Practice transformation

Wednesday, July 01, 2015 12:20 PM

Practice redesign prepares physician offices for changes in the health care system

by Allyson Gottsman, Colorado Health Extension System

State and federal programs are currently bringing trained practice facilitators and clinical HIT advisors into Colorado primary care offices to help them become examples of excellence in advanced patient-centered care. Practices should consider taking advantage of the many grant-funded programs that will help them move to the next level of patient-centered care.

As the recent Colorado Primary Care Collaborative meeting made very clear, there are major changes underway in the structure of our health care system and the payment system. Our practices need to carefully track these developments and plan how they will effectively adapt to these changes. For those practices that have been holding off on practice redesign efforts in order to see whether the whole thing would just blow over – the time is now, and there are major risks inherent in not beginning work as soon as possible to redesign your practice. Making the needed changes to adopt advanced primary care approaches takes time, and practices benefit from outside support to be successful.

Fortunately, funding is now available from state and federal groups to support these changes. There’s no need to reinvent the wheel when easily accessible programs are available to work with trained practice facilitators, clinical HIT advisors and peers to identify and share best practices. Multiple organizations are collaborating to offer these types of programs for free, but this won’t last forever.

Under the leadership of Perry Dickinson, MD, a family physician from the University of Colorado School of Medicine, 17 practice transformation organizations and health systems have joined the Colorado Health Extension System (CHES) to provide a cohesive, coordinated approach to practice transformation support services for primary care practices in Colorado. With more than 30 programs across the member organizations, there truly is an opportunity for everyone to get involved.

CHES members will be working to deliver two of the largest statewide primary care practice transformation efforts in Colorado’s history:  Evidence Now Southwest and the Colorado State Innovation Model.

Evidence Now Southwest is part of a national program funded by the Agency for Healthcare Quality and Research that will assist practices in primary care capacity to rapidly deploy evidence-based interventions into practices with an initial focus on cardiovascular risk. The program will engage 260 small primary care practices (208 in Colorado and 52 in New Mexico) to build critical infrastructure to help smaller primary care practices apply the latest medical research in the care they provide to their patients.

CHES practice transformation organizations will provide on-site practice facilitation and coaching, expert consultation, shared learning collaboratives and HIT support. Evidence Now is a great program for practices engaged in the early stages of redesigning their practices to build the foundation for advanced primary care and new payment models, and/or for practices particularly interested in work on reducing cardiovascular risk factors in their patients. For more information contact allyson.gottsman@ucdenver.edu.

The State Innovation Model (SIM), a significant statewide effort led by the governor’s office and funded by the Centers for Medicare and Medicaid Innovation, will engage 400 primary care practices over three years in practice redesign, with an emphasis on advanced primary care that includes behavioral health integration.

The initial cohort of 100 practices will start in February 2016, and more information regarding the application process will be available to interested practices over the next few months. In addition to on-site practice facilitation and coaching, help with HIT and HIE needs, and shared learning collaboratives, business consultation is also available to help practices evolve to new models of compensation based on the value of care.

SIM includes four interdependent bodies of work, all focused on achieving better population health, lower cost and a better experience of care for patients and their health care teams. The four interdependent pillars of SIM are practice transformation and delivery system redesign, compensation reform, data collection and reporting, and patient and community engagement. For more information, contact allyson.gottsman@ucdenver.edu.