Project Management POAC UpdateMichigan Primary Care Transformation Project

March 2013

Followups from December Meeting• High Deductible Health Plan Population Magnitude▫ Less than 2.5% of total current membership

• Fungal Outbreak Follow-Up▫ Discussion with CMS Project Officer – Outcomes

No exclusions to date for any state to date Would consider potential to exclude only if we could provide evidence that MiPCT

practices were differently and substantially effected than non MiPCT practices

• Incentive and Clinical Metric sets (attached) and athttp://mipctdemo.wordpress.com/resources/mipct-documents-and-presentations/

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Baseline Data

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Baseline Data

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Risk Group DCG Min and Max BandsVery High 701 to 9999+High 226 to 700Medium 76 to 225Low 21 to 75Very Low 0 to 20

Baseline Data

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Baseline Data

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March 2013 Progress Update• Patient Advisory Council Nomination Process extended until

3/11/13▫ Nomination link can be found at:

https://jodyooo.wufoo.com/forms/patient-advisory-council-nomination-form/

• Member List Increases ▫ Exciting News: New Payer Addition!▫ Increased Numbers of BCBSM Lives

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March 2013 Progress Update, cont.• MDC Dashboard Releases and Enhancements

▫ Most Recent Release (Feb 2012) BCBSM data included PMPM variable not shown as QA testing revealed greater variability than expected (likely

due to time period adjustments) but additional testing is in process to confirm and resolve)

Includes data from Jan 2010-July 2012

▫ Next Release: (End of April) To include Medicare, Medicaid, BCBSM Jan 2010-Dec 2012 data

▫ May Release Above with BCN Jan 2010-Dec 2012 data

• Additional MDC Reports▫ ED utilization (March)▫ Inpatient utilization (May)

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March 2013 Progress Update, cont.• Key Metrics

▫ Financial Outflows “New Money” being provided to POs and practices

▫ Provider Characteristics Number of PAs, NPs, Physicians CMs (CCM, HCM, MCM) CMs (full time/part time) Geography Large/Mid/Small practice IPA, PHO, PO classification

▫ Utilization ACS ED and overall ED visits ACS inpatient and overall inpatient stays Readmission within 30 days

• Town Hall and Success Story Updates

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March 2013 Progress Update, cont. • Key Metrics, cont.

▫ Patient Membership Total and by PO; by Practice (Adult; Ped; Total combined) By Payer By Major Chronic Condition/Dx and Risk Level

▫ Cost PMPM Overall and by payer PMPM by PO

▫ Risk level Average Overall and by payer and PO Percent very high, high, etc. (overall, by payer, by PO) Cost by diagnosis (for Major Chronic Conditions)

• Town Hall and Success Story Updates

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