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COPD Access to Community Health (CATCH)
Education, Research, and Quality Improvement SESSION TITLE: Education, Research, and Quality Improvement II SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM
COPD Access to Community Health (CATCH)
PURPOSE: CATCH works with a Medical Director, Pulmonologist, and mobile team of specialists to coordinate the care of COPD patients across disparate clinical settings;engaging beneficiaries, prevention, and comprehensive care delivered outside the typical clinical setting. Goals:identify COPD early, improve health outcomes and decrease the overall cost of treating the disease. METHODS: The CATCH team implements evidence-based treatment protocol for practitioners to identify, treat and manage COPD. The target population is the 10,900 Medicare and/or Medi-Cal beneficiaries in the County diagnosed with COPD and to enroll and assess 2,500 patients over three years. GOLD Guidelines are recommended as the best standard of care. Mobile spirometers for the ambulatory care clinics within the County health care system were purchesed, extensive trainings provided to clinical staff on performing pfts. A nurse case manager conducts extensive assessments. Assessments are presented at weekly mulitidisciplinary conference to develop the plan of care. CATCH has developed, tested and implemented a “hybrid” payment reform model for the treatment and management of COPD that includes combining provider incentive with a pre-ordained basket of services that are evidence-based and will become standardized treatment protocol because it is embedded in the EHR. CATCHpay combines provider incentives with the bundling of services for COPD treatment across multiple care levels (primary care providers, specialists, home health organizations, emergency departments and community based organizations) to result in: 1) better care coordination through the use of CATCH care managers; 2) Health Information Technology (HIT) driven, standardized, evidenced-based treatment for COPD patients; 3) heightened patient safety through improved flow of information among providers; 4) improved service delivery system through standardization of treatment; and 5) improved workforce efficiency as a result of greater adherence to care plans. CATCHPay is determined by the “power plan” established in EHR driving treatment for COPD patients diagnosed as GOLD stage 1, 2, 3 and 4. In order to mitigate the fluctuating costs of COPD treatment, the CATCHpay bundled payment model asserts a structure based upon a GOLD severity risk assessment (A, B, C D) that is tied to a 12 month “basket” of services for the COPD patient. RESULTS: CMS Preferred Measure Baseline (pre-CATCH) (post CATCH) Increase over Baseline Patients receiving influenza vaccine 31.5% 43.45% 38% Patients 65+ receiving pneumonia vaccine 25.2% 49.5% 96% Patients receiving smoking cessation intervention Spirometry Evaluation Inhaled bronchodilator therapy All-cause mortality rate Mental Health Status (PHQ-9) 26.8% 100% Average Score PHQ-9 8.7 6.8 ED/Hospital Visit Rate 5% 2.97% Total Cost of Care* $1750 PMPM $1690 CONCLUSIONS: Historically, COPD patients are misdiagnosed. GOLD Guidelines direct treatment based on the severity of disease as determined by assessing medical history, lung function and symptoms. CLINICAL IMPLICATIONS: The CATCH model provides proactive diagnosis and on-going, multi-factorial disease management that includes smoking cessation, influenza and pneumonia vaccinations, pulmonary rehabilitation and pharmacotherapy. DISCLOSURE: The following authors have nothing to disclose: Chris Landon, Susan White-Wood No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.721
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
journal.publications.chestnet.org
629A
EDUCATION, RESEARCH, AND QUALITY IMPROVEMENT
Chris Landon MD*; and Susan White-Wood Ventura County Medical Center, Ventura, CA
COPD Access to Community Health (CATCH)
PURPOSE: CATCH works with a Medical Director, Pulmonologist, and mobile team of specialists to coordinate the care of COPD patients across disparate clinical settings;engaging beneficiaries, prevention, and comprehensive care delivered outside the typical clinical setting. Goals:identify COPD early, improve health outcomes and decrease the overall cost of treating the disease. METHODS: The CATCH team implements evidence-based treatment protocol for practitioners to identify, treat and manage COPD. The target population is the 10,900 Medicare and/or Medi-Cal beneficiaries in the County diagnosed with COPD and to enroll and assess 2,500 patients over three years. GOLD Guidelines are recommended as the best standard of care. Mobile spirometers for the ambulatory care clinics within the County health care system were purchesed, extensive trainings provided to clinical staff on performing pfts. A nurse case manager conducts extensive assessments. Assessments are presented at weekly mulitidisciplinary conference to develop the plan of care. CATCH has developed, tested and implemented a “hybrid” payment reform model for the treatment and management of COPD that includes combining provider incentive with a pre-ordained basket of services that are evidence-based and will become standardized treatment protocol because it is embedded in the EHR. CATCHpay combines provider incentives with the bundling of services for COPD treatment across multiple care levels (primary care providers, specialists, home health organizations, emergency departments and community based organizations) to result in: 1) better care coordination through the use of CATCH care managers; 2) Health Information Technology (HIT) driven, standardized, evidenced-based treatment for COPD patients; 3) heightened patient safety through improved flow of information among providers; 4) improved service delivery system through standardization of treatment; and 5) improved workforce efficiency as a result of greater adherence to care plans. CATCHPay is determined by the “power plan” established in EHR driving treatment for COPD patients diagnosed as GOLD stage 1, 2, 3 and 4. In order to mitigate the fluctuating costs of COPD treatment, the CATCHpay bundled payment model asserts a structure based upon a GOLD severity risk assessment (A, B, C D) that is tied to a 12 month “basket” of services for the COPD patient. RESULTS: CMS Preferred Measure Baseline (pre-CATCH) (post CATCH) Increase over Baseline Patients receiving influenza vaccine 31.5% 43.45% 38% Patients 65+ receiving pneumonia vaccine 25.2% 49.5% 96% Patients receiving smoking cessation intervention Spirometry Evaluation Inhaled bronchodilator therapy All-cause mortality rate Mental Health Status (PHQ-9) 26.8% 100% Average Score PHQ-9 8.7 6.8 ED/Hospital Visit Rate 5% 2.97% Total Cost of Care* $1750 PMPM $1690 CONCLUSIONS: Historically, COPD patients are misdiagnosed. GOLD Guidelines direct treatment based on the severity of disease as determined by assessing medical history, lung function and symptoms. CLINICAL IMPLICATIONS: The CATCH model provides proactive diagnosis and on-going, multi-factorial disease management that includes smoking cessation, influenza and pneumonia vaccinations, pulmonary rehabilitation and pharmacotherapy. DISCLOSURE: The following authors have nothing to disclose: Chris Landon, Susan White-Wood No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.721
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
journal.publications.chestnet.org
629A
EDUCATION, RESEARCH, AND QUALITY IMPROVEMENT
Chris Landon MD*; and Susan White-Wood Ventura County Medical Center, Ventura, CA