PCMH Congress 2017

During this session, a large urban-based health system and a large statewide payer will present in tandem joint activities that support patient-centered care, patient experience, team-based approaches and reduction in costs. Steps to collaboration will be discussed and presented, enabling audience members to adapt and use in their clinical setting. (UAN 0850-9999-17-015-L04-P)

Learning Objectives

• Describe reports utilized to measure quality and utilization in the primary care setting
• List steps taken by the organizations to foster collaboration and enhance likeliness of success
• Identify strategies undertaken to stratify patient health risk from the provider and payer perspectives.

Advocate's ACO serves a wide geographic area that includes the seven counties, including Kendall, of greater Chicago as well as Central Illinois. Patient demographics and socioeconomics vary considerably from densely populated urban areas with a disproportionate share of Medicaid and uninsured, to suburban and rural areas that are generally more insured. The goal of the session is to understand how a large ACO and clinically integrated healthcare delivery system in the Chicagoland and Central Illinois region found value and return on investment through implementing NCQA's PCMH program. (UAN 0850-9999-17-028-L04-P)

Learning Objectives

• Learn how a large ACO and clinically-integrated healthcare delivery system found ROI through NCQA PCMH transformation of aligned independent primary care practices in a value-based environment

• Understand how to successfully scale NCQA PCMH clinical transformation throughout a large ACO primary care network

• Evaluate the impact of NCQA PCMH transformation through an analysis of quality performance from a robust clinical integration program