Summer 2009 What’s inside? Greetings from Chairperson (4-5) // From the Desk of the Executive Director (6) // Message from the Board of Directors (7) // Program Highlights (8-11) Institute for Nursing Centers Update (12) // Spotlight on New Programs (13-14) // Working to Eliminate Community Health Disparities (14-15) // NNCC in the News (15-16) // Data Talks (16) // Member Services and Resources (16) // NNCC Committee Updates (16-17) // On the Road with Nurse-Manages Health Centers (19-32) // The Coding Corner (33-34) // NNCC Technical Assistance (34) // Policy News (35-36) // Insurers’ Policies on Nurse Practitioners as Primary Care Providers (37-39) // NNCC’s Managed Care Contracting Project (40-41) // NNCC-Member Peer-Reviewed Articles (41) // Capstone Rural Health Center: A Leader in Technology (42-43) // International News (44) // NNCC Staff (45)
Board of Directors: Kenneth P. Miller, PhD, RN, CFNP, FAAN Chairperson
Making the Case for Nurse-Managed Care with Electronic Data Improving Chronic Care in Pennsylvania
M. Christina R. Esperat, RN, PhD, APRN, BC Immediate Past-Chair
by Grace Lee t is pretty safe to say that Pennsylvania has
practice coaches, and provider and consumer
Amy Barton, PhD, MSN Secretary
much room for improvement in the delivery
incentive alignment, starting with the Southeast
and management of chronic care. Almost 80
Pennsylvania region in May 2008. In adopting
percent of all health care costs in Pennsylvania
the Commission’s plan, Pennsylvania becomes
can be traced to 20 percent of patients who have
the first state to combine practice redesign with
chronic diseases, yet those with chronic diseases
reimbursement redesign in the management of
only receive about 56% of recommended care.
chronic care.
John Loeb, MSS Treasurer and Finance Chair Tine Hansen-Turton, MGA, JD Executive Director Susan Beidler, PhD, MBe, ARNP, BC Richard Cohen, PhD Jeri Dunkin, PhD, RN
I
Avoidable hospitable admissions for patients with
The model for improving chronic care delivery
asthma are three times higher in Pennsylvania
being adopted by the Commission is an integra-
compared to the best performing states in the
tion of the Chronic Care Model and the Patient-
nation, while avoidable hospital admissions for
Centered Medical Home concepts. The Chronic
patients with diabetes are four times higher. In
Care Model was developed by Ed Wagner of the
Phil Greiner, DNSc, RN
2005, there was $1.7 billion in potentially avoid-
MacColl Institute for Healthcare Innovation and
Denise Link, PhD, WHNP-BC, CNE, FNAP
able hospital charges for Pennsylvanians with
focuses on team-based coordination of care for
chronic disease.
patients with chronic illnesses. The Chronic Care
Sally Lundeen, PhD, RN, FAAN
In order to improve the health of Pennsylva-
Model is already being used in a number of state
James Paterno, MBA
nians with chronic diseases, Governor Edward G.
and national collaboratives such as the Health
Lenore Resick, PhD, RN
Rendell created the Chronic Care Management,
Disparities Collaborative (a HRSA implementation
Reimbursement and Cost Containment Commis-
through Federally Qualified Health Centers), and
sion (the Commission) in May 2007 as part of
Veteran’s Administration. The Patient-Centered
his Prescription for Pennsylvania health care
Medical Home concept comes from the Ameri-
reform plan. The Commission was charged with
can Academy of Pediatrics and is also becoming
developing a strategic plan for implementing a
more widely adopted across the country. It also
process to effectively manage chronic disease
features similar ideas such as team collaboration,
across the state and thereby improve the qual-
the use of decision support and clinical informa-
ity of care while reducing avoidable illnesses and
tion systems in patient care.
Nancy Rothman, RN, EdD Elaine Tagliareni, MS, RNC, EdD Donna Torrisi, RN, MSN, CRNP Rebecca Wiseman, PhD, RN
their associated costs.
In all, 33 practices representing internal
In February 2008 the Commission delivered
medicine, family practice, pediatrics, and nurse-
to the Governor and Legislature a plan to begin
managed practices serving 176,000 patients in
regional rollouts using learning collaboratives,
Southeast Pennsylvania are participating in the