Self-Management Workshops:
Surviving to Thriving
Jamie Hunter-Mitchell and Lisa Packard
Health Promotion Consultants & CDSME Master Trainers
February 27, 2018
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Qualis Health
• A leading national population health
management organization
• The Medicare Quality Innovation Network - Quality
Improvement Organization (QIN-QIO) for
Idaho and Washington
The QIO Program
• One of the largest federal programs dedicated to
improving health quality at the local level
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Why are we here?
• Understand the value and potential of
self-management workshops
• Recognize the limits of current
workshop delivery structures
• Imagine other models
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NCOA Video
• https://www.ncoa.org/healthy-
aging/chronic-disease/
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Prized resources: Workshop Leaders and Program Coordinators
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CDSME Evidence
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The Triple Aim
• Healthier PeopleSymptom management
Activity
Depression
Quality of life
• Better CareCommunication with health care
team
Medication compliance
Health literacy
• Smarter SpendingER visits
Hospitalizations
Ory MG, Ahn S, Jiang L, Smith ML, Ritter PL, Whitelaw N, Lorig KL. Successes of a national
study of the chronic disease self-management program: Meeting the triple aim of health
care reform. Med Care: 51(11):992-8, 2013 Nov
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CDSMP: Evidence Based
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Evidence
• Self-Management Resource Centerhttps://www.selfmanagementresource.com/resources/bibliography/
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CDSME Value
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Value
• For participants• Patient-centered
• Engagement activities
• Peer-group support
• Confidence building
• For providers• Improved health
outcomes
• Improved quality
performance outcomes
• Patient attraction and
retention
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Value
Number of Chronic Conditions Average Annual Spending
1 or fewer (32%) $2,025
2 or 3 (32%) $5,698
4 or 5 (23%) $12,174
Six or more (14%) $32,658
*Medicare beneficiaries. Source: CMS, “Chronic Conditions Among Medicare Beneficiaries: 2012
Chartbook Edition,” 10.2012.
The Cost of Chronic Conditions*
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Value
Estimated cost savings
$714 per person savings emergency room visits and hospital utilization*
- $350 CDSME estimated program costs
$364 per person net savings
Ahn S, Basu R, Smith ML, Jiang L, Lorig K, Whitelaw N, Ory MG: The Impact of Chronic Disease Self-
Management Programs: Healthcare Savings through a Community Based Intervention. BMC Public
Health, 2013, 13 (1):1141
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Sustainability
Chronic disease prevalence
CDSME
workshops
Community Participatory Approach
Multi-sector/cross-sector and public-private partnerships
Sustainability
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Our Regional Success Story
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Chronic Disease Self-Management Workshops in NCACH Region
supported with ACL grant and Older American Act funding
through AACCW
Growth of CDSME 2014-2017
Offer 5 self-management programs:• Chronic Disease Self-Management
• Tomando Control de su Salud
• Chronic Pain Self- Management (English/Spanish)
• Diabetes Self-Management
• Manejo Personal de la Diabetes
Workshops offered in:
Chelan, Douglas, Grant & Okanogan Counties
456 attendees
356 completers -attended 4 or more sessions
3 year Implementation grant 2013-2016
In 2013 identified two community partners:
▪ Community Choice
▪ Moses Lake Community Health Center
ACHIEVEMENTS
1. Sent two people from each organization for Master training.
2. Each program completed 2 CDSM workshops with a total of 31 completers.
3. Each program facilitated Lay Leader Training…
THEN
Received an AG grant to implement Chronic Pain program
Community Choice received an AG grant to implement DSM & Manejo
Received ACL sustainability grant Aug, 2016- June, 2018
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Workshop Data
0
2
4
6
8
2014 2015 2016 2017
Types and number of workshops
CDSM Tomando
CPSM DSM
Manejo
47%
38%
9%6%
Age Range
60+ 40-59 25-39 18-24
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Sustainability Innovations: Funding
• Medicare and Medicaid billing
• Payment reform quality measures• Diabetes: DSMP
• Chronic Disease: CDSMP
• Insurance carrier billing
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Estimated Medicare reimbursement
• Conditions for reimbursement
• Medicare, Part B
• Recognized Medicare provider
• Up to 10 hours of DSMT per 12 month
• AADE recognition/ADA accreditation
• G0109: DSMT Grp $14.71 (1.1.2017)
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SustainabilityTrends
• State
• Regional opportunities
• Federal
• Significant investment
• “Experienced, licensed organizations
exist throughout the country—partner
with them!”
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Potential Sustainability Solution
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Community-Based Approach
Affordable Housing
Senior Apartments
Libraries
Community Colleges
Senior Centers
Service Clubs
Churches
Faith-Based Organizations
Volunteer Organizations
Hospitals
First Responders
Clinics
District Health Departments
Pharmacies
Area Agencies on Aging
Tribal Governments
State Departments of Health
Accountable Communities of Health
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Learning Community
A group of individuals with a common
goal who create and participate in
opportunities to share and learn from
each other for the purpose of taking
action on what they learn in order to
achieve the common goal
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CDSME
Intentional Partnering
• Program quality
• Program efficiency
• Program coordination
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Sustainability
Chronic disease prevalence
CDSME
workshops
Community Participatory Approach
Multi-sector/cross-sector and public-private partnerships
Sustainability
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Q & A
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Contact
Jamie Hunter-Mitchell
Health Promotion Consultant
CDSME Master Trainer
206-288-2351
Lisa Packard
Quality Improvement Consultant
CDSME Master Trainer
206-288-2565
For more information: www.Medicare.QualisHealth.org/DSMP-
Washington
This material was prepared by Qualis Health, the Medicare Quality Innovation Network - Quality Improvement Organization (QIN-QIO)
for Idaho and Washington, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department
of Health and Human Services. The contents presented do not necessarily reflect CMS policy. WA-EDC-QH-3388-02-18
Gwen Cox
Practice Transformation Coach
(206) 288-2422