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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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Like the convenience of an instant PDF download but still want a hard copy of this book? Order both and save 35 percent!

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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