SEPA Fact Sheet 0 by 8l5bo3wv


									            Chronic Care Initiative South East Pennsylvania Project

    Convened by Penn Chronic Care Commission (PCCC), 45 members from
    insures/labor/doctors/academics/consumer reps
       o Practice Redesign Subcommittee
       o Consumer Engagement Subcommittee
       o Incentive alignment Subcommittee
       o Performance Measurement Subcommittee

   Six regional rollouts, Southeast Penn the first one

   In SEPA, practices must have three year commitment to:
      o Participate in seven days learning collaborative, currently focused on
         diabetes and pediatric asthma
      o Work with practice coach
      o Use patient registry
      o Achieve Level 1 NCQA PPC-PCMH by 12 months
      o Report data
      o Reinvest funds into the practice site

   Also, practices will make redesigned systems available to all patients

    Payers must provide enhanced reimbursement to physician offices
    proportionally in blended model:
       o Infrastructure development
       o Enhancement to existing Fee for service, ie PM/PM based on NCQA
       o Pay-for-performance

   Must reimburse IPIP for practice coaches

    Includes 33 pracitces
    165 clinicians
    176,000 patients
    Payers- Aetna, AmeriChoice (Medicaid), Health Partners (Medicaid),
    Independence Blue Cross, Keystone Mercy Health Plan (Medicaid)

   Evaluation based on:
     o 1.engaged providers2.patient self-care knowledge and skills
     o 3.patient function and health status
     o 4.primary care practice satisfaction
     o 5.appropriate and efficient utilization of services
     o 6.clinical care quality
     o 7.cost

   Practices must report monthly performance to IPIP

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