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The Kentucky Primary Care Association (KPCA) Clinical Services Support Program strives to assist members with KPCA member-driven continuous quality improvement in practice, leading to high quality healthcare delivery and successful participation in value-based care programs. Established program support includes in-practice services for meeting Managed Care Organization (MCO) and payer value-based agreement requirements. A 2020 expansion of program services also includes the addition of Clinical Education and Practice Facilitation support. Additional details of program services delivered by this collaborative team:

PRACTICE FACILITATION

  • Supports practices to facilitate performance improvement initiatives in healthcare delivery leading to sustainable practice-driven quality improvement infrastructure in practice
  • Supports practice member-driven agendas with a focus on KPCA annually selected target quality healthcare measures for complete patient populations
  • Support utilizes standardized, accepted quality improvement concepts and principles including gap analysis, best practice guidelines, workflow analysis, rapid change cycles, etc.
  • Developing program with goal of 8-10 KCPA IPA Member Practices per PEA to foster long-standing in-practice relationships for quality improvement program infrastructure establishment as desired by practice; Formal PEA –Practice services expectation of minimum 8 hours monthly facilitation service

VALUE-BASED AGREEMENT SUPPORT

  • MCO /Payer Value Based Agreement support
  • Supports MCO/payer-driven agendas with practice-led engagement of support personnel
  • Direct Practice-Selected Support of:
    • Payer Value-Based & P4P Program Handbook &
      Communications with awareness and education as
      selected by practice
    •  Quarterly Review of Current Performance &
      Trending according to payer claims data within
      participating value-based programs
    • Direct in-practice support for care gap closure,
      manual supplemental data submissions, and risk
      adjustment reporting
  • Each QI Specialist supports Kentucky geographical coverage area of at least 20 KPCA IPA Practices

CLINICAL EDUCATION

  • Supports education and implementation of:
    • Best practices for clinical quality and healthcare
      topics (disease specific, preventative, population
      management, care management/coordination, etc.)
    • Documentation and coding/billing best practices
      for quality measurement and credit.
  • Supports all KPCA members with membership-driven education
  • Support is delivered through continuously updated resources on KPCA hosted platforms, membership webinars, small group roundtable discussions, and on-site /virtual direct support curriculum established by lead educators in coordination with other Clinical Services team members and KPCA members
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