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Colloquium Issue Creating Five-Star Care Coordination, P.36 CAPG health Volume 10 • No. 3 Fall 2016 Colloquium Issue CAPG Proliferates in DC and Across the Nation, p.12 Creating Five-Star Care Coordination, p.36 Home Healthcare’s Critical Role in New Practice and Payment Methods, p.46 For your organization, KNOWING is transformative. Today, the right lab is far more than a lab. It’s a source of insight and innovation. It’s a catalyst for change. It’s a valuable resource you use to elevate everything you do. It’s a true partner in the pursuit of better outcomes—in the care you provide and the business you operate. Contact [email protected] to schedule a visit with a representative. Get to know us better. Visit QuestForHealthSystems.com. © 2016 Quest Diagnostics Incorporated. All rights reserved. 5616 Where Patient Satisfaction and Cost Savings Intersect When patients receive the right care in the right place at the right time, everyone benefits. Whether you are participating in an ACO, PCMH, or another new payment and delivery model, VITAS® Healthcare can seamlessly transition and care for your hospice-eligible patients. An interdisciplinary care team delivers VITAS’ comprehensive patient-centered care, wherever patients reside. Our superior care not only improves patients’ quality of life and improves patient satisfaction; it also results in reduced hospital readmissions and lengths of stay for some of the sickest and most costly patients. Contact us to find out more about a partnership with VITAS, the nation’s leading end-of-life care provider. SINCE 1980 800.93.VITAS • VITAS.com Over 30 years of The Impact of managed care experience 1,200 physicians Over 150 community offices Over 40 primary care offices Patients enter our community offi ces 2.5 million times each year Simi Valley Santa Clarita N 118 map not Porter to scale 23 Ranch 210 Northridge Panorama Thousand City Oaks Woodland 5 Hills 170 Burbank 2 Pasadena Ventura 101 134 Arcadia Westlake 405 The numbers may surprise you, but the most important number of all is one. It’s our commitment to caring Village 101 Westwood Alhambra Brentwood 10 for our community one patient at a time. From our top ranked hospitals to our vibrant and growing primary Malibu Pacific Century City Palisades Santa Monica West 10 60 Los Angeles care network, UCLA is world-renowned but focused right here at home. It’s a commitment we can all count on. Marina del Rey 605 90 5 110 405 710 105 Manhattan Beach Redondo Beach 91 Torrance Fountain Palos Verdes Valley Laguna Hills Irvine 1-800-UCLA-MD1 (1-800-825-2631) uclahealth.org uclahealth.org/getsocial UCLA1744 CAPG Ad Update(PRS)ms.indd 1 7/25/16 4:56 PM UCLA1744 CAPG Ad Update Round: Press Date 7.25.16 Colors 4/0 (Process) Trim 16.25”w x 10.25”h Production Mgr Andrew Edelstein Materials Date 8.5.16 Publication CAPG Bleed 16.5”w x 16.5”h Project Mgr Sheryl Evans Insertion Date Fall 2016 Advertiser UCLA Health Live N/A Client UCLA Health Client Contact Judi Goodfriend Publication Contact: PDFX1a to [email protected] Alternate Contact Debbie Rogers Donenfeld & Associates 8367 W. 4th Street, Los Angeles, CA 90048 310.756.5700 Over 30 years of The Impact of managed care experience 1,200 physicians Over 150 community offices Over 40 primary care offices Patients enter our community offi ces 2.5 million times each year Simi Valley Santa Clarita N 118 map not Porter to scale 23 Ranch 210 Northridge Panorama Thousand City Oaks Woodland 5 Hills 170 Burbank 2 Pasadena Ventura 101 134 Arcadia Westlake 405 The numbers may surprise you, but the most important number of all is one. It’s our commitment to caring Village 101 Westwood Alhambra Brentwood 10 for our community one patient at a time. From our top ranked hospitals to our vibrant and growing primary Malibu Pacific Century City Palisades Santa Monica West 10 60 Los Angeles care network, UCLA is world-renowned but focused right here at home. It’s a commitment we can all count on. Marina del Rey 605 90 5 110 405 710 105 Manhattan Beach Redondo Beach 91 Torrance Fountain Palos Verdes Valley Laguna Hills Irvine 1-800-UCLA-MD1 (1-800-825-2631) uclahealth.org uclahealth.org/getsocial UCLA1744 CAPG Ad Update(PRS)ms.indd 1 7/25/16 4:56 PM UCLA1744 CAPG Ad Update Round: Press Date 7.25.16 Colors 4/0 (Process) Trim 16.25”w x 10.25”h Production Mgr Andrew Edelstein Materials Date 8.5.16 Publication CAPG Bleed 16.5”w x 16.5”h Project Mgr Sheryl Evans Insertion Date Fall 2016 Advertiser UCLA Health Live N/A Client UCLA Health Client Contact Judi Goodfriend Publication Contact: PDFX1a to [email protected] Alternate Contact Debbie Rogers Donenfeld & Associates 8367 W. 4th Street, Los Angeles, CA 90048 310.756.5700 ON the Cover 12 Proliferating in Dc and across the nation new federal affairs staff and expanding national membership amplify CAPG’s advocacy on value-based care table of contents health DepartmeNts FeatUres Publisher Valerie Okunami Editor-in-Chief Don Crane 7 36 Editorial Advisory Board From the president Creating Five-star Care Coordination Lura Hawkins, MBA Amy Nguyen Howell, MD, MBA Mary Kay Payne, Arch Health Partners 8 38 Managing Editor Daryn Kobata Names in the News evolution of the Capitated/Delegated Editorial Assistant model in California and Beyond Nelson Maldonado Contributing Writers 10 Jim Agronick Bill Barcellona Upcoming events 40 Megan Calhoun Don Crane Creating practical solutions to enhance Rob Francis patient Outcomes Within Coordinated Rajesh Gade, MD Valerie Green-Amos, MD 18 Care Organizations Janelle Howe policy Briefing: accurate provider Directories Laura Jacobs Pamela Laesch, MD Will Change the World Stephanie Mamane Amber Manko 42 Tracey Moorhead Integrating Behavioral and primary Jeremy Rich, MD 22 healthcare: an Intricate partnership CAPG Health Magazine is published by Federal policy Update: transitions to a Valerie Okunami Media with provider and patient payoffs PO Box 674, Sloughhouse, CA 95683 New administration and U.s. Congress Phone 916.761.1853 capghealth.com Please send press releases and editorial 44 inquiries to [email protected] or c/o 31 the Domino effect of the CAPG Health, 915 Wilshire Blvd., Suite member spotlight: 1620, Los Angeles, CA 90017 affordable Care act For advertising, please send email to mhmD Clinical programs Committee [email protected] serves as system-Wide Quality engine Subscription rates: $32 per year; $58 two years; $3 single copy. 46 Advertising rates on request. Bulk third home healthcare: playing a Critical role class mail paid in Jefferson City, MO 34 Every precaution is taken to ensure the in New physician practice and accuracy of the articles published in CapG member list CAPG Health Magazine. payment methods Opinions expressed or facts supplied by its authors are not the responsibility of CAPG Health Magazine. © 2016, CAPG Health Magazine. 48 All rights reserved. Brown & toland physicians and aetna Reproduction in whole or in part without written permission is strictly prohibited. Continue successful accountable Care Collaboration 6 l capg health Fall 2016 From the president a messaGe FrOm DonalD CraNe, presideNt and CeO, CAPG CAPG members and Friends: I’m pleased to present the Fall 2016 CAPG Health issue. highlights in this edition include several articles contributed by speakers at the upcoming CAPG Colloquium, september 28-30 in Washington, DC, along with an update on CAPG’s expanding national presence and new DC staff. I trust you’ll find it informative and enjoyable. I also hope to see you at the Colloquium—one of our premier educational events on value- Donald Crane, based care delivery. a recurring theme for me this year is that we’re entering a new era of CAPG President and CEO learning and teaching. as ongoing policy, regulatory, and technological changes spur rapid transformation of our healthcare system, education and information sharing are becoming more and more critical to success. a prime example of the need for education is the pending start of MACRA, the medicare access and ChIp reauthorization act, which will effectively make value-based healthcare payment mandatory in medicare. In response to requests that CMS delay the law’s January 1, 2017 launch, the agency recently added some starting date flexibility, allowing physician groups to “pick their pace” in participating. CAPG had advocated for timely implementation, and we’re pleased that organizations who are prepared to start in January can still do so. regardless of when physician groups begin participating, however, the law will require major changes in how they practice—creating both a need and a huge opportunity for education and resources on what organizations need to successfully comply. We’re continuing to help fill this need for information with programs like our APC G educational series. the second symposium in the series, October 27 in Chicago, will cover the how-to’s of risk contracting, performance measurement, and other coordinated care areas. the final series webinar,h ealth plan Delegation Oversight, Compliance, and regulations, takes place December 2. learn more and register for these events at capg.org/riskessentials. Our website, capg.org, is another source for learning. there you’ll find resources including CAPG’s Guide to alternative payment models and our risk readiness tool, information on MACRA, a calendar of upcoming events, and much more. o OCTOBER SYMPOSIUM: HOW TO THRIVE IN RISK-BASED COORDINATED CARE October 27, 2016 • 9:00am - 4:00pm Hyatt Regency O’Hare, Chicago Opening reception Wednesday, October 26, 5:00-6:30 pm, Ventanas Room (11th oor) Register now at capg.org/symposium Fall 2016 capg health l 7 Names in the News syNermed receives moliNa healthcare’s Welcome to our NeWest members 2016 Innovative Award for doWNtoWN coordiNated care ceNter CAPG warmly welcomes these members who have recently joined: synermed has received molina healthcare’s 2016 Innovative award for excellence in clinical management and effective organizational Members partnership for its Downtown Coordinated Care Center angel medical Group, los angeles, Ca (DC3).
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