SustiNet Health Partnership

Medical Home Advisory Committee

Patient Centered Medical Home Committee Meeting by Webinar

February 24, 2010

Meeting Minutes

 Webinar Participants:  Ellen Andrews, Co-chair; Tory Westbrook, Co-chair; Jody Terranova; Dean Sperry; Maureen Smith; Ken Lalime; Richard Duenas; Jennifer Jaff; Laurie Cancialosi; Scott Wolf; James Stirling; Tanya Court; James Augur; Domenique Thornton; Evelyn Barnum; Lisa Cannella; Teresa Dotson; Robert Smanik

Office of the State Comptroller:  David Krause

Ellen Andrews opened the webinar by welcoming all participants.  Lee Partridge from the National Partnership for Women and Families gave a presentation on patient centered medical homes (PCMHs).  To access Lee’s presentation, click here.   

Ellen opened the discussion for questions, saying that Lee had mentioned that patient experience surveys done in MA aren’t working as a performance measure, and asking Lee to elaborate.  Lee said that the recognized standards tool, the group and clinician survey, isn’t widely used because it is very expensive.  Lee had previously mentioned an experiment using an all-payor approach, in this case using three health plans pooling their resources, pulling the sample from the entire caseload.  This would be the most accurate way to evaluate the success of the PCMH.  This would be a two step process of matching the PCMH participants’ practices with that data.

 Ellen said that NCQA accreditation requires tracking of patient satisfaction, and asked whether this was being done or not.  Lee replied that the NCQA recognition tool doesn’t have formal performance measures attached to it as their plan accreditation tool does.  The recognition tool will be reviewed beginning March 22^nd, and Lee said that suggestions are welcome, and should be submitted to the NCQA website.

James Stirling said that it seems that most PCMHs have a central payor, either an insurer or the state.  He asked how employers can contract directly with the PCMH system via their self-funded plan.  Lee answered that this would be done as a health plan is done, where criteria would be established for participating and financial incentives would be offered.  Usually employers use someone else to administer self-funded insurance programs.

Ellen asked if any health plans are measuring care coordination.  Lee said that there are very few, but that there are many people working to determine what would be a good measure of care coordination.  There are some care coordination measures currently going through the National Quality Forum process, but there not many. 

Ellen asked which states have good plans for medical homes.  Lee suggested looking at MN’s regulations, MA’s framework which contains good information on options and goals, and OK’s program, because they are functioning in an environment that’s not managed care, as a PCCM.  Lee also said that PA, VT and NC all have good programs.  Lee said that she would send Ellen some links so that she could examine state-by-state data.

Meeting was adjourned.