PMG-South to participate in historic partnership

August 24, 2012

The Center for Medicare & Medicaid Services Innovation last month announced which clinics will participate in its new national Comprehensive Primary Care initiative. Only three clinics in Jackson County were chosen, and all are part of the Providence health care system in southern Oregon.

The initiative is a pilot program to strengthen primary care through collaboration between public and private health care payers. This partnership is the first of its kind and is designed to provide improved access to quality health care at lower costs.

Providence Medical Group clinics selected for this national initiative include Medford Family Practice, Central Point and Phoenix Family Practice. Only five clinics were chosen in all of southern Oregon; the other two are in Grants Pass and Klamath Falls. Oregon is one of seven regions across the United States to be invited to participate in the program.

 

Through a competitive application process, practices were chosen based on recognition for their advanced primary care service by leading clinical societies; use of advanced health information technology; demonstration in practice transformation and improvement activities; and diversity of geography, practice size and ownership structure.

“This is a unique investment in primary care and the selection process was highly competitive,” says Carol Flinn, director of clinic operations for Providence Medical Group in southern Oregon.

“The Comprehensive Primary Care initiative allows us to continue development of the patient-centered medical home, which is designed to meet all of the patient’s needs – not just physical, but social and psychological as well.”

A patient-centered medical home, or PCMH, is a concept in which a team of health professionals care for patients, with the physician as “quarterback.” It can include non-physician providers, case managers, nurses, social workers, pharmacists, mental health workers and other key professionals in the health care delivery system.

Providence was selected for this grant in part because of the work it has already done in developing the PCMH and primary care services, including electronic medical records, nurse triage services, disease management software and tracking, and advanced access, to name a few. 

For patients, medical homes may offer longer and more flexible hours; use a truly integrated electronic health records system across the full continuum of care; coordinate care with patients’ other health care providers; better engage patients and caregivers in managing their own care; and provide individualized, enhanced care for patients living with multiple chronic diseases and higher needs.

Under the Comprehensive Primary Care Initiative, CMS will pay primary care practices a care management fee, initially set at an average of $20 per beneficiary per month, to support enhanced, coordinated services on behalf of Medicare fee-for-service beneficiaries. Simultaneously, participating commercial, state and other federal insurance plans are also offering enhanced payment to primary care practices that are designed to support them in providing high-quality primary care on behalf of their members.