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PMI Resdults Cycle 1 2004-2005. Practice Management Improvement (PMI) Initiative. Twelve-month quality assurance collaborative designed to i ncrease knowledge of practice management improvement among SBHC team members and demonstrate SBHC improvement in: Facilities - PowerPoint PPT Presentation
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PMI ResdultsPMI ResdultsCycle 1 2004-2005Cycle 1 2004-2005
Practice Management Practice Management Improvement (PMI) InitiativeImprovement (PMI) Initiative
Twelve-month quality assurance collaborative designed to increase knowledge of practice management improvement among SBHC team members and demonstrate SBHC improvement in:– Facilities– Business Operations (productivity,
coding)– Human Resources– Care Management (CQI, coding, charting)– Practice Compliance (CQI, coding,
charting)
Practice Management Practice Management Improvement (PMI) InitiativeImprovement (PMI) Initiative
First Cycle 2004-2005 (Beta Test) Six school-based health centers from
4 states (California, New York, Texas, West Virginia)
PMI ObjectivesPMI Objectives• Increase SBHC team’s knowledge and
understanding of practice management and practice management improvement
• Complete a situational analysis of the SBHC practice environment. Internal and external practice environments SCORE Model (facilities, business operations,
human resources, care management, and practice compliance)
Internal and External S.W.O.T. analyses
PMI ObjectivesPMI Objectives
Utilize SBHC situational analysis and recommendations to establish a mission statement for the SBHC
Develop a SBHC practice improvement plan/strategy with short and long term objectives that support the SBHC mission
PMI ObjectivesPMI Objectives
Code and document SBHC evaluation/ management office visits and preventive health visits appropriately.
Code and document SBHC mental health visits appropriately.
Use ICD 9 codes and other CPT codes appropriately to maximize SBHC reimbursement and to correctly report the services done in SBHCs.
PMI ObjectivesPMI Objectives
Utilize NASBHC’s CQI Tool to assess and improve the delivery of care related to the sentinel conditions
Implement a multifaceted approach for measuring the SBHC’s productivity across core components
PMI ActivitiesPMI Activities 4 Learning sessions
2 Site visits (pre and post score model, chart review, and coding compliance review)
1 Site visit (SWOT analysis, mission statement, outline practice management improvement plan)
Workplan for each objective
Quarterly progress reports
Monthly conference calls
Storyboards
Reunion
PMI TimelinePMI Timeline
FEBMARAPR
JANNOV DECOCTSEPAUGMAYJUNJUL
MAYJUN
LS2 L3LS1
SituationalAnalysis
Implementation of LS III
Work plan Objectives
LS4
Implementation of LS IV
Work plan Objectives
SituationalAnalysis
Implementation of LSI
Work plan Objectives
Implementation of LS II
Work plan Objectives
SCOREMODEL
SCOREMODEL
Nat’l Convention
LS = Learning Session
Objective #1Objective #1 - - Increase SBHC team’s Increase SBHC team’s knowledge and understanding of knowledge and understanding of practice management and practice practice management and practice management improvementmanagement improvement
• All team members at the participating site increased their knowledge and understanding of practice management and improvement
Objective #2Objective #2 - -Complete a situational Complete a situational analysis of the SBHC practice analysis of the SBHC practice environmentenvironment
All participating sites completed• Analysis of internal and external practice
environments, • SCORE Model (facilities, business operations,
human resources, care management, and practice compliance), and
• Internal and External S.W.O.T. analyses
Objective #3 - Utilize SBHC situational Objective #3 - Utilize SBHC situational analysis and recommendations to analysis and recommendations to establish a mission statement for the establish a mission statement for the SBHCSBHC
• All participating sites utilized their SWOT analysis and recommendations to establish or update their SBHC’s mission statement
• Mission statement(s) of sponsoring and/ or collaborating organizations reviewed to access alignment and differences with SBHC’s mission
Objective #4Objective #4 - Develop a SBHC - Develop a SBHC practice improvement plan/strategy with practice improvement plan/strategy with short and long term objectives that short and long term objectives that support the SBHC missionsupport the SBHC mission
• 83% of participating sites developed a practice improvement plan/strategy with short and long term objectives to support the SBHC mission
• All participating sites completed work plans related to learning session objectives
Objective #5Objective #5 - - Code and document Code and document SBHC evaluation/ management office SBHC evaluation/ management office visits and preventive health visits visits and preventive health visits appropriatelyappropriately..
• All participating sites demonstrated improvement from pre to post chart reviews /coding compliance audits in appropriate documentation and coding of evaluation and management visits and preventive health visits.
Objective #6Objective #6 - -Code and document Code and document SBHC mental health visits SBHC mental health visits appropriately. appropriately.
• All participating sites demonstrated improvement from pre to post chart reviews /coding compliance audits in appropriate documentation and coding of mental health visits
Objective #7Objective #7 - Use ICD 9 codes and - Use ICD 9 codes and other CPT codes appropriately to other CPT codes appropriately to maximize SBHC reimbursement and to maximize SBHC reimbursement and to correctly report the services done in correctly report the services done in SBHCs.SBHCs.
• All participating sites demonstrated improvement from pre to post chart reviews /coding compliance in appropriate documentation and coding of mental health visits.
Objective #7Objective #7 - Use ICD 9 codes and - Use ICD 9 codes and other CPT codes appropriately to other CPT codes appropriately to maximize SBHC reimbursement and to maximize SBHC reimbursement and to correctly report the services done in correctly report the services done in SBHCs.SBHCs.
• All participating sites demonstrated improvement from pre to post chart reviews /coding compliance in appropriate documentation and coding of mental health visits.
Objective #8Objective #8 - Utilize NASBHC’s CQI - Utilize NASBHC’s CQI Tool to assess and improve the delivery Tool to assess and improve the delivery of care related to the sentinel conditionsof care related to the sentinel conditions
• All participating sites demonstrated improvement from pre to post chart reviews in screening, identification, and treatment of the sentinel conditions contained in NASBHC’s CQI tool.
Objective #9Objective #9 - Implement a multifaceted - Implement a multifaceted approach for measuring the SBHC’s approach for measuring the SBHC’s productivity across core components productivity across core components
• All participating sites demonstrated improvement from pre to post situational analysis (SCORE model and interviews) in their systems and/or practices related to documentation and reporting of productivity and value added services.
Pre and Post OverallPre and Post OverallPMI SCORE Model Rating PMI SCORE Model Rating
66.7
85.2
0
10
20
30
40
50
60
70
80
90
Per
cen
t
Pre Post
PMI Score Model RatingsPMI Score Model RatingsPre and Post FacilitiesPre and Post Facilities
70
86.5
0
10
20
30
40
50
60
70
80
90
Per
cen
t
Pre Post
PMI Score Model RatingsPMI Score Model RatingsBusiness OperationsBusiness Operations
65.3
84
0
10
20
30
40
50
60
70
80
90
Per
cen
t
Pre Post
PMI Score Model RatingsPMI Score Model RatingsHuman ResourcesHuman Resources
75.5
98
0
10
20
30
40
50
60
70
80
90
100
Per
cen
t
Pre Post
PMI Score Model RatingsPMI Score Model RatingsCare ManagementCare Management
57.6
81
0
10
20
30
40
50
60
70
80
90
Per
cen
t
Pre Post
PMI Score Model RatingsPMI Score Model RatingsPractice CompliancePractice Compliance
72.3
86.7
0
10
20
30
40
50
60
70
80
90
Per
cen
t
Pre Post
PMI Score Model RatingsPMI Score Model RatingsBusiness OperationsBusiness Operations
65.3
84
0
10
20
30
40
50
60
70
80
90
Per
cen
t
1st Qtr 2nd Qtr
Pre and Post OverallPre and Post OverallPMI SCORE Model RatingPMI SCORE Model Rating
66.785.2
0.010.020.030.040.050.060.070.080.090.0
Percent
Pre % Post %
Average Total Score
SUMMARYSUMMARY
PMI OutcomesPMI Outcomes NASBHC involvement elevates status of
SBHC within sponsoring organization (from stepchild to focal point)
SBHC practice management improvements carry over to sponsoring and collaborating organizations’ systems overall
NASBHC’s PMI (score model, chart audit instruments) are being integrated/adopted by some state and local SBHC organizations
PMI OutcomesPMI Outcomes
Increase in all SCORE Model ratings from baseline to completion of cycle
Improvement in ICD and CPT coding
All sites are collecting data on productivity, including value added services
