A pilot program to improve primary care is showing signs of success at SAMA Healthcare, a family practice serving southern Arkansas.

Centers for Medicare & Medicaid Services (CMS) selected SAMA as one of 497 practices to participate in its Comprehensive Primary Care Initiative (CPCI). Funding from the program enabled SAMA to make several improvements, including new color-coordinated care teams.

 

What the CMS is doing to improve primary care

CPCI is a four-year pilot project. It is a collaboration among public and private payers to strengthen primary care. By investing more in primary care practices, the partners hope to achieve better health, better care and lower healthcare costs.

The CPCI aims to improve primary care in two ways:

1)      Practice redesign. These providers must comprehensively address five primary care functions: risk-stratified care, access and continuity, population health management, patient engagement, and care coordination. CMS outlines nine key milestones for the first year, ending with successful attestation for Stage 1 of Meaningful Use.

2)      Payment redesign. The Medicare fee-for-service remains in place. The CMS and private payers will deliver a Per-Beneficiary-Per-Month (PBPM) fee and will share savings with practices. Providers may use non-visit-based money to support care teams, technology investments or non-billable practitioner time.

If these approaches work in the pilot, CMS will implement them nationwide.

SAMA started the program in August 2012, relying on Allscripts Professional EHRTMand Allscripts Practice ManagementTM along the way. SAMA used CPCI funding to remodel parts of its clinic, upgrade equipment and move to a new staffing model that helps better coordinate patient care.

SAMA’s colorful approach to care coordination

In SAMA’s old staffing model, each doctor, nurse practitioner and physician’s assistant would work with a nurse or two to deliver care. It was challenging to provide continuity to patients, especially walk-in patients with acute care needs.

Now SAMA embraces a team concept. Each doctor leads a team that consists of a nurse practitioner, three nurses and a care coordinator. Each team wears a single color to help patients easily identify their caregivers.

First year outcomes are encouraging

Several measures are improving care at SAMA already. For example, a renewed focus on preventative care has increased diabetic foot exams 400% in one quarter. And increased colon cancer screenings led to early diagnoses for several patients.

Learn more in this video featuring SAMA Healthcare team members talking about their experience with CPCI.

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About the author

Former CIO / InfoSec Consultant / expert systems designer / Administrator for OB/GYN & OccMed practices / Family Therapist. Masters in Computer Science and Psychology; author of two books on artificial intelligence. In my "copious" free time I am a professional storyteller and inspirational speaker.

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