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The Unfinished Business of Health Care Reform, P.12 health Volume 11 • No. 2 Summer 2017 Annual Conference Issue Robert E. Moffit, PhD Federal Tax Policy: The Unfinished Business of Health Care Reform, p.12 Risk Contracting in Medicare Advantage Improves Survival, p.18 An IPA’s Rationale in Pursuing Alternative Payment Models, p.20 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 Mitigate Risk and Maximize Margins. Transition Your Terminally Ill Patients to VITAS. VITAS® Healthcare is uniquely positioned to provide value through direct, home-based hospice care for your most complex patients. We offer personalized care plans that improve patients’ quality of life, resulting in higher CAHPS® scores and meeting multiple HEDIS® benchmarks. VITAS’ longitudinal care continuum also results in: • Reduced 911 calls • Reduced ED visits • Reduced critical care unit utilization • Reduced hospital readmissions • Reduced medication spend Contact us to learn how a partnership with VITAS can help you manage downside risk while improving care delivery. SINCE 1980 800.873.5198 • [email protected] CAHPS® and HEDIS® are registered trademarks of the National Committee for Quality Assurance (NCQA). ON the Cover 12 Robert e. Moffit, PhD changing federal tax Policy: the Unfinished business of Health care Reform table of contents health DepartmeNtS FeatUreS Publisher Valerie Okunami Editor-in-Chief Don Crane 6 18 Editorial Advisory Board From the president risk Contracting in medicare advantage Lura Hawkins, MBA Amy Nguyen Howell, MD, MBA Improves Survival Mary Kay Payne, Arch Health Partners 8 Managing Editor Daryn Kobata Names in the News 26 Editorial Assistant research partnerships tackle population Nelson Maldonado health management Challenges Contributing Writers 10 Amy Adome, MD, MPH Bill Barcellona Upcoming events Don Crane Dilesh Doshi, PharmD 28 Scott C. Howell, DO an Urgent Case: treating and preventing Sayeed Khan, MD Joshua Liberman, PhD 14 physician Burnout Aloke K. Mandal, MD, PhD policy Briefing Melanie Lite Matthews Mara McDermott “Why are provider Directories Robert E. Moffit, PhD Amy Nguyen Howell, MD, MBA So Darned hard to Get right?” 30 Mosini Sinha, MD Improving Patient Engagement Diane Stewart Bart Wald, MD Boosts Colorectal Cancer CAPG Health Magazine is published by 16 Screening Rates Valerie Okunami Media Federal policy Update PO Box 674, Sloughhouse, CA 95683 Phone 916.761.1853 maCra’s Second Year: Implementation capghealth.com Status Check 32 Please send press releases and editorial California Quality Collaborative and inquiries to [email protected] or c/o CAPG Health, 915 Wilshire Blvd., Suite CAPG Members Improve Healthcare 1620, Los Angeles, CA 90017 20 For advertising, please send email to Value in California [email protected] CAPG Member Spotlight Subscription rates: $32 per year; $58 Physicians of Southwest Washington: two years; $3 single copy. An IPA’s Rationale in Pursuing 34 Advertising rates on request. Bulk third class mail paid in Jefferson City, MO Alternative Payment Models Organizational Quality and Superior Patient Every precaution is taken to ensure the accuracy of the articles published in Outcomes—A Holistic Approach CAPG Health Magazine. Opinions expressed or facts supplied by its authors are not the responsibility of 24 CAPG Health Magazine. CapG member list © 2017, CAPG Health Magazine. All rights reserved. Reproduction in whole or in part without written permission is strictly prohibited. 4 l capg health Summer 2017 From the president a messaGe FrOm DonalD CraNe, presideNt and CeO, CAPG CAPG members and friends, Welcome to the CAPG health 2017 Conference edition. this special issue includes several articles contributed by speakers at the CAPG annual Conference 2017. I hope they’ll inspire and engage you, whether you’re able to attend the conference in person or in spirit. the Conference theme—From Volume to Value in the New World Order: What Now?—reflects the current embattlement of healthcare under a new administration. With the affordable Care act’s fate still up in the air, many are feeling anxious and wondering in particular if the move to Donald Crane, CAPG President and CEO value will go on. CAPG is committed to ensuring it does. In spite of the political fighting, the value movement has drawn strong bipartisan support, shown in the near-unanimous Congressional passage of MACRA (the medicare access & ChIp reauthorization act). this almost unheard-of accord confirms that 1) While they disagree on the how-to of healthcare reform, both parties agree it’s imperative; and 2) Both recognize what CAPG members have long known: moving to alternative payment models is a proven nonpartisan solution for improving care delivery and cutting costs. Our resolve to stay the course is more important than ever. CAPG continues to strongly advocate for value, as well as develop education and resources to help physician groups thrive in MACRA and APMs. along with the annual Conference and CAPG Colloquium (www. capgcolloquium.com), November 8-10, we recently launched our complimentary educational Series 2017: Quality payment program Webinars with CmS (www.capg.org/qpp). Under a cobranding agreement with the Centers for medicare & medicaid Services, the webinars combine the agency’s MACRA expertise with CAPG members’ knowledge of its implementation on the ground. I also invite you to visit capg.org to find additional resources and publications such as our Guide toAPM s, risk readiness tool, and pharmacy Case Studies. regardless of the political ups and downs, CAPG is convinced that value will win the day—and we’ll continue working hard to advance the movement and help our members succeed. o At New West, we don’t just treat illnesses — we help people. Our coordinated and comprehensive approach is designed to partner with each person to enhance physical, mental and spiritual health. • Privately owned, primary care physician group • Hospitalist program including nurse case managers for continuity and transition of care • Behavioral Health, Cardiology, Endocrinology, Gastroenterology, and Neurology • Diabetes and Nutrition Center Meet your care team at nwphysicians.com • Integrated, relationship-based approach to patient care for 22 years 18 Denver metro area locations Excellent service. Every patient. Every time. 6 l capg health Summer 2017 Ventegra = Truth and Integrity It is our name. It is our core. It is how we do business. • We EMPOWER OUR CLIENTS to lower costs with our innovative solutions. • We are your VALUE-ADDED SOLUTION to Pharmacy Services Administration. • We help you STEER INTEGRATION of medical and pharmacy for enhanced quality of care. • We offerTRUE TRANSPARENCY on our services demonstrating true costs savings. Let us show you how Ventegra’s TRUTH and INTEGRITY can work for you. Ventegra, Inc., a California Benefit Corporation 450 North Brand Boulevard, Suite 600, Glendale, California 91203 858.551.8111, Ext. 109 • www.ventegra.com Client: Ventegra #2549 Created by: GSS Communiqations, 323.939.1181 Publication: CAPG 2017 / Ad #1 Dimensions: 8.125” x 10.875” trim Agency contact: Andrea Graham [email protected] Client contact: Peggy Frank ([email protected]) Names in the News the memorialCare medical Group office, located in WElcome tO OuR Newest Members Suite 2100, is staffed with 15 healthcare providers including board-certified OB/GYNs, certified nurse CAPG warmly welcomes these members who have midwives, and board-certified primary care physicians recently joined: specializing in family medicine, internal medicine and pediatrics. laboratory, digital x-ray, ultrasound, non- Organizational Members stress test services and retail pharmacy services are advantage medical Group, llC, Orlando, Fl available on-site for patient convenience. For more agilon health, long Beach Ca information, call 1-800-MEMOrIAL (636-6742). Jade health Care medical Group, Inc., San Francisco, Ca OCMMC also was recently recognized for its dedication New england Quality Care alliance, Braintree, MA to patient safety with an “a” hospital Safety ScoreSm primary Care of St. louis, llC, Ballwin, mO by the leapfrog Group, an independent national primed physicians, Cincinnati, Oh nonprofit run by employers and other large health tri Valley Internal medicine Group, murrieta, Ca benefit purchasers. Corporate Partner “We are extremely proud to receive another top Continuum health alliance, marlton, NJ grade in patient safety, which validates our tireless commitment to the well-being of our patients and Affiliate Partners served communities,” said marcia manker, CeO of Canvas medical, San Francisco, Ca OCMMC. “providing the highest quality care and patient Synergy pharmaceuticals. rossmoor, Ca safety remains among our top priorities and it is our responsibility to continue to enhance our efforts.” Associate Partner an “a” grade is one of the most meaningful honors healthaxis Group, llC, tampa, Fl a hospital can achieve, and one of the most valuable indicators for patients looking for a safe place to receive care. the hospital Safety Score, the gold News from Orange Coast Memorial standard
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