SAMA Healthcare Services El Dorado, AR 21,000+ active patients EMR - - PowerPoint PPT Presentation

SAMA Healthcare Services

 El Dorado, AR  21,000+ active patients  EMR  Allscripts Professional EHR  Open extended hours and

weekends

 Technologically advanced  Same day appointments

available

 Full Service: Lab, X-Ray, CT,

US, Bone Density, MRI, Allergy Clinic, and Pharmacy

• n Site

Why CPC??

CPC Timeline

 Applied for CPC in the spring of 2012  Accepted for CPC in August 2012  Started CPC in October 2012  Applied for CPC + in the spring of 2016  Joined ACO in July of 2016  Accepted for CPC +ACO track two in

November 2016

 Started CPC + ACO January 1, 2017

Payment System

 Per Member Per Month payments from

multiple payers

 Medicare  Medicaid

 Shared saving opportunity from several

participating payers

ALL CARE MANAGEMENT FEES MUST BE SPENT ON CPC ACTIVITY

How we used CPC Payments

 Majority of money was used for staffing  Staff training  Population Health Tools/Staff  Physical change to building

Creation of Teams

Description of Innovation

Change in traditional thought processes

Reactive vs Proactive

Change in scheduling template Changes to physical structure of our facility Immediate creation of eight new positions

Initial Teams Concept 2012

Change

 2008-2012

 27-29 Employees  Four MDs and Two APRNs

 August 1st 2012

 37 Employees  Four MDs and One APRNs

 Today

 74 Employees  Six MDs and Eight APRNs

Teams: Physical Change

Old sample closet and unused colonoscopy room

1 1

Teams: Physical Change

New Care Coordinator Offices

1 2

Continuity of Care

 Continuity of care is the process by

which the patient and the physician are cooperatively involved in ongoing health care management toward the goal of high quality, cost-effective medical care. Continuity of care is a hallmark and primary objective of family medicine and is consistent with quality patient care. - AAFP

Goals of Continuity of Care

• 1. Keep patient within their caregiver team
• 2. Keep patients within SAMA
• 3. Maintain continuity during specific episodes
• f care.

“If you find it; FIX IT!”

Losing Continuity

 Worst case the patient leaves SAMA

and goes to another provider. “Renegades”

 Number one cause is lack of access

Why does it matter??

 Accuracy of medical records  Accountable for cost  Accountable for quality  Best for the patient

Care Coordinators

 Transition of Care  Referral Management  Gaps in Care  LPN: Allow backup for others on team

Rebranding: Patient Engagemant

Outcomes

 Change in physician practices  Change in APRN practices  Change in accessibility  Change in continuity of care

Outcomes

 Diabetic Foot Exams

Year Number of Diabetics Number of Exams Percentage Completed 2012 852 60 7% 2013 881 373 42% 2014 1049 464 44% 2015 1214 677 56% 2016 1326 1030 78%

The Proof Is In The Pudding

Increase in revenue

 Seeing High Risk patients more often  Seeing a majority of patients within a week

• f hospital discharge allowing us to bill for

Transitional Care Management (99496)

 Increased Medicare Wellness Visits

 Initial  Subsequent

 Increase in lab and radiology services

 Preventative Services

Questions?