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Outcomes and Lessons from a Primary Care - Health Plan Partnership - the New Jersey Academy of Family Physicians and Horizon BCBS New Jersey

Wednesday, July 28, 2010
1:00 pm - 2:30 pm (Eastern)
12:00 pm - 1:30 pm (Central)
11:00 am - 12:30 pm (Mountain)
10:00 am - 11:30 am (Pacific)


Cari Miller
Director of Advocacy and Project Operations, PCMH Pilot Project Director, New Jersey Academy of Family Physicians (NJAFP), Trenton, NJ, (Moderator)

Nicholas Bonvicino, MD, MBA
Senior Medical Director, Clinical Network Management, Horizon Blue Cross Blue Shield of NJ, Newark], NJ

Kenneth Faistl, MD
Family Practice of Central Jersey, Freehold, NJ

Thomas McCarrick, MD
Town Medical Associates, Verona, NJ


In 2009 the New Jersey Academy of Family Physicians (NJAFP) and Horizon Blue Cross/Blue Shield of New Jersey (Horizon BCBSNJ) began partnering to assist primary care practices achieve recognition as Patient-Centered Medical Homes (PCMHs). At the outset, only one practice in New Jersey was recognized. Both partners knew the important role that the PCMH concept played in health care delivery and also acknowledged that functioning as a PCMH should go well beyond recognition alone. Therefore, NJAFP and Horizon BCBSNJ worked together to begin to transform office-based care from an acute episodic care model to the PCMH model for project practices.

Primary care practices participated in a NJAFP-developed and-directed educational program that included a weekly curriculum, delivered via conference call/WebEx. Participants were provided with templates, processes, guidelines, samples, resources, web links, and one-on-one consultation to help them meet or surpass the recognition standards. NJAFP consultants also provided technical direction to assist practices with the on-line survey submission. Practice physicians and staff shared experiences and best practices, including tips and ideas about their particular EHRs for those with the same systems.

After achieving NCQA PCMH recognition, practices have begun to receive a care coordination fee for Horizon members with diabetes, and are now actively involved in a quality metric reporting component, which is designed to support cost savings and cost sharing element. In addition, additional PCMH transformation activities are currently in process and will be discussed during the presentation.

The Audioconference agenda is set forth in Eastern Daylight Time below:
1:00 pm Welcome, Introductions, and Overview
Cari Miller (Moderator)
1:10 pm Lessons and Value from the Health Plan Perspective
Nicholas Bonvicino, MD, MBA
1:30 pm Practice Transformation Experiences
Kenneth Faistl, MD
Thomas McCarrick, MD
2:00 pm Panel Commentary
Panel Question and Answer Session

Cari Miller (Moderator)
2:30 pm Audioconference Adjournment



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JUNE 30, 2010
What if a Health System Decided to Create "Ideal" Primary Care?
Principal faculty: Joseph E. Scherger, MD, MPH, Vice President for Primary Care, Eisenhower Medical Center, Clinical Professor, Family Medicine, University of California, San Diego, Rancho Mirage, CA
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