Created a pilot program to help 50 primary care physician practices improve health system performance, increase quality of care, and decrease costs.

Challenge:

A goal of the Affordable Care Act (ACA) is to support innovation in health care delivery and payment aimed at improving patient care and population health and reducing health care costs. The ACA-established Center for Medicare and Medicaid Innovation (CMMI) awarded Connecticut a State Innovation Model grant in support of this goal to pilot multi-payer health care payment and service delivery models will improve health system performance, increase quality of care, and decrease costs for Medicare, Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries.

Solution:

Qualidigm recruited fifty (50) eligible primary care physician practices to take part in this pilot program, conducted survey and needs assessments, and created office-specific transformation plans with action steps, timelines, and milestones.  Over a period of 18 months, Qualidigm leveraged practice transformation interventions to assist practices in achieving 2014 NCQA recognition at Level II or Level III, Planetree Bronze Recognition, and meeting AMH Must Pass and Critical Factors requirements, Qualidigm convened and led an interactive learning collaborative with group education meetings, virtual group education, and technical assistance, a project-specific website, and in-office technical assistance.

Benefit:

The CMS-driven Connecticut State Innovation Model supports the transformation of primary care to the Advanced Medical Home model, which holds providers to quality standards of whole-person centered care, enhanced access, population health management, team-based coordinated care, and evidence-informed clinical decision making.