KFMC Leads Initiative for Primary Care Providers

The Kansas Foundation for Medical Care (KFMC) is working to carry out the new payment model initiatives set forth by Centers for Medicare & Medicaid Innovation (CMMI) through various efforts across multiple contracts. These models provide incentives to providers for making correct care decisions and for moving toward a more coordinated, integrated care system.

Ahead of the Practice Transformation Network grant award, KFMC has partnered with Maryland-based Aledade, to form an independent physician-led Accountable Care Organization (ACO) in Kansas: the Aledade Kansas ACO.  ACOs are networks of physicians who band together to deliver coordinated care to patients, operating under a payment structure that rewards positive health outcomes for patients, instead of the volume of healthcare services delivered.

"Family physicians have a unique connection with their patients,” said Dr. Farzad Mostashari, CEO and co-founder of Aledade. “They are best positioned to lead the transformation toward value-based healthcare, and our ACO will empower them to do so.  And just like these doctors have a special relationship with their patients, KFMC has a special relationships with Kansas physicians.  We’re excited to work with this team, and know this partnership will benefit Kansas’ independent doctors and their patients.”

Aledade ACOs focus on delivering the highest quality care to patients, with an emphasis on preventative care, high-value referral networks, and customized technology. Aledade offers unmatched analysis of patient claims and electronic health record (EHR) data to identify patients who need help before serious medical problems arise. Aledade’s partnership with KFMC will enable the new ACO to provide hands-on, personal support for physicians throughout the entire setup and operation of the new organization.

Jennifer Brull, MD, a leader in electronic medical record adoption and one of the first Kansas physicians to attest to meaningful use in the state, will serve as the organization’s medical director. “Aledade brings tremendous experience on the national scale, while KFMC brings true connections to doctors and patients in our home state.” said the Plainville-based Dr. Brull.  “It’s a powerful combination that will allow small primary care practices access to the tools of a big-city ACO, while retaining the small town feel that makes our practices special.  With trusted, knowledgeable partners like Aledade and KFMC, Kansas physicians will improve both the quality of the care we provide, and our own financial stability.”

The current payment model for providers is a fee-for-service, fragmented care system that is associated with a relatively low quality of care. The care delivered is inconsistent; there is a increased probability for medical error as well as many patient safety incidents and preventable deaths. In addition, this system is a significant contributor to the federal budget deficit. The costs are increasing faster than salaries and inflation, and American’s healthcare expenditures are by far the highest in the world.

The Practice Transformation Network grant will be the next step toward supporting the Centers for Medicare and Medicaid Innovation (CMMI) goals of development and testing of innovative health care payment and service delivery models.

Success with REC

Part of the reason we have high confidence in our ability to secure and execute the PTN grant is due to our Regional Extension Center (REC) work. We recently updated our impact map which can be viewed here.

We have helped over 1,674 providers select, implement, and or meaningfully use their Health IT. Additionally, through our strong partnership with The Kansas Hospital Education and Research Foundation, we have provided assistance to our 95 critical access rural hospitals.

To boil this down further, of the 9,891 healthcare providers in Kansas, 4,623 (or 46%) are registered with CMS for the EHR incentive programs. 3,141 EPs have already received at least one incentive payment for a combined total of over $80.7 million. We have assisted 806 of those earning an incentive for a total of $20 million.

There are 126 hospitals in Kansas, including 82 Critical Access Hospitals (CAHs) and 13 Rural Hospitals (RHs) who have benefitted directly from the REC grant. Thus far, 88 have adopted CEHRT and 66 have achieved Meaningful Use and have collectively earned over $198 million in CMS incentives.

As you can see, we have also worked with the FQHCs and RHCs throughout our state. The Kansas Association for the Medically Underserved has been a great partner throughout the REC Grant, and together we have assisted fifteen of the sixteen FQHCs in Kansas.

The Practice Transformation Network grant has lofty goals, and the team at KFMC are excited to continue working with the great caregivers throughout Kansas as we work towards the common goal of better care, improved health, and reduced cost of care.

Overview of our Practice Transformation Project

A new national initiative aims to support physician practices to move toward a pay-for-value health care system. The Center for Medicaid and Medicare Services' (CMS) Innovation Center is creating Practice Transformation Networks (PTN): On-the-ground technical assistance to help primary and specialty care practices achieve the Triple Aim and thrive in the pay-for-value environment.

The Radius PTN brings together highly successful Regional Extension Centers (RECs), Quality Innovation Network Quality Improvement Organizations (QIN-QIOs) and Regional Health Improvement Collaboratives (RHICs), to efficiently and effectively assist practices in data-driven transformation while creating PTN services embedded in local stakeholder communities. This approach will build a strong foundation to maximize alignment and sustainability, increase connection between providers of care and community support systems, and help influence widespread adoption of payment reform. Together we submitted an application to become a PTN.

If successful, Radius will provide no-cost support to primary care and specialty clinicians who want to use their health information technology to improve efficiency in their practice and to provide better coordination of care for their patients. We will help clinicians transform their practices and position them to thrive under new payment models and meet quantifiable improvement outcomes through use of data, joint learning opportunities and directly assisting practices. Finally, we will connect participating practices with peers who are successful clinical transformation leaders.

Who is Radius: While Radius is a new partnership, Radius partners have over 40 years of experience assisting front-line providers and engaging health care stakeholders. Our services improve outcomes and deliver measurable results that directly influence the care delivered to millions of people. The Radius partnership includes:

• HealthInsight in Nevada, New Mexico and Utah (applicant organization) along with the Nevada and Utah Partnerships for Value and the New Mexico Coalition for Healthcare Quality
• Kansas Foundation for Medical Care (KFMC) in Kansas along with the Kansas City Quality Improvement Consortium (KCQIC)
• MetaStar in Wisconsin along with the Wisconsin Hospital Association (WHA) and the Wisconsin Collaborative for Healthcare Quality (WCHQ)
• Pittsburgh Regional Health Initiative (PRHI) in Delaware, Pennsylvania and West Virginia along with Quality Insights and PASpread
• Stratis Health in Minnesota and North Dakota along with the Institute for Clinical Systems Improvement (ICSI) and Minnesota Community Measures (MCM).

We are also partnering with primary care associations through most of our states who will help administer Radius PTN services adapted to best meet the needs of their members including federally qualified health centers (FQHCs), and rural and tribal health centers.

Radius has also engaged Aledade, Inc., specialists in alignment with federal initiatives who will supply expertise on analytic strategies and methods to prepare practices for alternative payment models to augment our existing skills and abilities.

Working jointly, we will serve 13,000 providers to achieve the highest level of impact on quality and cost for the invested resources. Each entity brings deep existing connections with providers and stakeholders to assist in recruitment and alignment with other initiatives. The Radius partners have a long history of collaboration and implementation and use, health care system redesign, transparency and public reporting, and as conveners of multi-stakeholder improvement collaboratives, we are well positioned to serve as a PTN.

The transition to a reimbursement system that rewards value versus volume is inevitable. Together, we can be a part of leading and creating positive change for the entire health care system.

Working jointly, we will serve 13,000 providers across 19% of the US geography that has 11% of the country's Medicare, Medicaid and CHIP beneficiaries.

Aledade and Kansas Foundation for Medical Care in the news:

Clinical Innovation + Technology
Kansas Health Institute
Topeka Capital Journal