Michigan payers have agreed to include common PCMH metrics in their incentive programs.
2010: Extended access, e-prescribe, and registry use.
2011: Extended access, e-prescribe, registry use plus emergency department utilization.
The registry or EMR system must have built in decision rules and performance reporting
for at least one clinical measure.
Each health plan applies the metrics through its own contracting and incentive programs.
The four part white paper series “Primary Care is in Crisis”, created by four MPCC taskgroups, was released in spring of 2009. The series identifies factors contributing to the primary care crisis, possible solutions, and recommendations for actions MPCC might take.
MPCC leadership review the recommendations in the white paper series and identified several as top priority for MPCC action during 2009 and 2010. Work groups were created to design and implement action plans for the top priority objectives.
1. HIT Implementation. Chaired by Dr Ernest Yoder, MD. The work group created a HIT
Implementation Handbook and an HIT Interest Group on LinkedIn. For instructions on
joining the LinkedIn group click here.
2. PCMH Change Package/Toolkit. Chaired by Carolyn Mickiewicz. This group created
a PCMH Toolkit.
3. Self Management Support for Primary Care Practices and Consumers. Chaired by
Stacey Hettiger. This group created a Self-Management Support Toolkit for primary
care practices
4. PCMH Spread. Chaired by Dr. Lawrence Abramson, MD. This work group worked to
define the types of supports practices need in order to transform to PCMH.
5. Primary Care Workforce State Plan. This group worked to develop a State plan for
primary care workforce.
Click here for the Priorities Committee's 2010 Report.
Michigan IPIP was a primary care practice transformation program in effect from 2008 through June 2010 that combined participation in learning sessions with on-site coaching in order to implement components of PCMH and effective chronic illness care. The coaches, quality experts recruited from industry, assisted practices in four key areas:
1. Use of a registry to identify patients with diabetes/asthma prior to the visit.
2. Use of condition-specific decision support tool (e.g., a visit planner)
3. Creation of a customized flow diagram and protocols to standardize the care process.
- Use nursing standing orders to increase reliable execution.
- Use a standard protocol.
- Assign specific care team roles (who does what in the protocol).
- Conduct frequent monitoring of protocol use.
4. Educate patients in self-management and support their efforts.
Components of IPIP will be carried forward in other practice transformation projects in Michigan.
Click here for additional information.
Click here for a description of the IPIP project, outcomes and lessons learned.
Click here for the IPIP Evaluation Report.
Michigan Definition of Patient-Centered Medical Home (PCMH)
In 2008, Michigan health plans, insurance companies and primary care professional associations met a few times to create a common basis for approaching PCMH in the State. The group
1. Reached concensus on a MI Definition of PCMH consisting of the Joint
Principles of the Patient-Centered Medical Home with four Michigan -specific
footnotes.
2. Charged a metrics taskgroup with recommending a core set of PCMH metrics.
Their work informed the payers group which met subsequently (see above).
page updated 2/7/2011