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Care Compacts in the Medical Neighborhood: Transforming PCP-Specialist Care Coordination
Care Compacts in the Medical Neighborhood: Transforming PCP-Specialist Care Coordination
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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 specialists—in 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:

  • 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;
and much more.

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
  • Glossary
  • For More Information
  • About the Speakers
Publication Date: July 2014
Number of Pages: 25
ISBN 10: 1-941329-20-9 (Print version); 1-941329-21-7 (PDF version)
ISBN 13: 978-1-941329-20-7 (Print version); 978-1-941329-21-4 (PDF version)
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