Report on Pathways to Excellence Steering Committee Meeting of November 20th
The Pathways-to-Excellence (PTE) Primary Care Steering Committee met for its final meeting of 2008 on November 20th at the MMA offices in the Frank O. Stred Building in Manchester. Following are notes from the meeting, prepared by Ted Rooney, RN, MPH, and Sue Butts-Dion, staff to the Committee which is sponsored by the Maine Health Management Coalition.
a) National Partnership Priorities update
i) The National Priorities Partnership (NPP) is gaining steam: http://www.nationalprioritiespartnership.org/
ii) On November 17th, there was a national launch in Washington D.C. with a multi-stakeholder list of speakers supporting the Partnership, including the American Board of Medical Specialties (ABMS). The purpose of the NPP is to bring together leading national stakeholders to take action on coordinated priorities designed to advance safety and quality in the U.S. health care system. The NPP highlights the importance of providing the public and other stakeholders with standardized information on patient experience.
i) The Maine Chapter of the American College of Surgeons is working closely with PTE to implement the National Surgical Quality Improvement Program in Maine hospitals as one of two national demonstration projects (the other is in Portland, Oregon).
ii) Dr. Letourneau and Mr. Rooney are working with the Maine Chapter leadership on the initiative.
iii) A letter soliciting interest is being distributed to all Maine hospitals. A copy of the letter was distributed.
2) PTE Steering Committee Update
a) Staff is recommending combining the PTE Primary Care and PTE Specialty initiatives. While there was initially only one committee, eventually the committee was split between primary care and specialty care. The recommendation to go back to one committee is made at this time because:
i) Most of the individuals attending PTE Specialty meeting also attned the PTE Primary Care Steering Committee.
ii) It is rare for a specialty physician to attend the PTE Specialty meetings
iii) Currently, many specialty physicians are meeting outside the PTE meetings (e.g. orthopedics, gastroenterology, surgeons, cardiology)
iv) Holding three PTE meetings in one day is becoming a resource issue for staff (and participants)
v) In the future, one of the main customers of specialty and quality metrics will be PCP's
i) Change can only come by primary care and specialties working together
ii) Do we know why specialty physicians don't attend the PTE Specialty Steering Committee meetings?
iii) Can't have an us vs. them focus
iv) MMA is hosting a joint PCP-Specialty meeting around the Patient Centered Medical Home on December 16 at 5:30pm.
c) The Steering Committee believed that it could adequately combine the two groups.
i) Current attendees from PHO's also represent specialties
ii) We can use the end of PTE Physician Steering Committee meetings if there is an opportunity for specialty physicians to attend. This will also make it possible for PTE Hospital Steering Committee members to attend, since specialty issues overlap both primary care and hospitals.
iv) Steering Committee members unanimously endorsed this change, effective 2009
3) Health Plan/Employer updates:
a) The State Employee Health Commission will continue to use both green and blue ribbons in their tiered networks so any practice with two ribbons, either blue or green, will qualify for the enrollee co-pay waiver.
b) Cigna, Aetna, and Harvard Pilgrim are continuing to use both blue and green ribbons in their Pay for Performance programs for 2009
c) Anthem presented on their national program which will be rolled out throughout Wellpoint states. It is based on the model they have used in Maine and some other states for several years.
4) PTE to Bridges to Excellence/National Committee on Quality Assurance Update
a) Current numbers
i) Office System Survey
(1) PTE: 300 blue ribbons
(2) NCQA recognition: 30 physicians in 7 practices
(1) PTE: 208 blue ribbons
(2) NCQA: 135 physicians in 45 practices
(1) PTE: 130 blue ribbons
(2) NCQA: 108 physicians in 31 practices
(1) Expect flurry of activity
(2) NCQA giving some conflicting information to practices
(3) Even with EMR, there is a burden on the practices
(4) GE now is uploading data directly to BTE so practices using its service do not have to do anything additional to have data submitted to BTE
b) Pediatrics Criteria
i) Steering Committee unanimously approved:
ii) Practices with a PTE blue ribbon for immunization and asthma care...
(1) If previously achieved a score of 75 points or more within the past three years, PTE blue ribbon will automatically carry over to 2009 for one more year
(2) If previously achieved a score of 60-74 points within the past three years, previous PTE ribbon will carry over in 2009 for one additional year, but will be converted to a "Maine-specific" green ribbon.
iii) Practices which did not submit or did not previously receive a blue ribbon for PTE immunization and asthma care outcomes and would like to achieve a blue ribbon for 2009, or would like to improve their existing score for immunizations and/or asthma (1) Can submit outcomes information directly to PTE (2) Targets for obtaining a green or blue ribbon for immunizations will be based on updated national and New England immunization averages.
c) POL, update
i) Jennifer Herman from MassPro/BTE has been in Maine conducting sample office system survey site visits
ii) Physician practices involved report a very positive experience
5) Website update
a) Draft website link was reviewed with positive comments
9) Special Focus Group on PCP-Patient Communications
(a) Beth Austin from Crescendo Consulting and Lisa Letourneau, M.D. reviewed consumer engagement approaches being used in MHMC Employee Activation, Aligning Forces for Quality and Patient Centered Medical Home Initiatives
(b) Group provided positive feedback
(c) Group was interested in continuing this process and future sessions will be scheduled .
Committee will meet next on Thursday, Feb. 26, 2009 at MMA. [return to top]