*Due to space limitations, please plan to call in to one of the calls to save seats for everyone. Following the calls, a FAQ document will be posted on the website () that will include responses to questions from both calls. For questions, contact Michele Brown: Email: Telephone: 508 421 5919 Fax: 508 856 6650 Application Package Submission Checklist Check if complete Item Due Date Submit letter of intent to apply electronically to: CTCRI@umassmed.edu Letter to include: Practice name, practice address, physician champion, application key contact name, email address and phone. If a multisite practice, indicate physician champion at each site Wednesday, May 3 2017 Final Package for Submission Submit a Letter of support* from at one physician, nurse practitioner or physician assistant leader in the practice signed by all providers in the practice Tuesday, May 23, 2017 Practices that are part of an ACO must submit an ACO letter of support. Tuesday, May 23, 2017 Completed Application Package Checklist Tuesday, May 23, 2017 Completed Application Form Tuesday, May 23, 2017 Written response to essay questions Tuesday, May 23, 2017 Copy of sample standardized and a sample customized EHR report (if you have the capability) Please remove any protected health information (PHI) before submitting sample reports Tuesday, May 23, 2017 Copy of Meaningful Use attestation from one provider Tuesday, May 23, 2017 Completed application packages – including completed checklist - should be received by 5:00 PM on Tuesday May 23, 2017. Email application package to: CTCRI@umassmed.edu For questions, contact Michele Brown: Email: Telephone: 508-421-5919 Fax: 508-856-6650
NCM/CC completes standardized learning program as defined by CTC-RI. Month 7 Report level(s) of engagement of high risk patients as defined by CTC-RI. Month 9 Submit to OHIC Cost Management Attestation October 15 Planned Care: Population Health /Quality Reporting Submit clinical quality data as defined in Performance Incentives Exhibit 3 Month 6 Submits to OHIC quality measure information October 15 Access and Continuity Reports to CTC Quarterly Provider Panel Report indicating open/closed panel status for new patients and 3rd next available appointment for existing patients Month 6 Submit before and after hours protocol, as defined by CTC-RI. Month 9 Patient/Family Engagement CAHPS survey: Submits patient panel to approved data vendor (or “How’s Your Health” option to be determined Timeframe determined by CTC Comprehensiveness and Coordination Submits Transition of Care Policy and Procedure Month 6 Identifies high volume specialists serving patient population and submits 2 compacts: a) high volume specialist, and b) behavioral health. Month 9 Practice transformation Submits budget and staffing plan and use of funds to support care delivery model to CTC Month 3 Submit NCQA PCMH work plan to CTC Month 9 with Practice Facilitator 1-2 x a month Month 1 and on-going Attends 50% of learning network meetings 1 Month 1 and on-going 1 Learning Network Meetings: Orientation, Best Practice Meetings, Breakfast for Champions, and Large Learning Collaborative Measurement Period 2 (MP 2) 7/1/18 to 6/30/19 PCMH-Kids Care Delivery Requirements Due Date (if applicable) last day of Care Management Submits reports on high risk patients, as defined by CTC, to Health Plans and CTC and achieves 40% engagement rate Quarterly (July/October/January/April) Submits to OHIC Cost Management Strategy Attestation October 15 Submits report that demonstrates 75% of high risk patients who were hospitalized receive a follow up interaction including medication reconciliation within 2 business days Month 12 Planned Care: Population Health /Quality Reporting Submits quarterly quality data January/April/July/October Submits to OHIC quality data information October 15 Access and Continuity Reports to CTC Quarterly Provider Panel Report indicating open/closed panel status for new patients and 3rd next available appointment for existing patients Quarterly Submit to CTC screenshots demonstrating patient access to a secure web portal, enabling secure messaging, appointment requests, referrals, and prescription refills. Month 3
Contract Year PMPM Rate for Care Coordination PMPM Rate for Transformation PMPM Rate for Performance Incentives Max PMPM Year 1: Start-Up $2.50 $1.00 N/A $3.50 Year 2: Performance Year 1 $3.00 N/A $0.50 for meeting thresholds (ED/quality/customer experience) $3.50 Year 3: Performance Year 2 $3.00 N/A $0.50 for meeting thresholds (ED/quality/customer experience) $3.50 APPENDIX B: 2017 PCMH-Kids PMPM Rates
Reviewers Score Sheet Application Essay Questions Total # PR 1 PR 2 PR 3 PR 4 (if applicable) Curr Care (max 1) Geo Dist (max 2) NCM/ CC Cap (max 2) Pt Inv (max 2) % Med (max 3) NCQA (max 1) EHR (max 4) BH (max 3) E #1 (max 10) E #2 (max 10) E #3 (max 10) E #4 (max 10) E #5 (max 10) E #6 (max 10) Pedi (max 78) 1 2 3 4 5 6 7 8 9 10