Eugene Pediatric Associates has achieved another critical milestone — we were the top pediatric clinic (by far) in performance of Coordinated Care Organization (CCO) Quality Metrics for our region.
What is a CCO? It’s an innovative idea in Oregon where health care providers (physical health care, mental health care and sometimes dental care providers) have agreed to work together to serve people who receive health care coverage under the Oregon Health Plan (Medicaid). EPA is part of a CCO.
This new concept in paying clinics based on specific quality measures is called “pay for performance.” The idea is to give better care to more people for less money. Seventeen broad quality measures in Oregon touched both pediatric and adult medical care. The measures specific to Eugene Pediatric Associates’ performance were:
- Follow up office visits at least every 12 weeks with children who have ADHD.
- Mental and physical health assessment of children placed in foster care within 60 days of placement.
- Emergency Room utilization decreases.
- Adolescent well checks at least once per year.
- Developmental screening at well checks before age three.
- Patient-Centered Primary Care Home enrollment.
- Patient satisfaction/access to care questionnaires.
- Electronic Health Record adoption.
- Screening for depression.
Those clinics that had an outstanding rating for quality and number of patients served received more money. Those clinics serving fewer patients or underachieving on the metrics received less. That we did an outstanding job on these metrics speaks to several factors.
First, our clinic was rewarded for being on the leading edge of technology and change. When the drumbeat of health care reform made it clear to me that a conversion from paper charts to electronic was needed, and when the PCPCH program was announced, we did not wait, we led our field. The complicated and expensive transition to electronics, which included adding staff to attend to the million new details, paid off. The results have all benefitted the kids we serve.
Second, Eugene Pediatrics is the perfect size to make rapid transformation. Change is hard, especially when hundreds or thousands of doctors and nurses are forced to change work habits they have had for decades. Larger, more corporate clinics are struggling in this new paradigm. When it’s a smaller clinic like ours, we can meet as a team, talk about new regulations and implement them quickly.
Third, and perhaps most importantly, our patients are engaged. Look again at the list of requirements and notice that several of them depend upon patients doing what is in the best interests of their kids:
- Come for well checks.
- Answer detailed developmental questionnaires.
- Utilize expensive emergency room care only in a true emergency.
We at Eugene Pediatrics work hard to reach out to you and give our best care at every opportunity, and you respond. For that, we are truly grateful. Working together, we can make the greatest positive impact for your kids’ health.
Health care reform is moving quickly in a very new direction. Instead of paying for services given, doctors in the future will be paid if their clinics meet increasingly complex quality metrics. For now, it’s mostly the government-insured system leading us in this direction, but private insurance companies also are starting their own quality metric programs.
Eugene Pediatric Associates is ready for all of that because, ultimately, we must meet these challenges and be a leader if we are to do what we love the most: earn your trust and take care of your precious children. Every step of the way.