patient centered medical home – kids
DESCRIPTION
Patient Centered Medical Home – Kids. Thursday, February 6, 2014 7:30-9:00 a.m. 301 Metro Center Blvd., Warwick, RI Patricia Flanagan, MD, FAAP, Co-Chair Elizabeth Lange, MD, FAAP, Co-Chair. Selection Sub-Committee. Charge: - PowerPoint PPT PresentationTRANSCRIPT
Patient Centered Medical Home – Kids
Thursday, February 6, 20147:30-9:00 a.m.
301 Metro Center Blvd., Warwick, RI
Patricia Flanagan, MD, FAAP, Co-ChairElizabeth Lange, MD, FAAP, Co-Chair
Selection Sub-CommitteeCharge:• Develop criteria for selection of initial pilot PCMH-Kids practices
• Develop application and scoring process for practice selection
• Develop outreach strategy to insure eligible practices are informed
• Recommend selection process to Planning Committee/Conveners
• With staff support, conduct selection process, score applications, and make recommendations to Conveners
• Develop timeline for the application and selection process.
Members(10)• Dr. Elizabeth Lange, Waterman Pediatrics, Co-Chair• Dr. Renee Rulin, Unitedhealth Care, Co-Chair • Dr. Ailis Clyne, Baldhill Pediatrics • Andrea Galgay, RI Blue Cross/Blue Shield • Blythe Berger, Department of Health • Deb Florio, Office of Health and Human Services • Dr. Deidre Gifford, Office of Health and Human Services • Mary Evans, RI Health Centers Association • Dr. Stephen Davis, Neighborhood Health of RI • Tina Spears, Rhode Island Parent Information Network
Selection Sub-Committee
Selection Sub-Committee
Summary of Call 1/22/14:• Population focus: focus on high utilizers, which are often CSHCN, Medicaid, Cedar. But way to put in application is murky. Leadership will take and think about
• Goal of PMCH-Kids: To improve the pediatric practice to make them more able to accept these populations. If we improve practices we will improve care. Goal is transformation.
o Need a clear definition of children with special health care needso Get at this through an essay question: what do you currently do for care coordination
and behavioral health? What are your barriers?
• Want a mix of practices: high-achieving as well as practices who want to change, but don’t have the resources. Will consider using the pre-reqs from CSI Adults. Believe requiring EHR is necessary for this round (can take a practice 6-12 months to implement EHR, additional time to produce reports. This would affect the PMCH-Kids timeline.)
• Also want to look at cultural diversity (i.e. languages spoken)
• Next conference call: February 19 7:30-8:30am
Measures Sub-Committee Charge: • Review available data on quality, health disparities, disease
prevalence, utilization and cost of healthcare for children in RI
• Review standardized measures of pediatric healthcare quality, including those used in other pediatric PCMH programs
• Review available measures for feasibility of collection and alignment with other RI programs
• Recommend set of quality, patient experience and utilization measures to Stakeholder coalition for inclusion in contract
Measures Sub-Committee Current Members (23)
• Dr. Patricia Flanagan, Lifespan Co-Chair • Ronald Seifer, Bradley Co-Chair• Stacey Aguiar, Department of Health • Blythe Berger, Department of Health • Dr. Elizabeth Lange, Waterman Pediatrics • Dr. William Hollinshead, RIAAP• Dr. Betty Vohr, Woman & Infants Hospital • Carrie Feliz, Providence Public Schools • Dr. Dinusha Dietrich, Smithfield Pediatrics • Dr. Deidre Gifford, Office of Health and Human Services• Dr. Keivan Ettefagh, Aquidneck Medical Associates • Dr. Marco Ferretti, East Bay Pediatrics• Dr. Nicole Gergen, Hasbro Children’s Hospital • Dr. Joanna Brown, Lifespan • Junhie Oh, Department of Health • Dr. Nathan Beraha, Anchor Pediatrics • Peter Hollmann, Blue Cross Blue Shield Rhode Island • Dr. Jose Polanco, Blackstone Valley Community Health Center • Dr. Shirley Spater Freedman, Samuels Sinclair Dental Center • Judi Stevenson Garcia, Rhode Island Department of Education• Debra Hurwitz, CSI Adults • Rebecca Labeau, • D Bergh,
Measures Sub-CommitteeSummary of Call 1/27/14:
• The goal of the Measures Sub-Committee is to select measures that will drive outcomes and change in practices. Come up with ideas, as a group, on how children are different and think about how to build the child into the medical home.
• Reviewed charge. No further edits needed at this point.
• Reviewed current measures in specific areas: dental, developmental, behavioral, social emotional and school settings.
• Next meeting will be a discussion of specific measures: complex care coordination (CEDARR & foster care), family engagement, equity and transition.
• Next conference call: March 6, 2014 from 7:30-8:30 am
CSI-RI Community Health Teams
• Part of our strategic to create two community health teams (CHT)
• South County (serves 9 CSI Practices) and Pawtucket (serves 8 CSI Practices)
• Teams will incorporate a community health worker-a person to connect patients to community resources
• Teams will also incorporate a behavioral health care manager
• CHT will work with the primary care provider and nurse care manager as part of the team to coordinate care and manage the patient
• Focus on high-risk patients as identified by the health plans
CSI-RI Integrated Behavioral Health Workgroup
• Goals: to eliminate disparity in health care outcomes for people with mental health conditions, prove communication and coordination, leverage existing resources
• Focus areas of medical conditions: Diabetes, COPD, and CHF• Focus areas of behavioral health: depression, anxiety, and
substance abuse• What needs to happen for goals to be reached:
– Clear consensus definition of behavioral health
– Develop and test potential models of intervention (compacts, CHT, consultative model, co-location, integration)
– Define data needs and metrics
– Payment system that supports integrated behavioral health
• Current work: inventory CSI practices and response to Senator Miller and Representative Bennett’s Joint Commission to Study Integrated Behavioral Health
Race to the Top • Survey of Wellbeing in Young Children (SWYC)
o Developmental milestones
o Social/emotional development
o Family risk factors
o Autism-specific screening at 18 & 24 months
• Collaboration Efforts
o Rhode Island Department of Education
o Healthcentric Advisors
o American Academy of Pediatrics
o Executive Office of Health and Human Services
• DRAFT Resource Grid
Questions
Contact Information
Patricia Flanagan MD, FAAP, Co-Chair
401-444-7987
Elizabeth Lange MD, FAAP, Co-Chair
401-751-8683