MiPCT/CTC Overview:Member List Distribution Option for POs

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Agenda

1. Partnership Description

2. Member List Enhancements: CTC “Spotlight” Preview

3. Timing and Expectations

4. Next Steps

5. Q & A

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PARTNERSHIP

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Partnership Description

• Opportunity (option not a requirement) for POs to participate

• Attempt to reduce the administrative burden on POs and to allow them to focus their efforts on supporting the provision of team-based care within their practices

• No fee to PO for participating (covered in the MiPCT administrative budget)

• POs that participate would continue to receive their member list and other products from the MDC as well as any future MDC reports

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Parternship Description2013 Patient List Improvements

CTC distributes list directly to Care

Managers (with copy to PO)

MDC distributes single list containing Medicare, Medicaid , BCBSM, and

BCN members

MDC provides POs with access to lists

Improvements w/MiPCT CTC Partnership

NEW CTC/MiPCT Member List

Option (per PO consent) for direct list distribution to

Care Managers (POs would still receive full list

from MDC)

PO distributes list to Care Managers

OR

And MDC provides POs with access to

lists

NOW:

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Partnership Description - PO Benefits

• What’s in it for POs

– Reduced PO admin burden and cost

– More timely distribution to care managers with ADT feeds where available

– More user-friendly format for Care Managers (red, yellow, green coding, etc.)

• What Do POs Get?

– Upon PO agreement and consent to participate:

• Direct distribution (with up to three ADT feeds where available) of member lists to care managers to optimize their ability to appropriately identify and service patients with care management.

• POs maintain access to the same information, etc.

• “First come, first served” opportunity (anticipated that POs who participate early may be advantaged in terms of the link to increasing G and CPT code volume.)

• What is the Cost to POs

– No charge to POs

– Absorbed within MiPCT budget

• Target Timing

– CTC Spotlight/Member Lists available to consenting POs and care managers in July 2013

– ADT feed to follow as Phase 2: Exact Timing TBD

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Partnership Description - Care Manager Benefits

• What’s in it for Care Managers

– No Longer waiting for list distribution from PO

– ADT Alerts where available

– More user-friendly format for Care Managers

• Risk Levels (red, yellow, green)

• High Deductible Health Plan

• Easy identification of New and No Longer Eligible Patients

• What Do Care Managers Get?

– Immediate Access to Member Lists

– Sort and Filter Member Lists based on Key Data Elements (i.e. Risk Level, Diagnosis and Payer)

– Print Member List as needed

• Target Timing

– CTC Spotlight/Member Lists available to consenting POs and care managers in July 2013

– ADT feed to follow as Phase 2: Exact Timing and Extent of ADT Feeds TBD

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MEMBER LIST ENHANCEMENTS:CTC SPOTLIGHT PREVIEW

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Phase 1: MiPCT Member Lists via CTC Spotlight

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Phase 1: New Member Alerts via CTC Spotlight

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Phase 2: Admission/Discharge Alerting

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Data Security

• External security audit review performed in 2012 with CynergisTek and subsequent review planned for 2013 upon CTC Version 2 rollout completion

• Annually CTC undertakes:

– Risk analysis of the company, our processes, assets, applications, data (under a NIST 800-30 based risk management program)

– Review of all our policies and BAAs internally and with lawyers

– Disaster recovery test

– External network/application security tests

• Work with Healthcare Law Consultancy (CTC) to address new HIPAA omnibus regulations (September 2013)

– Policies in place and updated as HIPAA regulations change to address things such as security breaches including notification to affected parties.

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TIMING AND EXPECTATIONS

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Phase 1: Timing and Expectations

• Pre-Launch Product Refinement• Addition of HDHP Indicators

• Testing by clinical user expert panel of care managers

• PO Launch Recruitment• May 31 and June 5: Overview webinars

• By June 17: Responses from POs to participate in Launch

• By June 30: Convene user group and PO setup

• Phase 1: “Go Live”• July 2013 target date

• User support and testing/refinement to continue

• Collect user feedback in 360 degree feedback with CTC

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Phase 2: Timing and Expectations

• Partner with MiHIN to leverage State HIE– Spectrum Health ADT Feed

– Trinity ADT Feed

– more to come as available

• Leverage experience with MiHIN/CareBridge Spectrum feed

• Attempt to prioritize ADT feeds of most value to MiPCT practices

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PO CTC Leads Responsibilities

• Each PO who participates in the MiPCT/CTC partnership for member list distribution will be able to designate two people who will serve as the PO CTC Leads.

• Leads serve an important role in the partnership and:– Provide CTC with information about which Care

Managers (and associated practices) that lists should be available for (at launch and afterwards in continuing operations)

– Are involved in product and user testing

– Coordinate training, provide user feedback, and desired improvements

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Next Steps

• Submit Registration Form for participation in the launch by June 17th

– POs in the launch set will participate in user acceptability testing prior to the Go-Live date (July member list distribution).

• POs who wish to join later will be able to do so at a later point. Details and timing will be released about this option after the launch set’s needs have been accommodated

• If you have additional questions after the webinar, please send them to mipctdemo@michigan.gov

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Q & A