Rob Gaslin, Controller SAMC-Baker City

Patient Centered Primary Care Home

02/18/2014

Baker City, Oregon

SAHS Strategic

Plan

Location – Frontier Designated County Population – 16,210 Size – 3,068 sq miles Interesting fact:

• Home to the largest pure gold nugget ever found

Saint Alphonsus Medical Center – Baker City

SAHS Strategic

Plan

Member of CHE/Trinity Health Critical Access Hospital/RHC’s/Nursing

Home Owned Clinics

• EMR installed 7/2011• PCPCH certified 10/2012 and 6/2013

Under 2011 criteria Reapplied for tier 3 status 2/14 under 2014 criteria

2011 to 2014 Application

Baker Clinic certified as PCPCH tier 2 under 2011 criteria

Baker Clinic reapplied as PCPCH tier 3 under 2014 criteria

Valley Medical Clinic certified as PCPCH tier 3 under 2011 criteria

2014 criteria add significant number of standards• Longer application• More opportunities

Scoring

Tier 1: 30-60 points and all 10 must-pass measures

Tier 2: 65-125 points and all 10 must-pass measures

Tier 3: 130 or more points and all 10 must-pass measures

PCPCH Core Attributes

SAHS Strategic

Plan

#1 Access to Care• A. In-Person Access• B. After Hours Access• C. Telephone & Electronic Access• D. Same Day Access• E. Electronic Access• F. Prescription Refills

PCPCH Core Attributes, cont.

SAHS Strategic

Plan

#2 Accountability• A. Performance & Clinical Quality• B. Public Reporting• C. Patient and Family Involvement in Quality

Improvement • D. Quality Improvement• E. Ambulatory Sensitive Utilization

PCPCH Core Attributes, cont.

SAHS Strategic

Plan

#3 Comprehensive Whole Person Care• A. Preventative Services• B. Medical Services• C. Mental Health, Substance Abuse, &

Developmental Services• D. Comprehensive Health Assessment &

Intervention• E. Preventive Services Reminders

PCPCH Core Attributes, cont.

SAHS Strategic

Plan

#4 Continuity• A. Personal Clinician Assigned• B. Personal Clinician Continuity• C. Organization of Clinical Information• D. Clinical Information Exchange• E. Specialized Care Setting Transitions• F. Planning for Continuity • G. Medication Reconciliation

PCPCH Core Attributes, cont.

SAHS Strategic

Plan

#5 Coordination & Integration• A. Population Data Management• B. Electronic Health Record• C. Complex Care Coordination• D. Test & Result Tracking• E. Referral & Specialty Care Coordination• F. End of Life Planning

PCPCH Core Attributes, cont.

SAHS Strategic

Plan

#6 Person & Family Centered Care• A. Language/Cultural Interpretation• B. Education & Self-Management Support• C. Experience of Care• D. Communication of Rights, Roles and

Responsibilities

External Resources

The EOCCO has fully embraced the PCPCH as the foundation or cornerstone of frontier health transformation. • EOCCO has been very quick to remove barriers

to proper, cost-effective care

Baker County Complex Care Continuum• Hospital, Clinics, Sherriff, Police, Mental Health• Next step – expand model for Medicaid

Incentive Payment

PCPCH Tier 2 PCPCH Tier 3 EOCCO & Providence Health Plan

Effects

Questions?

Thank you!