Michigan Multipayer CPC+ Monthly Briefing

This bimonthly briefing provides multipayer commercial CPC+ news for Physician Organizations (PO), practices, providers, and other partners.   To be added to the distribution, please send an email with the subject line “Add Me to Michigan Multipayer CPC+ Newsletter Distribution” to MichiganMultipayerCPCPlus@med.umich.edu. Find Past Editions of this Newsletter and other CPC+ Michigan Multipayer updates at www.cpcplusmichigan.org.

May – June 2019

Included in May – Junes Issue 

  • Progress on the CPC+ Michigan Multipayer Dashboards
  • Congratulations to the Poster Presentations (attached to this mailing) and Award Recipients from Michigan at the National Meeting in Baltimore
  • A summary of the new Primary Care First demonstration that will begin in 2020.  Note that while Michigan CPC+ practices are not eligible, other practices that meet criteria are eligible.
  • Key Highlights of the National Meeting, including CMMI Director Adam Boehler’s reminder that even with the roll-out in 2020 of the Primary Care First (PCF) demonstration, it is independent of the CPC+ demonstration. He stressed that it is still the case that if the CPC+ evaluation substantiates that CPC+ achieves a favorable outcome in the Mathematica evaluation, it will be integrated in ongoing Medicare payment after the demonstration end.  As the third largest CPC+ region in the nation, the hard work you are doing in practices to deliver optimal care and achieve outcome success on CPC+ metrics matters even more.
  • The MiCMT upcoming trainings
  • May-June 2019 Michigan Multipayer CPC+ Briefing
  • 2019_Natl_Mtg_Poster_D1_F2_West_Ann_Arbor_General_Medicine (003)
  • 2019_Natl_Mtg_Poster_D1_F3_Briarwood_Medical_Group (003)

Great News on Michigan CPC+ Multipayer Dashboard Progress!

Thanks to CMS and Priority Health, data for all three payers will be included in the CPC+ Multipayer Dashboards.  We are hopeful to receive and add this additional data by early fall.  BCBSM has already provided data which has been integrated into the dashboards.  We are grateful to all three payers for this achievement as it will allow CPC+ practices in Michigan to see reporting from a population perspective.  Watch over the next few months for additional information from the Michigan Data Collaborative on dashboard access.   Once implemented, this will make Michigan one of the six CPC+ regions (of the eighteen in the demonstration) where a multipayer dashboard exists.   Practices and POs will be able to see their own performance, how their performance compares to others, and how we are performing at a statewide level.

Congratulations to Michigan CPC+ Practices Recognized by CMS

Two Michigan CPC+ practices, West Ann Arbor General Medicine and Briarwood Medical Group (both University of Michigan practices) were selected to present posters at the CPC+ National Meeting.  West Ann Arbor’s poster was on “Standardizing Roles in a Diabetes Care Management Model” and Briarwood’s was titled “Integrating a Behavioral Health Collaborative Care Model”.   Congratulations to these practices for their hard work and for sharing their success with CPC+ colleagues.  Their poster presentations are attached to this newsbriefing.  Recognition also goes to Debra Burbary from Prism Medical Group who was recognized by CMS/CMMI for her strong commitment to the CPC+ model and progress!

Comment Period on the ONC Interoperability Proposed Rule Closes June 3rd

At the CPC+ National Meeting this year, in a session about IT and EHRs, practices and POs were reminded of the comment period for the new proposed Office of the National Coordinator (ONC) Interoperability rule.  The proposed rule attempts to guard against information blocking, etc.  This may be an opportunity to address some of the EHR vendor issue and challenges that some practices have experienced by submitting comments describing the barriers that you have experienced and preferences re: the proposed rule.  Comments are due by 11:59pm on June 3rd) and can be submitted electronically at: https://www.healthit.gov/topic/laws-regulation-and-policy/notice-proposed-rulemaking-improve-interoperability-health. If you are encountering what you feel are unfair barriers or challenges from your EHR vendor, this is an opportunity to make CMS and ONC aware.  A summary of the proposed rule (compiled by the American College of Allergy, Asthma and Immunology) is at: https://college.acaai.org/advocacy/resources/summary-proposed-rules-interoperability-electronic-health-information

Key Lessons of the 2019 CPC+ National Meeting

It was wonderful to see so many faces from Michigan at the National CPC+ Meeting in Baltimore on May 8 and 9th.  Whether you attended in person or virtually, it was a wonderful chance to hear from top CMMI (Center for Medicare and Medicaid Innovation) and CMS (Center for Medicare and Medicaid Services) leadership and to learn about the work done in other regions.  Here is a snapshot of the highlights we captured from the meeting:

  • CMMI Director Adam Boehler expressed a very strong commitment to primary care, including the CPC+ demonstration.  Importantly, he clarified that even with the roll-out in 2020 of the Primary Care First (PCF) demonstration, this new program is independent of the CPC+ demonstration.  Hence, it is still the case that if the CPC+ evaluation substantiates that CPC+ achieves the outcomes required (lower cost with same quality; higher quality with same cost; or higher quality with lower cost), then it will be integrated in ongoing Medicare payment after the demonstration end.  This is tremendously exciting news and an additional reason to work hard for CPC+ success in our 414 Michigan practices.  Whether in avoidable emergency department and inpatient use, blood pressure and hemoglobin A1c control, or patient experience of care, our opportunity to deliver excellent care in Michigan will contribute greatly to the potential for success as Michigan is the third largest CPC+ region.
  • Dr. Andrew Morris-Singer delivered a plenary session about Relational Leadership at all levels.  He noted that humans are wired for connection, attuned to social messaging, and that we must be attuned to the gap between the signals we think we send to others and how they may perceive them. When there are gaps, he encouraged team members to apologize and engage them in conversation to create bridges to understanding.  He also noted the importance of demonstrating to teams and patients that:
    • They are in an environment of psychological safety and important to others;
    • We must remember to ask for their help and feedback so that their perspective can be understood;
    • To regularly celebrate individuals and acknowledge their success as well as their personal risk-taking; and
    • That we can all take actions to build connection and community
  • In a “Leveraging Data for Improvement” session, the presenters suggested some interesting measures and approaches to consider, including:
    • Assessing the number of hospital admission that also had emergency room visits;
    • Isolating and focusing on a high emergency department use disease condition for interventions by
      • Exploring a set number with case reviews;
      • Assessing whether there were care compacts with the hospitals used;
      • Identifying whether the patients were in high risk tiers; and
      • Assessing the need for advanced care planning for patients with late-stage chronic conditions

CMS/CMMI Roll Out a New Demonstration for non-CPC+ Practices

You may have heard about the new CMS/CMMI demonstration, Primary Care First or PCF, which will begin in 2020.  Please keep in mind that while current CPC+ participating practices are not eligible, other practices in our region who meet criteria (detailed below) are.  A brief summary of the PCF demonstration follows below as it relates to Michigan.

CMS-CMMI Roll Out.jpg

*Primary Care First Performance Adjustment:

  • Year 1: Acute Hospital Utilization
  • Years 2-5: Acute Hospital Utilization + Quality Gateway:
    • Primary Care CAHPS
    • A1C control (% pts >9%), HTN control, Care Plan, Colorectal CA screening

Michigan Institute for Care Management and Transformation (MICMT) Upcoming Courses and Educational Offerings

MICMT (formerly MiCMRC) Care Management Educational Webinars

Title: Pediatric Asthma

Date and Time: Wednesday, June 26, 2019 at 2 pm

For details and registration: www.micmrc.org

MiCMRC Complex Care Management Course Registration: for course details and registration click here

MiCMRC Approved Self-Management Support Programs: to learn more please visit www.micmrc.org

The MiCMRC Patient and Family Engagement New eLearning Module Is Now Available!

MiCMRC has launched the eLearning module “Patient and Family Engagement”. Nursing and Social Work CE contact hour available. This new eLearning module is part of a series titled “Basic Care Management Program”. Full details available

at the Michigan Care Management Resource Center website www.micmrc.org Also, for Patient Engagement resources click here

Contact Us! How Can We Help? Supporting CPC+ POs and Practices in Michigan

The joint commercial CPC+ payers in Michigan are working together to support multipayer alignment with the University of Michigan. We advocate with CMS to emphasize the important role that POs play in supporting CPC+ and work with them as partners in the Michigan CPC+ community, work with all participating payers in Michigan to create consistency in payer policy and approach wherever possible, and work to remove roadblocks that practices and POs face in CPC+ implementation and operations. We are interested in your experience of what is going well and what your find challenging. Please contact the CPC+ Michigan Regional Convener, Diane Marriot (dbechel@umich.edu or 734 998 0390) at any time to share your ideas and experiences.

To be added to the distribution list for future editions, email MichiganMultipayerCPCPlus@med.umich.edu with “Please Add Me to the Michigan CPC+ Newsletter Distribution List” in the subject line