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Primary Care Transformation

Primary Care Transformation. PA 574: Health Systems Organization Session 5 – May 1, 2013. Why Primary Care?. At the nexus of levels of prevention Does secondary Overlaps with primary and tertiary Natural point for entering individual level care system

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Primary Care Transformation

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  1. Primary Care Transformation PA 574: Health Systems Organization Session 5 – May 1, 2013

  2. Why Primary Care? • At the nexus of levels of prevention • Does secondary • Overlaps with primary and tertiary • Natural point for entering individual level care system • Most “upstream” entry point for individual • Classic public/population health interventions have no individual “entry” point • Potential to leverage and connect the levels of prevention and care within and across a system

  3. What is Transformed? • About Primary Care Functions: • Not specific treatments • Not specialty of providers • Leading to orientation of systems • PC Functions (similar to PCPCH core attributes) • Usual Source of Care • First contact for new health conditions • Comprehensive care for the majority of health problems • Long-term person focused care • Care coordination across providers

  4. Is This Functional Orientation Unique? • Really about coordination(?) • Across individual conditions/states/needs • Across time • Across services • Across providers • Across systems • Really about basic organization/system functions and characteristics (as opposed to “health care”)?

  5. Is This Functional Orientation Unique? • Many programs with similar core function/coordination focus: • Program of All-Inclusive Care for the Elderly (PACE) – coordinated care program/home for elderly • Assertive Community Treatment (ACT) - coordinated care program/home for persons with severe and persistent mental illness • Chronic Care (CC) model - coordinated care program/home for persons with single/multiple chronic physical health conditions

  6. Questions Raised? • What is the limit of the scope of the PCPCH? • How does scope affect “fit” for average or specific person? • Relevance to individual • Ability to perform on cost and population health • Where should “home” be? • Case of behavioral/physical health care integration • How do we get PCPCHs to work with others and vice versa? • What do we need to do to make transformation successful?

  7. PCPCH EvaluationYour Professors at work (Wallace, Gelmon, Rissi) plus others from Providence CORE • Implementation of the PCPCH model – including PCPCH Program elements; the number and distribution of PCPCH clinics and clients served; and, barriers and benefits of the Program. • Fidelity to the PCPCH Model – including the number and tiered distribution of recognized PCPCH clinics, and consistency of PCPCH-designated clinic characteristics with the normative model. • Clinical Quality - including the selection of specific indicators from among those established by OHPR, and PCPCH clinics’ assessment and reporting of performance and clinical quality improvement. • Cost & Efficiency of Care - including baseline rates and trends in utilization patterns and costs which can be derived from administrative claims data. • Patient Experience of Care - including assessment of care satisfaction and experiences corresponding to PCPCH model core attributes. • Provider & Staff Experience - including perceptions of coordination, integration, and identification of key factors which influence PCPCH implementation.

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