Pennsylvania

In response to Pennsylvania’s growing chronic disease burden and its impact on healthcare spending, the Governor issued Executive Order 2007-05 on May 21, 2007. This order created the Pennsylvania Chronic Care Management, Reimbursement and Cost Reduction Commission, also known as the Chronic Care Commission. The Commission proposed and then implemented the Pennsylvania Chronic Care Initiative (CCI) designed to achieve four strategic goals:

  • Widespread use of a new primary care reimbursement model that rewards PCMH care based on the Chronic Care Model.
  • Broad dissemination of the Chronic Care Model to primary care practices across Pennsylvania, through regional chronic care learning collaboratives. 
  • Achievement of tangible and measurable improvement in patiient satisfaction, access to care, health outcomes and quality of life.
  • Reduction in the cost of providing chronic care with the reduction of avoidable hospitalizations and emergency room visits and mechanisms to ensure that some of the savings are realized by all entities paying for health care. 

The first rollout (Southeast PA) started in May 2008 and six more learning collaboratives were launched through December 2009, involving a total of 152 mostly small and medium-size primary care practices and 640 providers (75% of the practices have 5 or fewer FTE providers). In four of PA’s seven regions, 17 payers, including Medicaid, provided $30 million in infrastructure payments to practices to support transformation. Since 2009, the state’s contracts with Medicaid managed care organizations (MCOs) have required MCOs to participate in the CCI. Phase II of the CCI began in January 2012 with funding from the Multi-payer Advanced Primary Care Practice demonstration.

CHIPRA: 
Yes
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
No
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
12,759,200
Uninsured Population:
10%
Total Medicaid Spending FY 2013: 
$21.0 Billion 
Overweight/Obese Adults:
64.5%
Poor Mental Health among Adults: 
35.5%
Medicaid Expansion: 
Yes

WellSpan Internal Medicine - Freedom Way

Practice Type: 
Primary care practice
Practice Setting: 
Urban
Practice Address: 
2350 Freedom Way, Suite 150
York, PA 17402

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

WellSpan Family Medicine-Thurmont

Practice Type: 
Primary care practice
Practice Setting: 
Suburban
Practice Address: 
52 Water St.
Thurmont, PA 21788

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

Wellspan Family Medicine-Lake Street

Practice Type: 
Primary care practice
Practice Setting: 
Suburban
Practice Address: 
136 Lake St
Ephrata, PA 17522

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

WellSpan Family Medicine-Herr's Ridge

Practice Type: 
Primary care practice
Practice Setting: 
Suburban
Practice Address: 
820 Chambersburg Rd.
Gettysburg, PA 17325

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

Wellspan Family Medicine-Granite Run

Practice Type: 
Primary care practice
Practice Setting: 
Suburban
Practice Address: 
264 Granite Run Dr
Lancaster, PA 17601

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

WellSpan Family Medicine-Fairfield

Practice Type: 
Primary care practice
Practice Setting: 
Suburban
Practice Address: 
4910A Fairfield Rd.
Fairfield, PA 17320

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

WellSpan Family Medicine-East Berlin

Practice Type: 
Primary care practice
Practice Setting: 
Suburban
Practice Address: 
105 Fourth St., P.O. Box 727
East Berlin, PA 17316

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

WellSpan Family Medicine-Aspers

Practice Type: 
Primary care practice
Practice Setting: 
Suburban
Practice Address: 
2060 Carlisle Rd.
Aspers, PA 17304

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

WellSpan Family Medicine North Fourth Street

Practice Type: 
Primary care practice
Practice Setting: 
Suburban
Practice Address: 
30 N. 4th Street, 2nd Floor
Lebanon, PA 17046

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

WellSpan Family Medicine ELCO

Practice Type: 
Primary care practice
Practice Setting: 
Suburban
Practice Address: 
6 Perri Avenue
Myerstown, PA 17067

Each practice commits to recruiting 2 to 3 patients to be full members of their Quality Leadership Team. The patient(s) give guidance and direction in the best approaches to improving care using the Institute for Healthcare Improvement's (IHI) Triple Aim as a guide for what care should be.

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