CP3 Empanelment Webinar Slides - Center for Care Innovations

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Empanelment Series 1.0, Part 1 “The Need to Belong” CCI CP3 Population Health Management Low-Intensity Track Webinar Monday, October 10, 2016 from 1pm-2pm

Today’s Faculty

Megan O’Brien, Program Manager, CCI

Amy Ham, PCMH CCE

Empanelment Webinar Series EMPANELMENT 1.0: Two, 1-hour EMPANELMENT 2.0: Two, 1-hour webinars to develop a strong foundation webinars to develop & share best practices on the basics of paneling. on other issues affecting patient panels. 1. October 10, 2016 at 1pm “The Need to Belong” Topics Covered: Why Panels are Important, Where to Begin, Special Circumstances, and Paneling Reports

3. January 2017 “Behind the Shadows” Topics Covered: Paneling & QI Reporting, Shadow Panels, and Best Practices

2. November 7, 2016 at 11am “There’s No Room” Topics Covered: Determining Panel Size, 4 cut-method, and Continuity Reporting

4. January 2017 TBD Topics Covered: Strategies for Increasing Capacity to See More Patients

Off ice Hours • Virtual office hours via phone or a web-based service will be set up following the webinars to give participants the opportunity to dive deeper and ask questions of presenters.

• If you are interested in setting up office hours, please email Megan ([email protected] s.org)and include the following information: – (1) which faculty you are interested in; – (2) the scope of the questions you have; – (3) whether you are interested in 30 or 60 minutes; – (4) if you are interested in other organizations joining in, or want individualized time.

• I will work with you on scheduling office hours.

CCI Data Analytics Knowledge Center

Datadrivenculture.org

Agenda •Review the role of paneling in patient-centered practice •Identify key steps in paneling and panel management. •Discuss how to adjust for locums, part-time providers, midlevel providers •Review basic elements in panel reporting

Defining Panels and Panel Management • A panel is the list of patients assigned to each care team in the practice. • Panel Management is population-based care – meaning the care team is concerned with the health of the entire population of patients, not just those who come in for visits.

Why is Panel Management Important? Empanelment must be an early change on the journey to becoming a PCMH, because other key changes such as continuous, team-based health relationships, enhanced access, population-based care, and care coordination depend on the presence of such linkages. –Katie Coleman and Kathryn Philips

Empanelment enables a practice to provide proactive and planned care for a population of patients. -Safety Net Medical Institute

Visits with the same provider positively affect patient experience, clinical care, and patient outcomes. -Safety Net Medical Institute

Benefits for the Practice • Creates efficiency through reduction of intensive chart review • Controls costs, reducing duplicate tests, medications, referrals • Defines process for fair distribution of workload • Data-driven decisions supporting practice management and support.

Where Do We Begin? • Assign all patient to a provider panel, and confirm assignments with the providers and patients • Assess practice supply and demand and balance patient load accordingly • Use panel data and registries to proactively contact, educate and track patients.

Which Providers to Panel • Part-time Providers • Locum • Mid-Level Providers • Specialty Providers (OB, Dentist) • Residents

Pre-Empanelment Work • Record PCP in structured field • Determine Average visits per patient per year (AVPY) by provider type • Determine number of appointment slots for each provider Safety-Net Medical Home Initiative Determining the Right Panel Size

Calculating Panel Size FORMULA DEMAND BxF Average visits per patient = Appointment needs of current Number of unduplicated patients number of visits/number of population seen in the last year X Average patients Visits per Patient per Year H Actual hours worked x SUPPLY Number of appointment slots Productivity Provider availability available on the schedule last 100 hours 3.25 patients per year hour = 325 slots RIGHT PANEL SIZE H/F The number of patients the Number of appointment slots provider can support based on available on the schedule last 325/3.14 = 103 patients current availability year / Average Visits per Patient per Year

Empanelment • Review patient visit history – Patient ID, Visit Date, Assigned PCP and Provider Seen – Do not include, specialty or nurse visits – If patients are not assigned do so based on visit history

• Review initial patient assignments – Identify patients not yet assigned, or assigned to providers no longer with the organization. – For pediatric patients, 17 and older develop a plan to transition them to adult care

The Four-Cut Methodology Cut

Report Description

PCP Assignment

1st Cut

Patients who have seen only one provider in the past year Patients who have seen multiple providers, but one provider the majority of the time in the past year Patients who have seen two or more providers equally in the past year (No majority provider can be determined)

Assigned to that provider Assigned to the majority provider Assigned to the provider who performed the last physical exam Assigned to the last provider seen

2nd Cut 3rd Cut

4th Cut

Patients who have seen multiple providers

Example Patient Sam Trish Lisa John

Provider 1 1* 2 5 1

Provider 2 5 4 0 1

Provider 3 2 4* 0 1*

Assigning Patients to Panels Incorporate the voice of the patient in this process. This can be done by training front office staff or the clinic’s call center to ask patients which clinician they see regularly and assign them as they register. Safety Net Medical Home Initiative Resources: • Sample PCP Assignment Policy • Scripting for Appointment Scheduling • Sample Provider Staffing and Scheduling Policy

Monitoring Empanelment • Size of panel by clinician and how it compares to target panel size for the practice. • Percentage of total patients unassigned to a panel • An access measure, such as 3rd Next Available Appointment per clinician (the average number of days between a request for an appointment and the 3rd available appointment for that clinician— a more sensitive measure of true appointment availability).

Example Provider Name

Current Panel Difference between Size Target Panel Size and Average visits per Clinical Target Panel Panels on patient/year Hours Size 8/31/2016 3/01/2015 Current Panel Size 9/30/2016) 9/30/16

Change

Dr. Smith

3.5

300

257

200

57

220

-20

Sally Rice, PA

3.19

600

564

600

-36

575

25

196

-196

174

22

Un-paneled Patients

Target Panel Size = Clinical Hours * Productivity (3)/ Average visits

Q&A

Remember, press *7 on your phone to unmute yourself. Press *6 to mute yourself.

Upcoming Opportunities

Webinars

November 2016: • Empanelment Series 1.0, Part 2 “There’s No Room” • Monday, Nov. 7 at 11am • Alternative Encounters, Part 1 • Thurs, No. 17 at 11am • Alternative Encounters, Part 2: • Wed., Nov. 30 at 1pm

January 2017-September 2017: Webinar and In-person workshops will focus on topics: • Team-based care • Patient engagement • Population health management • Empanelment 2.0

Off ice Hours • Virtual office hours via phone or a web-based service will be set up following the webinars to give participants the opportunity to dive deeper and ask questions of presenters.

• If you are interested in setting up office hours, please email Megan ([email protected] s.org)and include the following information: – (1) which faculty you are interested in; – (2) the scope of the questions you have; – (3) whether you are interested in 30 or 60 minutes; – (4) if you are interested in other organizations joining in, or want individualized time.

• I will work with you on scheduling office hours.

CONTACT INFORMATION • Tammy Fisher: [email protected] • Megan O’Brien: [email protected]

THANK YOU!

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CP3 Empanelment Webinar Slides - Center for Care Innovations

Empanelment Series 1.0, Part 1 “The Need to Belong” CCI CP3 Population Health Management Low-Intensity Track Webinar Monday, October 10, 2016 from 1pm...

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