Federal medical demonstration project brings recognition to the High Country
by Linda Burchette
Ashe, Avery, and Watauga counties have been selected to participate in a three-year demonstration project funded by the Centers for Medicare and Medicaid Services.
In an effort to improve quality outcomes for patients and cap the rising costs of healthcare, the three above-named counties are part of an exclusive group of just seven North Carolina counties participating in the project called the Multi-payer Advanced Primary Care Practice (MAPCP) demonstration.
Community Care of North Carolina (CCNC) is administering the demonstration project and has partnered with Medicare, Blue Cross Blue Shield (BCBS), and the State Health Plan (SHP).
“The multi-payer initiative is an opportunity for North Carolina primary care physicians to expand and strengthen the tools they have to keep our citizens healthy,” said CCNC Physician Consultant R.W. Watkins, MD, MPH. “At the same time, participation in this project once again shows how North Carolina is a national leader in providing innovative health solutions. Working with partners in both the public and private sectors, we are creating a national model for success.”
Locally, AccessCare of the Blue Ridge is leading the project under the direction of Medical Director Dr Greg Adams.
During the three year project, local practices are focusing on the creation of “patient-centered medical homes” (PCMH), and the use of technology to manage patient populations and improve the quality of care while decreasing the cost of healthcare. So, the PCMH is a model for the re-design of primary care intended to improve the quality and efficiency of primary care delivery. PCMH emphasizes things like improved access to clinicians, the relationship between patients and their primary care physicians, and employs a team-based approach to care.
Another critical aspect of the program is that qualifying Medicare, BCBS and SHP patients will be eligible to receive care management services from AccessCare of the Blue Ridge’s team of local Registered Nurse care managers. These care managers can assist the clinicians in coordinating care, supplementing health education, and facilitating communication.
“[Being involved in the initiative] also helped formalize a team approach around patient care that we did not have in place before,” said Dr. David Yale of Avery County. “This was very useful. We now have weekly meetings focused on the medical home approach to care, and everyone has started to frame their thinking in a more proactive way. The real trick was how to keep the focus on the patient, not the process. The process should be invisible; the patient should remain the focus.”
AccessCare of the Blue Ridge is partnering with Appalachian State University (ASU) to train and place students in local practices. The students are learning about leadership, change management, and healthcare initiatives in a real-world and first-hand application, and the practices are receiving invaluable assistance. ASU has the distinction of being the only university in the country to assist in the PCMH recognition project.
Participating practices in Ashe County are: Ashe Pediatrics, Ashe Medical Associates, Dr Henry Clay, High Country Family Medicine, and Mount Jefferson Family Medicine.
“Ashe is one of seven counties in NC participating in this initiative,” said R.D. Williams, CEO of Ashe Memorial Hospital. “Ashe Memorial works closely with AccessCare of the Blue Ridge to manage the care of Medicare, Medicaid, Blue Cross and State Employee Health Plan insurance beneficiaries. Ashe Memorial and many other providers in the local area provide information on a regular basis to Care Coordinators working for AccessCare. This information includes hospitalization data as well as Emergency Department utilization data. The Care Coordinators analyze this information and work with the patient and their primary care physician to be sure the patient has the assistance they need to manage any illness they may have. The intent of the program is to more closely manage patient’s care though the many levels of care delivery, reducing duplication, improving outcomes, and ultimately reduce costs for the patient and the healthcare system.”
Primary care practices can still sign on to participate. For more information, please contact: Susan Marlowe at 828-265-1339.
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