Center for Public Payer Implementation

1
Center for Public Payer Implementation Breakout
Session April 28, 2009
2
Agenda

• Welcome Introductions
• Review of past years accomplishments
• Planning for upcoming year
• Moderated panel discussion Building and funding
  the Medical Home
• Lynn Mitchell, MD, Oklahoma State Medicaid
  Director
• Linda Strand, PharmD, PhD, Distinguished
  Professor College of Pharmacy University of
  Minnesota
• Lisa Watkins, MD, Assistant Director, Vermont
  Blueprint for Health
• Moderator Terry McInnis, MD, MPH, Medical
  Director- Health Policy and Advocacy
  GlaxoSmithKline

3
CPPI 2008-2009 Accomplishments

• State Medicaid Working Group, Lesley Reeder, RN,
  BSN, Chair
• Where weve been
• Identified key considerations of the Medical
  Home model
• Highly coordinated care
• Use of existing resources and working
• Have an evaluation plan across agencies as
  needed
• Align reimbursement with desired outcomes
• Legislative budget request language
• Coordination of care across physical
  behavioral/mental health
• systems

4
CPPI 2008-2009 Accomplishments
State Medicaid Working Group, Lesley Reeder, RN,
BSN, Chair

• Identified key considerations of the Medical Home
  model

• Highly coordinated care
• Use of existing resources and working
• Have an evaluation plan across agencies as needed
• Align reimbursement with desired outcomes
• Legislative budget request language

• Coordination of care across physical
  behavioral/mental health systems
• Patient/family centeredness
• PCP support education
• Referral tracking
• Focus on multiple morbidities
• Medication management
• Client education

• Developed a partnership with the National Academy
  of State Health Policy (NASHP)
• State Medicaid Medical Home Summit, July 2008
• NASHP publications

5
CPPI 2008-2009 AccomplishmentsFederal
Programs sub-group, Gary Jacobs, SVP Corporate
Development, Universal American, Chair

• Met with various internal champions in key
  federal departments (DOD, FEHBP, VA, HRSA) to
  discuss their version of Medical Homes. Work to
  further engage.
• Met with critical players on Health Reform debate
  (Energy and Commerce, Senate Finance, Ways and
  Means) to migrate Medical Home into reform
  proposals
• Work on Best Practices Model
• Work with CMS on Medical Home demonstration
• Cultivate Medical Homes in Medicare Advantage
  settings

6
CPPI 2008-2009 Accomplishments

• Sample List of Guest Speakers in 2008 2009
• James F. Coan, Office of Research Development and
  Information, CMS - Medicare Medical Home
  Demonstration
• Dr. Lisa Watkins, Assistant Director, Vermont
  Department of Health Update on the Vermont
  Blueprint for Health
• Julie Schilz, BSN, MBA, Colorado Clinical
  Guidelines Collaborative -Reimbursement Models
  for Medical Home
• Marjie Harbrecht, MD, Executive Director of
  Colorado Clinical Guidelines Collaborative
• Dave Downs, MD, Internal Medicine, Kaiser
  Permanente - Promoting a Culture of Coordination
  of Care
• Claudia Schlosberg, Director of Policy and
  Advocacy, American Society of Consultant
  Pharmacists

7
CPPI 2008-2009 Accomplishments

• Sample List of Guest Speakers in 2008 2009
• Dr. Penny Shelton, PharmD specializes in
  Geriatric Pharmacy, President of NC Pharmacist
  Association and has a leadership role in ASCP
  Polypharmacy Geriatric medication issues
• Chris Dawe, Senate Finance Committee Health
  Policy Team -The Senate's Plan to unveil its
  Health Reform Proposal
• Dr. Kaytura Felix-Aaron- Federally Qualified
  Health Centers (FQHC) with medical homes
• Commander Kevin Dorrance, Department Head of
  Internal Medicine (IM) at National Naval Medical
  Center (NNMC)- The NNMC on a pilot program, they
  started a year ago its mission being to deliver
  primary care/GAP analysis and perform an initial
  review on medical homes, with a focus on direct
  care.

8
CPPI Next Steps for 2009-2010

• Suggestions from call participants
• How to fund
• Gaining legislative support in states
• Return on investment projections
• Health information technology infrastructure
• Best practices for care coordination
• Payment reform
• Identify additional Federal Programs to draw
  experience from
• Identify key National Organizations that we can
  utilize to enhance out-reach communications

9
CPPI Next Steps for 2009-2010

• Suggestions from call participants
• Critical lobbing or use Medical Homes in Health
  Reform
• Help navigating new federal legislation
• Identifying federal funding opportunities
• Creating a common vocabulary and set collateral
  material created around Medical Homes
• Growing the Medical Home Model in Federal
  Programs
• Fostering Medical Homes as a key element of
  Health Reform
• Role of Medical Home in Medicare

10
CPPI Thanks You!
Terry McInnis, MD, Co-Chair, Center for Public
Payer Implementation Medical Director, Health
Management, GlaxoSmithKline   Allen Dobson,
Co-Chair, Center for Public Payer Implementation
North Carolina Department of Health and Human
Services, retired   Jijo James, MD, MPH,
Co-Chair, Center for Public Payer Implementation
Medical Director, Pfizer Health
Solutions   Subgroup Leaders Federal Programs
Gary Jacobs, Senior VP, Corporate Development,
Universal American State Medicaid Chair Lesley
Reeder, RN, BSN Colorado Department of Health
Care Policy and Financing