701 Pennsylvania Ave. N.W.
Suite 700
Washington, DC 20004
(202) 737-5980
dmaa@dmaa.org
www.dmaa.org

Sunday, Sept. 7, 1:30 - 2 p.m.
PACESETTERS SERIES

This presentation will highlight an advanced medical home demonstration project between an integrated health system and health insurance company, a novel approach that enhances care coordination for primary care patients and intensifies chronic condition care to improve health and financial outcomes. The presentation will define the advanced medical home, describe the model of care delivery and review outcomes. Building on the success of an earlier diabetes program and restructuring nurse roles to keep increased nurse salary costs to a minimum, the demonstration project focuses on diabetes, coronary vascular disease and hypertension and integrates preventive care services. The population, adults seen at one of four project clinics, is estimated at 3,164 patients.

Wanda Hanson, RN, MSN, is chronic disease coordinator at MeritCare Health System. She received her bachelor's in nursing from the University of North Dakota and her master's in gerontological nursing from the University of California, San Francisco. Ms. Hanson is experienced in hospice and home care.

Managed care organizations and provider groups have been separately using disease management approaches to assist their members and patients with chronic diseases. To support the medical home model, a health plan partnered with a provider group to increase patient activation and integrate diabetes disease management. This initiative increased member engagement from 23 percent to 47 percent and provided more efficient care delivery resulting in improved clinical outcomes, exceptional care and a flexible project structure with high portability potential. Understand a common clinical framework for improving chronic illness care, how to adapt the model for use in other settings and key factors to deliver successful outcomes.

David Brumley, MD, MBA, is the medical director of health management at Blue Cross Blue Shield of Massachusetts. He chairs the DMAA Quality Awards Committee. He previously served as senior medical director at Oxford Health Plans, with Medical Scientists Inc. and Blue Cross Blue Shield of Rhode Island.

Joe Kimura, MD, MPH, is the medical director of quality measurement for Harvard Vanguard Medical Associates and Atrius Health. He also serves as the director of continuing professional education. Dr. Kimura, a board certified internist, received his bachelor's from Stanford University, his doctorate from Washington University and his master's from Harvard University.

Co-existence of mental health and substance abuse (MH/SA) with medical illness is significant. Estimates of comorbidities range from 20 percent to 80 percent in primary care, with a 25-year disparity in life expectancy between the general population and those with serious mental illness. A solution to documented access issues might be integration of mental health practitioners within primary care. Hear about a community model from Cherokee Health Systems that couples primary care education with screening and treatment of common MH/SA conditions by co-locating behavioral health providers in the primary care clinic and organizing integrated practice teams. This model provides practical applications of behavioral health, including medication adherence, health behavior change, chronic pain management, weight management and smoking cessation. Outcomes presented include demonstrated effectiveness in improving outcomes, ensuring appropriate utilization, reducing medical costs and raising patient and provider satisfaction.

Dennis Freeman, PhD, has served as the CEO of Cherokee Health Systems since 1978, a community-based provider of integrated primary care and behavioral health services in Tennessee. Former Surgeon General Dr. Satcher presented him with the 2007 Best Practices in Primary Care Award at the National Center for Primary Care conference.

George Rust, MD, MPH, is professor of family medicine and the interim director of the National Center for Primary Care at Morehouse School of Medicine. His career has focused on primary care for underserved populations, starting in migrant farm workers health, and for the past 16 years, building bridges between academic and front-line clinicians to improve primary care and eliminate health disparities.

Jerry Vaccaro, MD, became president and COO of APS Healthcare Inc. in 2007. Previously, he served as CEO of United Behavioral Health and president and CEO of PacifiCare Behavioral Health. Dr. Vaccaro has an extensive background in community mental health and public sector work and serves on numerous boards.

In 2007, DMAA began developing a second survey tool for its members to use in assessing the satisfaction of those they serve. Phase I of the Provider Satisfaction initiative included three focus groups with physicians from across the United States to hear their experiences with disease management programs. Phase II will be the development of the actual survey instrument. Session participants will hear the focus group findings to include physicians' evaluations of disease management programs in relation to their practice of medicine.

Claudia L. Schur, PhD, is vice president and deputy director of the Center for Health Research and Policy at Social & Scientific Systems. Dr. Schur has more than 20 years of experience in designing surveys and analyzing health care data sets to improve the information available to policymakers.