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, bringing 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 4.7% 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.
Accountable Health Communities
The federal government has selected Oklahoma’s Route 66 Coalition to receive a $4.5M grant to create an Accountable Health Community where social issues and needs, and not just medical needs, are addressed to improve health. Led by Oklahoma’s non-profit health information network, MyHealth Access Network, the Route 66 Coalition also includes the Oklahoma City-County and Tulsa Health Departments and more than 200 other health care and social service organizations in Oklahoma.
Oklahoma’s Route 66 AHC program will screen more than 75,000 Oklahomans each year for social needs in five key areas that can lead to poor health outcomes: housing insecurity, food insecurity, utility assistance, interpersonal violence, and transportation. Patients seeking medical care will be asked questions related to these five core human needs and, if necessary, connected with community social service “navigators,” a new role in the city-county health departments funded by the AHC grant. The navigators will work with the patients and their families to evaluate their needs and help them select the best organizations to improve their situation. MyHealth serves as the project’s bridging organization, connecting and coordinating all of the moving parts of the program. In addition, MyHealth is providing the technology to connect and securely exchange data and enable electronic referrals to social service agencies and other providers when needed.
The new approach to health care and wellness is made possible by the coalition of more than 400 health-related organizations from across Oklahoma that make up the MyHealth Access Network. The organizations participating in MyHealth have been able to securely exchange health care records since 2010, serving hundreds of thousands of Oklahomans who seek health care each year.
“The members of MyHealth are using technology and shared data to be more responsive to patient needs,” said Kendrick. “That approach will improve lives. It will also save money and help us to address the ongoing question, ‘how can we drive down the cost of medical care for everyone and make it more affordable and accessible?”
Oklahoma’s Accountable Health Communities program begins in May with nine months of planning organization and is expected to be fully implemented by early 2018.
The Strategic Health Information Exchange Collaborative (SHIEC)
The Strategic Health Information Exchange Collaborative (SHIEC) is the national trade association of health information exchanges (HIEs). Its more than 50 member organizations manage and provide for the secure digital exchange of health data for hospitals, healthcare providers and other participants serving more than half of the U.S. patient population. As the unbiased data trustees in their communities, SHIEC member organizations are critical to advancing effective, efficient healthcare delivery locally, regionally and nationally to improve health.