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This Brave New World of Healthcare Reform

by Trish J. on 4/25/2016 7:30:45 PM

 What we’re experiencing in our country today with regard to healthcare delivery system redesign and payment reform is unprecedented. Last week, The Center for Medicare & Medicaid Services (CMS) announced the launch of the Comprehensive Primary Care Plus (CPC+) program, its largest-ever initiative to transform and improve how primary care is delivered and paid for in America. CPC+ is the next phase of the Comprehensive Primary Care (CPC) initiative that has been underway for nearly three years. It will bring together Medicare, commercial insurance plans, and State Medicaid agencies to provide continued financial support for practices to make fundamental changes in their care delivery and advance the transition from fee-for-service models to value-based care. The engagement of these stakeholders has been, and will continue to be, integral to creating successful and sustainable change.

An “all-in” approach

Government and commercial payers are engaged. Medical practices are also investing time and effort to redesign the delivery system, and hospital systems - which own more than 60% of medical practices today - are engaged as well. The other key stakeholders in this unfolding story are patients and employers. They are two of the three payers in our healthcare system, along with Medicare/Medicaid. As a patient, I’m a consumer of services. As an employer with a company-sponsored health plan, HealthTeamWorks is a payer. On both sides, the ever-increasing healthcare cost burden is unsustainable, and consumers and employers are demanding change; that is, improved quality, better coordinated care, better patient experience, and lower costs.

Engagement by ALL stakeholders is driving momentum like I’ve not seen before in my 25 years working in healthcare. This time, it’s not just CMS-driven payment reform like it was in the days of managed care and capitated prospective payments to providers. They were both failed government attempts to reform the payment system without investing in systemic redesign of the way care and information are delivered.

Why this time is different

What’s different today is that the government is not only investing in payment reform but is also shifting the focus of the delivery system to population health management as a key ingredient for change. It’s a heavy lift and I believe it has a great chance of working. The New England Journal of Medicine recently studied two-year quality and cost results for the CPC program. The improvements observed in access to care and care management of high-risk patients are evidence that this is a work in progress, and I believe that improvements to date from the CPC pilot will pale in comparison to the greater improvements that will occur over the next three years; even more so with the implementation of CPC+. The return on stakeholders’ investments should be substantially greater in the post-pilot years ahead.

I think CMS leaders agree, as evidenced by their expanded investment in the CPC+ program and many other current Center for Medicare & Medicaid Innovation (CMMI)-funded initiatives like the State Innovation Model (SIM) and Transforming Primary Care initiative (TCPi). These programs are foundational investments in delivery redesign and payment reform. And although the results are not significant in terms of bending the cost curve just yet – that outcome will occur more quickly and dramatically as we advance toward the Medicare milestones for shifting to value-based payments under the MACRA/MIPS framework in 2017-2019. The takeaway here is that the short-term results should motivate us to keep working toward the long-term results.

Key threats to success

There are many who disagree with this approach and my enthusiasm for it. I share their concerns, particularly to the extent that we won’t see the results we’re working toward if we don’t: 1) make the simple changes to better coordinate and integrate patient care in our healthcare delivery system; 2) effectively address the complex social determinants of health at the community and national levels; and 3) achieve greater activation of healthcare consumers in accepting responsibility for their personal health status. These are three key elements among the many crucial pieces of the puzzle that define sustainable change toward better healthcare, better health and the solvency of Medicare and Medicaid for future generations of Americans.


Accountable Health Communities Model to Link Clinical and Social Services

by Heather W. on 1/27/2016 1:53:00 PM

The CMS Innovation Center has launched the Accountable Health Communities Models, a pilot program designed to screen Medicare and Medicaid beneficiaries for health-related social needs, the U.S. Department of Health and Human Services has announced. It's designed to bridge clinical- and community-based services, helping to make underprivileged patients with unmet health-related social needs better aware of the clinical services available in their area. Read more here.


Working Together to Transform Healthcare: It Takes A Region

by Heather W. on 1/12/2016 1:46:00 PM

HealthTeamWork®’s Marjie Harbrecht, M.D. writes on the challenges facing stakeholders during this pivotal "transition period" in healthcare transformation.  To effectively move forward, we'll need comprehensive initiatives that are built on a shared vision, with common approaches for delivery system redesign, common quality measures, methods for data sharing, value-based payment models and consumer engagement. Read more here.


Where We'll Be Next in 2016

by Heather W. on 1/6/2016 1:42:00 PM

January 29, 2016 – Colorado Transforming Clinical Practices Initiative Learning and Networking Event. Denver, Colorado
February 1, 2016 – Colorado TeleHealth Consensus Conference. Brighton, Colorado
February 4, 2016 – Independent Providers Association Annual Meeting. Fort Collins, Colorado


Even Manning Needs Coaching, by David Ehrenberger, MD

by Heather W. on 7/31/2015 12:07:00 PM

When Peyton Manning was recently questioned about his ability to be coached by new Broncos head coach, Gary Kubiak, the record-holding NFL quarterback simply stated, “I love being coached.” He went on to say that he was looking forward to learning Kubiak’s philosophies, and enjoys asking questions and continually learning. His response struck a chord with me to think that one of the most decorated and successful quarterbacks in history still relies heavily on coaching to stay on top of his game and continue developing his skills.
The culture of football is one where coaching is the norm. In fact, it would be very strange for any sports team not to have a coach. As primary care physicians, we’re trained early on by our professors and “coached” through residency, but once given the seal of approval to practice medicine on our own, we tend to take on the role of leader and coach for our practice and staff.
This model has served us well for many decades. However, we’re embarking upon a new era of healthcare where we’re being asked to change the way we practice medicine and demonstrate the quality and value of care we’re providing to our patients. As we move into this new phase of healthcare, I believe we can all use a little coaching.
That’s where leaders like Marjie Harbrecht, MD, who recently stepped down as CEO of HealthTeamWorks® after 18 years of service, have been instrumental to primary care practices. As physicians, we’re trained to diagnose and treat symptoms. But we need coaches like those on the HealthTeamWorks® staff who are well-versed in practice transformation to help us implement – and most importantly, sustain meaningful changes in the way we practice medicine. Changes that help us run a good business, effectively treat chronic diseases, and coordinate patient care.
Under Harbrecht’s leadership, HealthTeamWorks® was the first in the nation to pilot a Multi-payer, Multi-stakeholder Patient-Centered Medical Home (PCMH) program. The work was revolutionary because Dr. Harbrecht was able to bring together a group of unusual suspects – payers, providers, public health, health systems, and state agencies – to develop consensus on an approach to transform care and figure out an effective way to pay for it.
The Multi-payer project helped lay the groundwork for more rapid, widespread transformation efforts in future years. This project and many others across the nation resulted in various how-to guides to implement medical homes that providers and payers can use as a blueprint for change. But since old habits die hard, to be successful long-term, practice groups must continue to improve beyond simply checking off the boxes of a list of PCMH to-dos. That’s where on-going coaching services like HealthTeamWorks® provides will become more and more essential to ensure practices truly ingrain the culture of transformation in their practice.
I want to personally thank Dr. Harbrecht for her leadership and vision to take HealthTeamWorks® from where they started as Colorado Clinical Guidelines Collaborative to where they are today. I’m also excited for their future with new CEO, Bert Miuccio, taking the reins. Bert joins HealthTeamWorks® not only with a strong foundational background and understanding of PCMH and practice transformation, but also with skills in business development that can help HealthTeamWorks® continue to grow to meet the needs of providers in Colorado and across the nation.
Continual coaching is a concept that I hope my fellow practitioners begin to adopt into practice. I believe it’s necessary not only for us but also for our patients to thrive in the future. 


Where can we connect next?

by Kristen D. on 9/9/2014 8:05:23 AM

HealthTeamWorks is excited for the large line-up we have planned for this fall. We're traveling coast-to-coast to educate and connect with organizations looking to invest in proven quality improvement work to achieve Triple Aim objectives and get measurable results. We will be in more than 15 states this fall for national and regional conferences, including:

  • Inovalon Client Congress (Washington, DC)

  • NAACOs Fall Conference (Washington, DC)

  • Vail Engaging Communities in Education and Research Conference Conference (Vail, CO)

  • NRHA Critical Access Hospital Conference (Kansas City, MO)

  • MGMA Annual Conference (Las Vegas, NV)

  • ACO Leadership Conference (Nashville, TN)

  • AMGA Quality Leadership Annual Conference (New Orleans, LA)

  • PCPCC Annual Conference (Washington, DC)

  • STFM Conference on Practice Improvement (Tampa, FL)

  • IHI Annual QI Forum (Orlando, FL)

What educational resources could HealthTeamWorks develop to make your QI work easier? How can we support your organization to better manage the health of your patient population as you continue to grow your integrated communities of care? Reach out to us to schedule a call or in-person demo at one of these conferences.


HealthTeamWorks Co-Hosts First PCPCC Western Regional Conference

by Kristen D. on 7/16/2014 12:12:24 PM

Last month, HealthTeamWorks was proud to co-host the PCPCC Western Regional Conference with the Patient-Centered Primary Care Collaborative (PCPCC) and the Colorado Academy of Family Physicians  (CAFP). The three organizations welcomed more than 340 medical home professionals to Denver for a two-day intensive conference on the impact, opportunities and challenges of the medical home model of care.

This first-ever PCPCC 2014 Western Regional Conference, "Health Care Transformation: Overcoming Challenges to Reach the Summit," -- offered participants panel discussions and workshops focused on the critical role of patient-centered primary care in achieving delivery system reform. In all, participants from more than 20 states in the United States and Canada were challenged to expand their notions of what success has been achieved and will look like in the future for the PCMH model. 

The conference included opening remarks by HealthTeamWorks CEO, Dr. Marjie Harbrecht and HealthTeamWorks-coached physician, Rick Budensiek, DO. And closing remarks by Dr. Harbrecht and HealthTeamWorks Board of Directors President Dave Ehrenberger, MD.  

Keynote presentations featured New York Times bestselling author T.R. Reid delivering a synopsis of his book, The Healing of America, and University of California at San Francisco School of Medicine Chair of Family and Community Medicine, Dr. Kevin Grumbach, explaining some of the statistical support for a team-based model of care. 

We are pleased to have collaborated to provide such outstanding educational and networking opportunities for some of the community's greatest contributors. With such a thought-provoking inaugural conference, we're excited to have set a high standard for future PCPCC Western Regional conferences. 

To view pictures from this conference, follow us on Facebook.


Where Are We Next?

by Kristen D. on 5/20/2014 5:58:34 AM

LAKEWOOD, COLO. - As spring begins to draw to a close, HealthTeamWorks is encouraged by the great start to the year we've experienced. Our regional directors, program managers, coaches and CEO have met individuals interested in improving the cost, quality and clinical outcomes in their practices from the dozens of conferences they've spoken at, and workshops and learning collaboratives they've hosted across the country. We've been overwhelmed by the volume of people we've met who are not only eager to improve the outcomes seen in their practices, but they're also motivated to make changes to improve the satisfaction of their physicians, staff and patients. We couldn't agree more!

Here at HealthTeamWorks we are focused on providing our clinical transformation clients a summer packed with access to our staff and opportunities to improve their mastery of our methodology. In addition to our hands-on site visits, we're preparing to host three learning collaboratives for our Colorado-based programs this summer. These multi-day workshops are modeled after the Institute for Healthcare Improvement (IHI)’s breakthrough learning collaborative series and allow participating practices to grow through an “all teach, all learn” approach to training.

In addition to our high-touch interaction with our clients, HealthTeamWorks is expanding the reach of our clinical transformation solutions to organizations outside of our current initiatives, HealthTeamWorks is excited to be hosting two events which are open to the public.

May 29-30, 2014: Intensive Training for Care Managers in Primary Care In response to high demand, HealthTeamWorks is pleased to announce its newest training program to improve efficiency in the management of high-risk patients. Our two-day, in-person, Intensive Training for Care Managers in Primary Care is designed for new or licensed (RN, SW, NP, PA) care managers in primary care. This introductory care management training will provide an overview in how to create a care management program in primary care, as well as sample tools and resources needed to launch the program.

For more information, read here.

June 8-10, 2014: 2014 PCPCC Western Regional Conference
In conjunction with our partners the Colorado Academy of Family Physicians (CAFP) and the Patient-Centered Primary Care Collaborative (PCPCC), HealthTeamWorks is pleased to welcome hundreds of health care professionals for the first-ever PCPCC 2014 Western Regional Conference. This 1 1/2 day conference will take place at the Hyatt Regency Denver Tech Center and offer participants the opportunity to participate in panel discussions and workshops that will focus on the critical role of patient-centered primary care in achieving delivery system reform.

For more information, read here.


It was a busy spring! Did we see you at any of these national conferences?


Colorado practices benefit from in-office support to improve patient care and efficiency with funding from the Colorado Health Foundation

by Kristen D. on 12/9/2013 8:29:10 AM

LAKEWOOD, COLO. - HealthTeamWorks is now accepting applications for the 2014 installment of our PCMH Foundations program after receiving a generous grant from the Colorado Health Foundation.

The grant, which will provide practice transformation coaching to more than 100 Colorado practices free of cost, supports a program starting in January of 2014.

In an effort to provide support to those practices early on in their transformation while also providing advanced curriculum to practices across Colorado already on their transformation journey, the program will encompass two parts.

A continuation of the current PCMH Foundations program will continue to lay the groundwork for practice transformation of new practices and those still early on in their journey to practice transformation. A more advanced Innovations program will expand on pre-established concepts and continue support for many practices who are looking to achieve the Triple Aim. 

New practices will master the basics of the Joint Principles of PCMH, a document established in 2007 through the collaboration of four national healthcare organizations, including the AAFP and AAP, while previous and already advanced practices will expand to more complex topics like integration of behavioral health and patient activation.

"HealthTeamWorks is excited to be able to continue serving the practices here in Colorado with which we have built a strong relationship, but we are eager to begin teaching on a larger scale this advanced curriculum we have been developing," said PCMH program manager Amber Carlson.

Applications will be accepted through the end of the year and organizations interested in these free services to enhance value and quality of care should contact Amber Carlson for more information at 303-446-7200 or jkleppe@healthteamworks.org

More information on the program:

To apply for PCMH Foundations, please click here.


HealthTeamWorks Releases Innovative Pregnancy-Related Depression Guideline Supplement

by Kristen D. on 10/15/2013 4:48:47 AM

HealthTeamWorks and the Colorado Department of Public Health and Environment (CDPHE) are pleased to present a new guideline supplement on Pregnancy-Related Depression (PRD), which can be found on our website. This resource supplements the widely-used Depression Guideline.

PRD is a mood disorder that occurs during pregnancy or up to one year postpartum and is the most common complication of pregnancy among women in Colorado. A condition that can adversely affect the health of the woman, developing fetus and baby, PRD is either not detected and/or inadequately treated too often. 

Areas covered in the one-page supplement include

  • Risk and protective factors specific to pregnancy-postpartum;

  • Distinguishing “baby blues” from PRD; 

  • Cross-cultural considerations;

  • Suggested approaches to conversations about depression;

  • Preparing your practice to provide effective PRD care;

  • Screening considerations;

  • Other psychiatric diagnoses and common co-occuring conditions (such as tobacco and alcohol use);

  • Shared decision-making about treatment; and,

  • Options for managing PRD.

Multiple treatment options are outlined in the supplement, including lifestyle (important for all women to prevent and improve depression), mental health services and medication. 

HealthTeamWorks and CDPHE will continue their collaboration in 2013-2014 to implement the PRD supplemental guideline in diverse settings around Colorado. The implementation phase will include efforts to identify and promote mental health and community and resources to improve care for women with PRD.

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