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    This is how CPC+ is changing physician offices for the better

    Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Lori E. Rousche, MD, a family physician in Souderton, Pennsylvania. She is also the hospice medical director for Grand View Health in Sellersville, Pennsylvania. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.

     

    Comprehensive Primary Care Plus (CPC+), the new model for primary care in America, is changing the way physicians run their offices in a revolutionary way. I am seeing many improvements in outreach to our most complicated patients and hopefully will see improved outcomes and enhanced care going forward. Let’s take a look at the evolving role of the clinical staff in regards to the quality measures that the government is tracking:

     

    More from Dr. Rousche: Dipping a toe into the world that is CPC+

     

    There are 14 electronic Clinical Quality Measures (eCQMs) that will be scored for our involvement in CPC+. (More information on the Quality Payment Program and MIPS can be found at https://qpp.cms.gov/.)  Nine of these measures must be reported on for our first year of involvement. For the 2017 reporting period, a practice must choose to report results on two of the three outcome measures. The three measures are: depression remission at twelve months, controlling high blood pressure, and diabetes: hemoglobin A1c poor control with result greater than 9%.

    Practices must also report on two of the four complex care measures: use of high-risk medications in the elderly; dementia cognitive assessment; falls, screening for future fall risk; and initiation and engagement of alcohol and other drug dependence treatment.

     

    Further reading: Why physicians may want to apply for the CPC+ program

     

    In addition, an office must pick to report on five of the ten remaining measures from the outcome measures or the complex care measures, or from the seven choices as follows: closing the referral loop (receiving a specialist report); communication and care coordination; cervical cancer screening; diabetes eye exams; preventive care and screening of tobacco use; population health; use of imaging in low back pain, efficiency and cost reduction; and breast cancer screening.

    To accurately track these measures and to reach out to patients to fulfill these actions requires a joint effort from all of the office personnel. We have doled out some of these responsibilities to our administrative staff and some of them to the clinical staff.

    Next: This is how we do it

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    • [email protected]
      I read this article and it sickens me to see what our profession has become. I am board certified in Family Practice since 1980, in one location all this time, and have enjoyed every one of my patients each and every visit. We have have been minced and shredded by insurance and government regulations and horribly distracted from the real practice of medicine. We now seem content in accepting bits and pieces of shrinking revenue that might be left over from what the executives, hospitals, and specialists leave for us. We work to crunch numbers, meet goals on paper, and reach arbitrary marks even when our patients do not comply. We are now controlled daily with the hope of gaining some percentage or bonus if we fill in the blanks properly. Shameful. How low can we go? We three physicians in our office quit traditional care last December and will never go back. We found Freedomhealthworks.com and they assisted in our transition to Direct Primary Care, Westfieldpremier.com. We have found the missing nirvana, happiness, and new vigor, free of any restraints from insurance and government. Instead of 35 patients daily, I see ten or twelve. Long, quality filled, wonderful visits with each and every patient, just the way I was taught. I sleep well knowing I have done an extraordinary fine job each day. This is the only way primary care can survive the future. Overworked, stressed, tired, frustrated? try a refreshing restart, enjoy medicine once again. Dr Habig
    • UBM User
      Thank you for your clear and frank assessment of the changes with this model, including increased burden on the staff. Here's the real question: is there some kind of increased reimbursement to pay for the better-traned staff and higher intensity of visit for the provider or is it only more payments via greater patient throughput from using this assembly-line approach?

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