Pennsylvania

In response to Pennsylvania’s growing chronic disease burden and its impact on healthcare spending, the Governor issued Executive Order 2007-05 on May 21, 2007. This order created the Pennsylvania Chronic Care Management, Reimbursement and Cost Reduction Commission, also known as the Chronic Care Commission. The Commission proposed and then implemented the Pennsylvania Chronic Care Initiative (CCI) designed to achieve four strategic goals:

  • Widespread use of a new primary care reimbursement model that rewards PCMH care based on the Chronic Care Model.
  • Broad dissemination of the Chronic Care Model to primary care practices across Pennsylvania, through regional chronic care learning collaboratives. 
  • Achievement of tangible and measurable improvement in patiient satisfaction, access to care, health outcomes and quality of life.
  • Reduction in the cost of providing chronic care with the reduction of avoidable hospitalizations and emergency room visits and mechanisms to ensure that some of the savings are realized by all entities paying for health care. 

The first rollout (Southeast PA) started in May 2008 and six more learning collaboratives were launched through December 2009, involving a total of 152 mostly small and medium-size primary care practices and 640 providers (75% of the practices have 5 or fewer FTE providers). In four of PA’s seven regions, 17 payers, including Medicaid, provided $30 million in infrastructure payments to practices to support transformation. Since 2009, the state’s contracts with Medicaid managed care organizations (MCOs) have required MCOs to participate in the CCI. Phase II of the CCI began in January 2012 with funding from the Multi-payer Advanced Primary Care Practice demonstration.

CHIPRA: 
Yes
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
No
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
12,759,200
Uninsured Population:
10%
Total Medicaid Spending FY 2013: 
$21.0 Billion 
Overweight/Obese Adults:
64.5%
Poor Mental Health among Adults: 
35.5%
Medicaid Expansion: 
Yes

Conestoga Family Practice - Terre Hill

Practice Type: 
Primary care practice
Practice Setting: 
Rural
Practice Address: 
770 Broad St
East Earl, PA 17581

Each practices commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

Cocalico Family & Sports Medicine

Practice Type: 
Primary care practice
Practice Setting: 
Rural
Practice Address: 
30 W Swartzville Rd
Reinholds, PA 17569

Each practices commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

Chanceford Family Medicine

Practice Type: 
Primary care practice
Practice Setting: 
Rural
Practice Address: 
10 Muddy Creek Forks Rd, Suite 3
Brogue, PA 17309

Each practices commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

Apple Hill Internal Medicine

Practice Type: 
Primary care practice
Practice Setting: 
Suburban
Practice Address: 
25 Monument Rd, Suite 140
York, PA 17403

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

Independence Blue Cross, Jefferson University form collaboration

Independence Blue Cross and Jefferson University have announced a new collaboration designed to boost innovation in health care across the region.

The Independence Blue Cross – Jefferson Health Innovation Collaboration will be jointly and equally funded up to $2 million by Independence and Jefferson, and the program will be run through the Independence Blue Cross Center for Health Care Innovation and Jefferson’s Innovation Pillar. The collaboration will begin July 1.

Nature And Nurture: What’s Behind the Variation In Recent Medical Home Evaluations?

Recent evaluations of two regional medical home pilots (i.e., efforts to improve the capabilities and performance of primary care practices) within the Pennsylvania Chronic Care Initiative (PACCI) have produced differing results.

News Author: 

Pennsylvania Medical Home Model Links Data, Quality, Savings

Performance improvements are attributed in part to tying physicians' performance bonuses to actionable patient data. But "not all medical home interventions are alike," one researcher notes.

A medical home model in Pennsylvania that provided timely and pertinent patient data to physicians and paid bonuses for the resulting improved care showed significant improvements over comparison practices, a RAND study shows.

News Author: 
John Commins

Medical home intervention with shared savings shows quality and utilization improvements

A three-year study of a 'medical home' intervention that paid bonuses to physician practices based on financial savings has shown significant improvements in quality and use of some medical services relative to comparison practices, according to a new RAND Corporation study.

The study is the first published evaluation of a multipayer medical home intervention that featured shared savings for primary care practices. The results appear in the June 1 edition of JAMA Internal Medicine.

Dr. Douglas Spotts and Dr. William Warning Appointed to Pennsylvania PCMH Advisory Council

 Pennsylvania’s Dept. of Human Services has announced that the Pennsylvania Academy of Family Physicians’ (PAFP) past-president and current Board Chair Douglas Spotts, MD and Crozer-Keystone Health System’s Family Medicine Residency Program Director William Warning, MD have been appointed to the state’s first Patient-Centered Medical Home (PCMH) Advisory Council. Dr. Spotts is also the Chief Medical Information Officer at Evangelical Community Hospital in Lewisburg.

Geisinger Health System patient-centered medical home (ProvenHealth Navigator)

Launced in 2006, Geisinger Health System’s ProvenHealth Navigator® is an advanced patient-centered medical home that initially served the needs of elderly Medicare patients. Two years later the Navigator was expanded to include the health system’s broader adult commercial population. 

Pagine

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