage
G and CPT care management codes
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Billing and Coding Seminars
Sessions will be approximately three hours long
(morning or afternoon)
Billers, coders, care managers, PO representatives,
and others involved in the coding and billing
process should attend
15
Sequestration
President Obama signed an order that imposes
across-the-board Federal spending reductions (also
known as sequestration) for Federal payments
effective as of April 2013.
If Congress does not take action to avert this,
monthly payments to practices and POs will be
reduced by 2% beginning April 1, 2013 and this will
continue until there is resolution about the Federal
budget and Federal deficit.
16
Metrics Year Three
You’ve referred patient out…what next?
Behavioral health metrics supplied by Dr. Zeman
Committee meets to review all process and clinical
outcome proposed metrics
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Physician Engagament
Highly engaged
Moderately engaged
Minimally engaged
Totally disengagement
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Open Discussion
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QUESTIONS?
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