Improving the Health of Oklahomans-Evolving the Way Healthcare Works in Oklahoma
Comprehensive Primary Care Initiative (CPC)
MyHealth’s strong community relationships have positioned it at the Trusted Third Party for quality and value assessment, as well as a neutral convener for community health improvement projects. In 2012, MyHealth was selected as the convening organization for a demonstration project launched by the Centers for Medicare and Medicaid Services called the Comprehensive Primary Care initiative (CPCi). The initiative is a multi-payer value-based payment model focused on the transformation of primary care practices into patient centered medical homes.
MyHealth’s governance includes multiple healthcare stakeholders, including patients, providers, payers and employers and these representatives were brought together to help lead this CPCi program. MyHealth supported the creation of a Field Service Team consisting of experts in practice transformation who leveraged data from the Payers and MyHealth to teach practices how to provide higher quality, cost efficient care. MyHealth also provided daily alerting about critical patient events such as hospital admissions, discharges and transfers as well as ER visits. In addition, MyHealth serves as data aggregator for the program, brining claims and clinical data together and providing claims-based measures (HEDIS) and clinical based measures (eCQM’s) as well as unique hybrid measurements possible only with combined clinical and claims data. These measures are used by providers to guide their day to day management of patients as well as by the payers and employers to assess value and reward high-performing providers and patients.
In its first year, the Tulsa region’s CPCi doctors delivered a savings of 7% (compared to peer practices in the region) to CMS, and a 5% savings in the second year. This performance leads the other six regions testing the CPCi model, generating net savings of $10.8 million and earning more than $500,000 in shared savings payments for the practices. A participating Medicare Advantage Plan saved nearly 15% over two years, and the local Blues Plan also achieved significant savings, with significant payments planned to participating providers who meet the quality targets as calculated by MyHealth. Payers reported significantly improved utilization of preventive care services and each participating payer reported improvement in several quality indicators.
Healthy Hearts for Oklahoma
Healthy Hearts for Oklahoma is a comprehensive project aimed at creating an effective, sustainable system to help primary care practices across Oklahoma improve cardiovascular disease management and prevention. It provides a critical infrastructure to help ensure better health for all Oklahomans, especially those in remote and rural areas of the state
The University of Oklahoma (OU) received a 3-year, 15 million dollar grant as part of the Agency for Healthcare Research and Quality initiative, EvidenceNOW – Advancing Heart Health in Primary Care, which supports the broad U.S. Department of Health and Human Services effort for Better Care, Smarter Spending, and Healthier People, and is aligned with the Department’s Million Hearts® national initiative to prevent heart attacks and strokes.
Dr. Steven Crawford of the OU College of Medicine’s Department of Family and Preventive Medicine and Dr. Dan Duffy at the School of Community Medicine in Tulsa head the Oklahoma research effort.
The work involves critical collaboration with many Oklahoma healthcare-centered organizations including MyHealth Access Network, the Oklahoma Foundation for Medical Quality, the Public Health Institute of Oklahoma, the Community Service Council, Oklahoma Center for Healthcare Improvement, Oklahoma Primary Care Association, Oklahoma Area Health Education Centers, Coordinated Care Oklahoma, as well as Brigham and Women’s Hospital in Boston.