Incentive Working Group New Incentives Supporting Patient Medical

Incentive Working Group: New Incentives Supporting Patient Medical Home and Primary Care Network GPSC Summit April 16 th, 2018

In this presentation… • Background on Incentive Working Group • Panel Management Incentive • Draft PMH Practice Management Incentive

Presenter Disclosure • Dr George Watson – No commercial interests • Mark Armitage – No commercial interests

What does Incentive Working Group do? • Support GPSC’s Family Practice Incentive Program • Develop recommendations on new incentive fees or programs

GPSC members have told us… • Simplify incentive fees • Increase flexibility of incentives fees to support team-based care • Align incentives to support integrated models of care (e. g. PMH & PCN)

Supporting a foundational element of PMH and PCN: panel management • Compensation for front-end panel work • Ongoing compensation for ongoing panel management and data-informed QI

Panel Management Incentive Available later in 2018

PSP – Understanding Your Patient Panel • EMR tools for panel management • EMR tools for: Med Access, Wolf, Intrahealth, Osler (available now); Oscar (later in 2018)

PSP – Understanding Your Patient Panel • Past 18 months • In-practice support from Regional Support Staff – Application of EMR panel tools – Training/supporting clinic staff

Phase 1: Empanelment Phase 2: Initial Panel Clean Up Phase 3: Panel Optimization Phase 4: Datainformed QI (ongoing) Description: Physicians have an accurate and up to date list of “active” patients for whom they have been confirmed as the Most Responsible Provider. Panel size should be assessed to ensure balance of supply/demand for physician’s time. Description: Physicians have accurate and up to date disease registries for 35 chosen disease indicators on PSP UYPP tool. Description: Physicians have accurate disease registries for a total of 10 -15 indicators to support planned proactive care (e. g. recalls and/or care planning) based on needs of each disease registry. Clinic has dedicated time and has assigned roles for panel management. Description: Physicians are actively using their accurate registries as a basis for quality improvement activities using the PSP coaching framework. Est. timeframe to complete: 1 month Est. timeframe to complete: 2 -3 month Est. timeframe to complete: 6 -12 month

Commitment Phase 1: Empanelment Phase 2: Initial Panel Clean Up Phase 3: Panel Optimization Phase 4: Datainformed QI (ongoing) Description: GP demonstrates their commitment to undertaking the work of UYPP and to the Patient Medical Home model. Description: Physicians have an accurate and up to date list of “active” patients for whom they have been confirmed as the Most Responsible Provider. Panel size should be assessed to ensure balance of supply/demand for physician’s time. Description: Physicians have accurate and up to date disease registries for 3 -5 chosen disease indicators on PSP UYPP tool. Description: Physicians have accurate disease registries for a total of 10 -15 indicators to support planned proactive care (e. g. recalls and/or care planning) based on needs of each disease registry. Clinic has dedicated time and has assigned roles for panel management. Description: Physicians are actively using their accurate registries as a basis for quality improvement activities using the PSP coaching framework. Est. timeframe to complete: 2 -3 month Est. timeframe to complete: 1 month Est. timeframe to complete: 6 -12 month Panel Management Incentive One-time Payment Amount: $2000 Requirements: 1) Completion of PMH Assessment 2) Commitment to complete UYPP phase 1 -3 within 12 months One-time Payment Amount: $1000 Requirements: Completion of phase 1 and 2 PMH Practice Management Incentive One-time Payment Amount: $3000 Requirements: Completion of phase 3 Ongoing payment In development: seeking feedback at Summit

PMH Practice Management Incentive Draft – Seeking feedback at Summit

What is the PMH Practice Management Incentive? • Ongoing quarterly payments to eligible GPs for ongoing PMH development and management work

What are eligibility requirements? • Complete PSP’s Understanding Your Patient Panel Phase 3 • Commit to 12 PMH attributes • Commit to PCN (when PCN is available)

Payment Amounts? Tier 1 - ≈$4000 per year or ≈$1000 per quarter • Ongoing panel management • Ongoing management of patient medical records • Data informed practice improvement

Payment Amounts? Tier 2 - ≈$12, 000 per year or ≈$3000 per quarter (tier 1 $4000/yr + tier 2 $8000/yr) • • • Ongoing tier 1 activities Team-based care Patient centered care Timely access PCN participation

Payment Amounts? • Adjusting payment amounts by panel size and complexity

Getting your feedback…