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READY BY 2014:CLINICIAN CAPACITY SURVEY HIGHLIGHTS
Presentation for CSRHA Annual ConferenceNovember 16, 2011
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Co-facilitators:
Casie Parrish, M.P.A., Administrative Coordinator, WCN
Lyman Dennis, MBA, PhD, CPHIMS, HIMSSPrincipal, Eldorado Consulting
Charla Parker, M.P.A.Presenter, CEO, WCN
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Survey Objectives
Survey Highlights
“Think Tank” Solutions – Attendees1. Physician Recruitment & Retention2. Preparing for P4P3. Improving PCP/Specialty Care Communications
Summary and Next Steps
Participation Map
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Study Goal:To identify the capacity of safety-net providers to take on newly insured patients according to standards set under the Affordable Care Act and to utilize that information to develop technical, educational and funding assistance programs.
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Kaiser Permanente Southern California Community Benefit
Kaiser Permanente National Community Benefit
Study Sponsor
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Survey Partners in CA
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Arizona Association of Community Health Centers
Great Basin Primary Care Association
Survey Partners in AZ and NV
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What did we learn?
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Clinicians Are Eager to Express Their Opinions
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Clinicians Hate to Complete Surveys
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Nevada◦ 17 started and all completed survey
Arizona◦ 11 started and 7 completed survey
California◦ 29 started survey and 13 completed
◦ Nearly all were from rural communities
Survey Responses: 57 total
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Ability to take new patients into panel?
Yes responses:a. 50-60%b. 60-70%c. 70-80%d. 90-100%
What do you think they said?
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Provider Ability to Increase Patient Load• AZ 85.7%• NV 93.8%• CA 93.3%Physical Office Capacity to Increase• AZ 100%• NV 87.5%• CA 100%
Clinicians’ Perspective on “Ready by 2014”?
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Clinician Perception of Ability to Add 25% More Patients
26.83% Not Ready 23.08% Not Ready
39.02%
31.71%
17.07%
4.88%7.32%
Increase your registered patient population by
25% - % Roll Up
12345
53.85%
15.38%
15.38%
7.69%
7.69%
Increase your registered patient population by
25% - % CA
12345
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Perception of PCMH Readiness
Not Ready 9.76% Not Ready 0%
34.15%
41.46%
14.63%
2.44%7.32%
Be fully certified as a PCMH
% Roll Up
12345
38.46%
38.46%
23.08%
Be fully certified as a PCMH - % CA
12345
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Perception of Ability to Enter into ACO Contracting Relationship
Not Ready 26.83% Not Ready 23.08%
19.51%
26.83%
26.83%
14.63%
12.20%
Enter into an ACO contracting relation-
ship % Roll Up
12345
15.38%
23.08%
38.46%
23.08%
Enter into an ACO contracting relation-
ship % CA
12345
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Recruitment and Retention of Clinicians
Improving Communications Between PCP’s, Specialists, Hospitals, etc.
Participating in Pay-for-Performance Programs
Top Critical Issues
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Provider Recruitment & Retention
#1Critical Issue
Degree of Challenge:
Extreme33.33%
Considerable 41.67%Moderate 16.67%Low 2.78%None 5.56%
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More Pts. – Not Enough PCP’s
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How to see more patients with reduced$’s?
#2:Participating in Pay-for-Performance Programs
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*Better Care
*Better Health
*Lower Costs
The 3-PART AIM:
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Workflows before implementing EHR are different from those after
EHR adoptionPractice Manager
Practice Manager
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Workflow Redesign for Increased Efficiency◦ Reduces Cost
Panel Management for Patient Centered Access◦ Provides Better Care
Population Care Management for Improved Health Outcomes◦ Provides Better Health for the Community
Practice Management Coaching
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Improving Communications Between PCP, Specialists, Hospitals & Ancillary Providers
No. 3 Optimizing EHR Critical Issue
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The Past Information System
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Potential for Real Time Health Information Exchange
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Real time data creates opportunity for shared decision making between provider and patient
According to an IOM report, uninformed patients spend 40cents per dollar more on unnecessary care and less-involved patients often demand unwarranted tests and treatment because they don’t know about varying risks and benefit
Shared Decision Making
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How do we move from past to present to the future integrating all of the new Ready by 2014 “guidelines”?
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Convene in small groups – 5minutes1. Assign a discussion leader2. Assign a recorder3. Assign a reporter Identify challenges faced with your topic – 5 minutes
Identify innovations that are overcoming those challenges – 30 minutes
Chose one innovative practice to share with larger group – 10 minutes
Report back out at the end of 50 minutes
Assignment for “Power Dating” Break-outs
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Attendee’s ShowcaseInnovations
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Conclusion Summary of Break-out Reports Next Steps
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Opportunities for the Future of Improved Financial & Clinical Performance
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UCSF Practice Management Facilitation◦ 2 scholarships available: No. and So. CA
Practice Based Research Opportunities◦ Application of Predictive Analytics in PCP Office◦ Colorectal FLU-FIT Best Practices Project◦ Other topics being developed
Ongoing Peer Support and Networking New CMO Boot Camp
◦ April 22, 2012 Las Vegas
WCN Current Program Offerings:
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Survey Summary & Best Practices Resources Will be posted on WCN website
www.westerncliniciansnetwork.net or contact Charla Parker, MPA at (530) 383-5030
[email protected] Casie Parrish, MPA at (916) 993-7770 x3670 [email protected] Lyman Dennis, MBA, PhD, CPHIMS, FHIMSS [email protected]
Resources and References
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With Special Thanks toThomas Bodenheimer, M.D. Associate Professor, UCSF Center for Excellence in Primary Care