Wyoming Care Coordination Network April 11, 2019
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Who’s in the room? 3
Wyoming Care Coordination Network Mountain-Pacific Quality Health 4
Mountain-Pacific Chronic Care Management (CCM) Support Provide care Engage patients and coordinators with empower them for long- targeted educational term continued program tools and resources to participation distribute to patients • Focus on 20-minute monthly interventions 5
Mountain-Pacific CCM Support • Disease-specific information − Vaccines − Nutrition − Safety • Medication safety tools − Medication disposal − Medication bags − Pill planners − Adherence and health literacy • Plus MORE 6
Calendar of Events April May Specialties and CCM What have we What they want to learned in the first know and share with year? primary care June July Patient and Family Skin care for Advisory Council patients with (PFAC) Perspectives chronic disease on CCM 7
Medication Minute Influenza and Antibiotic Stewardship 8
A Quick Update on Influenza
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Antibiotic Stewardship in CCM Find out when antibiotics are necessary. Visit: http://www.cdc.gov/getsmart 13
Antibiotics in Chronic Care • In 2014, 266.1 million courses of antibiotics were dispensed to outpatients in U.S. community pharmacies. This equates to more than five prescriptions written each year for every six people in the U.S. • Total inappropriate antibiotic use, inclusive of unnecessary use and inappropriate selection, dosing and duration, may approach 50% of all outpatient antibiotic use. • An estimated 80-90% of the volume of human antibiotic use occurs in the outpatient setting . Antibiotic Prescribing and Use in Doctor’s Offices. The Centers for Disease Control and Prevention. September 27, 2017 Available from: https://www.cdc.gov/antibiotic-use/community/programs-measurement/measuring-antibiotic-prescribing.html 14
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So far… 17
Total Patients 316 260 254 245 243 230 217 191 150 101 35 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 18
Total Revenue Billed $140,000.00 $120,000.00 $100,000.00 $80,000.00 $60,000.00 $40,000.00 $20,000.00 $- 19
Clinic Total Mar-19 Feb-19 Jan-19 Dec-18 Nov-18 Oct-18 Sep-18 Aug-18 Jul-18 Jun-18 May-18 0 20 40 60 80 100 120 20
Recruitment • Arrowhead Family Medicine – Evanston • Rocky Mountain Family Medicine – Casper • Cheyenne Regional Medical Center – Cheyenne − Four Clinics • Rawhide Clinic - Lusk 21
What Is Being Measured? • CCM usage at physician level – pre vs. post implementation • Transitional Care Management (TCM) usage at physician level (Fee for Service [FFS] Clinics) • Admission, readmission and emergency department (ED) utilization − CCM beneficiaries vs. population – pre vs. post • On the horizon − Medication usage − Physician surveys 22
Resources https://www.mpqhf.org/QIO/quality-improvement- initiatives/chroniccaremanagementccm-home/ 23
OPEN DISCUSSION • Sharing successes and overcoming barriers • Community resource discussion − Strong community partners • CIGNA • TCM • Annual wellness visit (AWV) and Advanced Care Planning (ACP) • Behavioral health 24
Join Us Next Month! Date: May 9, 2019 Time: 3:00 – 4:00 PM
Questions? Brandi Wahlen Email: bwahlen@mpqhf.org Phone: 307-439-2369 Kevin Franke Email: kfranke@mpqhf.org Phone: 307-439-2373 Stevi Sy, PharmD Email: ssy@mpqhf.org Phone: 307-439-2375 Developed by Mountain-Pacific Quality Health, the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Montana, Wyoming, Alaska, Hawaii and the U.S. Pacific Territories of Guam and American Samoa and the Commonwealth of the Northern Mariana Islands, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Contents presented do not necessarily reflect CMS policy. 11SOW-MPQHF-WY-C3-19-20
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