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March 8, 2018
Greetings All,
Patient-centered outcomes research is evolving, and it advocates for more collaboration between researchers, doctors, patients and caregivers. Nationally, there is ongoing work to explore how and to what extent evidence and an orientation towards patient and community health outcomes are informing decision-making in state and local health systems.
I had the privilege of participating in a February 27 roundtable session, Spreading Ideas - Improving Outcomes: Driving Innovation in State & Local Health Systems where I had the honor of sharing the great work done by HCHs. The program brought together voices from across the spectrum of health policy, clinical care, and public health. Everyone around the table shared their insights, perspectives, and feedback vital to further the understanding of challenges and opportunities for promoting evidence-informed and patient-centered care and health interventions. This convening also generated recommendations to empower combined efforts in improving population health outcomes
Stay tuned as a final report is pending and a goal of the HCH program is to share this research with all of you.
Best Wishes,
Bonnie
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Thanks and Well Wishes for Cally Vinz
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 The Health Care Homes (HCH) team wants to say “Thank You!” to Cally Vinz, retiring Vice President of the Institute for Clinical Systems Improvement (ICSI), for her tremendous support of HCH. Cally served as chair of the HCH Advisory Committee for the past two years, as a member of the Learning and Technical Assistance Workgroup, and as a Certification Committee member since 2015.
Speaking of her experiences watching HCH develop from its early years to the present, Cally described seeing the positive impact of the program in Minnesota across the care delivery spectrum. "The Health Care Homes model supports new trends in care delivery design that need to be further implemented, and plays an important role in supporting Minnesota’s position as a national leader in health care delivery innovation."
Cally is retiring from ICSI, but has no plans to end her efforts to improve the wellbeing of Minnesotans. She intends to use her skills in areas such as bridge building and facilitation to continue passionately supporting the promotion of health.
Once again, thank you Cally and best wishes from Health Care Homes as you take the next steps on your journey!
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Don't Miss Learning Days! April 3-4, 2018 in St. Paul
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Register by March 22 to attend this annual get together for health care home care teams and community partners. Network with your peers, learn from each other and acquire take home skills you can use!
- Connect with participants as an exhibitor or sponsor – space still available!
- Nominate an individual or care team for a Health Care Homes Innovation Award (self-nominations welcome!) – Deadline March 9
- Share your success stories on the Health Care Home Wall of Fame.
Visit the Health Care Homes website for an online brochure, information about the conference and registration instructions.
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The Learning Management System (LMS) is Up and Running!
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The Health Care Homes LMS debuted in early January with our first e-Learning course, Foundations of Health Care Homes Certification. It has been a success, drawing positive comments from HCH-certified clinic staff such as:
- Jill Swenson, Sanford clinics, stated simply, “I Loved it!”
- Ranet Scmeichel, Ortonville Area Health Services, referring to the Foundations course, “…have completed 4 of the modules. I found them very informative and well designed.”
- Laura Vaneps, Scenic Rivers Health Services, “I have gone through 4 modules and think this is awesome… I am so grateful for this as it will be very helpful in educating and getting staff on the same page.”
HCH is excited to introduce a new course - "Check-up from the Neck Up". This course focuses on Alzheimer’s and dementia and provides clinicians and care team members with tools and knowledge to support assessing cognition in older adults.
For more information and to create a LMS account, visit the HCH Learning Management System webpage.
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Care Coordination Cost Study - article by Lacey Hartman
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 Minnesota’s HCH program, administered by the Minnesota Department of Health (MDH), is aimed at developing patient-centered, team-based care that links the medical component of primary care to wellness, prevention, self-management, and community services. The Minnesota Departments of Human Services and Health (DHS and MDH) contracted with the State Health Access Data Assistance Center (SHADAC) at the University of Minnesota to conduct a study of the costs of HCH care coordination for adults. In order to estimate the cost of care coordination, SHADAC used a case study approach and developed a list of activities (or “ingredients”) that define care coordination and collected information about the costs associated with each of these activities at six non-acute, primary care clinics.
SHADAC found that the costs for care coordination varied considerably across sites, and the variation was primarily due to the number of hours devoted to care coordination and the credentials and wages who performed care coordination activities. Clinics appreciated the flexibility afforded by the HCH model design to operationalize certification standards according to clinic and patient needs. Across the board, staff reported the high value of care coordination to the patients. Many noted that it improved the efficiency of care delivery and likely saved costs and resources.
Read the Minnesota Health Care Home Care Coordination Cost Study (PDF) found on the HCH website. This report was written by the following staff at SHADAC: Elizabeth Lukanen, MPH; Lacey Hartman, MPP; and Christina Worrall, MPP.
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MACRA Benefits for certified HCHs
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 The Medicare Access and CHIP Reauthorization Act (MACRA) led to establishment of the new CMS Quality Payment Program consisting of two tracks: the Merit-based Incentive Payment System (MIPS), and Advanced Alternative Payment Models (APMs). Health Care Homes (HCH) certified clinics participating in MIPS receive 100% of possible points in the Clinical Practice Improvement Activities (CPIA) category. Clinics must attest to their certification status to obtain this benefit.
How do clinics attest that they are a certified HCH?
Patient Centered Medical Home Attestation is listed as an activity choice in the Improvement Activities Selection Tool. Search using the keyword PCMH.
ACTIVITY ID: IA_PCMH
"I attest that I am a Patient Centered Medical Home (PCMH) or Comparable Specialty Practice that has achieved certification from a national program, regional or state program, private payer, or other body that administers patient-centered medical home accreditation and should receive full credit for the Improvement Activities performance category."
The CMS site states, “NOTE: This tool is for informational and estimation purposes only. You cannot use this tool to submit or attest to measures or activities."
Deadlines are fast approaching to submit data for the 2017 MIPS performance period. CMS experts will answer commonly asked questions about the submission feature and answer attendees' questions live on a MIPS "Attestation for Advancing Care Information and Improvement Activities" webinar Wednesday March 14 from 3 to 4 pm ET.
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MDH HCH Portal web address as of 12-28-2017
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MN.IT at MDH moved the HCH Portal application to the Amazon Cloud on Thursday December 28, 2017, resulting in a new web address: https://hchcertification.web.health.state.mn.us/login.seam.
The old web address (https://apps.health.state.mn.us/hchcertification/login.seam) will redirect to the new web address until June 2018. Please update any personal browser bookmarks that point to the MDH HCH Portal.
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Community Health Workers (CHW) Conference May 23, 2018
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The Minnesota CHW Alliance 2018 conference, "New Horizons for Community Health: Thriving at the Forefront of Health Transformation", is Wednesday, May 23, at the TIES Center in Falcon Heights. CHWs, Promotoras/es, supervisors, providers, educators, students, community-based nonprofits, government agencies, health plans, payers, researchers, funders, policymakers and interested others are all welcome to attend. The registration site will open this month.
The Alliance is seeking volunteers to join the conference planning committee, serve as breakout faculty and help on the day of the conference. They are also seeking sponsorships and exhibitors.
For more information, contact: Joan Cleary, Executive Director, MN CHW Alliance joanlcleary@gmail.com 612-250-0902.
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Noteworthy Info & Resources
Recertification Resources. When applying for HCH recertification, please visit the HCH website for updated Recertification Requirements in the Guides and Tools area. Website resources outline First Recertification Requirements along with Second Recertification and Subsequent Recertification Requirements and contain many useful links.
The Office of Rural Health and Primary Care (ORHPC) has posted "Emerging Professions Guide to Professionalization" on the ORHPC website.
View the newest HCH YouTube video "Health Care Homes in Minnesota" on the MDH YouTube channel.
Visit the Health Care Homes YouTube playlist for more videos on how Health Care Homes certification is transforming primary care and improving health for patients, families and communities.
MDH Children and Youth with Special Health Needs program awarded $32,000 grants to five clinics to implement quality improvement projects for improving care coordination for children and youth with special health needs: Children’s Minnesota, Lakewood Health System, Unity Family Health Care, West Side Community Health Services, and Essentia Health.
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