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With the advent of the medical neighborhood, care coordination is no longer the sole domain of the primary care practice (PCP) but a responsibility shared among all providers that touch the patient.
But how to formalize co-management of patients by PCPs and specialistsin a way that both assures efficient delivery of high-quality healthcare and addresses the 'pain points' of each provider group?
Care Compacts in the Medical Neighborhood: Transforming PCP-Specialist Care Coordination describes WellPoint's efforts to clearly define these roles and responsibilities: the testing of care compacts in its Patient-Centered Specialty Care (PCSC) program.
In this 2014 venture, WellPoint has recruited 20 progressive specialist practices to work with its established patient-centered medical home practices to test the use of care compacts as a means of bridging primary care-specialist collaborations.
In this 25-page resource, Robert Krebbs, director of payment innovation at WellPoint, Inc., describes how the care compact, adapted from a Colorado System of Care/Patient-Centered Medical Home (SOC/PCMH) template, addresses such care coordination concerns as communications, referrals, patient handoffs, and more.
This HIN special report provides details on the following:
and much more.
- Selection criteria for participating specialties;
- WellPoint's three-part scorecard to evaluate care coordination, quality and appropriateness of care in the PCSC program, as well as future scorecard goals;
- The tiered savings incentive approach supporting PCSC and anticipated evolution of the reimbursement model;
- Templates for care coordination agreements and strategies for addressing 'pain points' from provider group perspectives, including specifics around patient referrals, provider communications, and more;
- Engaging specialists in the use of care compacts and the role of care coordination;
- Best practices and suggested add-ons for care compacts and referral agreements;
- Tools, education and learning collaboratives to support the use of care compacts;
- Future plans for the Patient-Centered Specialty Care program;
Care Compacts in the Medical Neighborhood: Transforming PCP-Specialist Care Coordination underscores how care compacts, also known as care collaboration agreements or referral agreements, are helping to construct a framework for care coordination within a medical neighborhood.
Table of Contents
- Care Compacts: Forming the Foundation of PCP-Specialist Care Teams
- Introducing Patient-Centered Specialty Care
- Limited PCSC Rollout
- Tiered Savings Approach
- The PCSC Scorecard
- Components of Care Coordination
- Defining Care Compacts
- Template for Collaborative Care Agreements
- Engaging Specialists in Care Compacts
- Opportunity to Address Primary Care, Specialist ‘Pain Points’
- Furthering Care Coordination in the Medical Neighborhood
- Best Practices in Referral Agreements
- Add-Ons to Care Compacts
- Education and Engagement
- Lessons Learned and Early Feedback
- Q&A: Ask the Experts
- Participant Selection Criteria
- Estimated Savings from Care Compacts
- Primary Care Practice Sign-On
- Future Specialty Participation
- Practice Care Coordination Capabilities
- Care Compact Best Practices
- Sharing Savings Between PCPs and Specialists
- Non-Financial Rewards and Incentives
- Conditions Conducive to Care Compacts
- Care Compact Challenges for Practices
- Including Champions in Care Compacts
- For More Information
- About the Speakers