Start Date: 5/13/2020 9:00 AM CDT
End Date: 5/14/2020 3:00 PM CDT
Venue Name: TPCA Conference Center Location:
710 Spence Lane
Nashville, TN United States 37217
Tennessee Primary Care Association
This training is designed to advance the clinical provider’s understanding of value-based care. Provider leaders are encouraged to bring their c-suite peers to provide opportunity for discussion of team based strategies to strengthen patient care through innovation.
Community health center pursuit of value-based payment (VBP) presents an opportunity to strengthen patient care through innovation. The goal of the session is to share what Federally Qualified Health Centers (FQHCs) and primary care associations (PCAs) in other states are doing to pursue VBP, and facilitate a discussion among this group as to how those lessons may apply to the unique Tennessee market.
Discussion will include use of alternative payment methodologies (APMs) to create and implement clinically and financially integrated delivery systems for care coordination services; a pay-for-quality program; and a shared savings/risk opportunity on total cost of care. There will be special attention paid to the role of clinical providers and their leadership in the necessary care delivery transformation.
Presenter: Art Jones, MD, Health Management Associates
Art Jones has more than 25 years of experience as a primary care physician and chief executive officer (CEO) at a Chicago area community health center. The health center was an early adopter of managed care, successfully operating under a partial capitation payment system for all ambulatory and emergency room services and shared savings for inpatient services since the early 1990s. Starting with the Medicaid population, similar contractual arrangements were later extended to the Medicare and commercial populations. He was the architect for the first capitated FQHC APM nationally in 2001. The health center earned recognition as a high performer under these advanced APMs, ranking in the 99th percentile nationally among FQHCs for managed care margin. Part of the success was due to developing an intensive medical management program for individuals confined to their home or a long-term care institution.
Dr. Jones was one of the founders and continues to serve as the chief medical officer for Medical Home Network (MHN), an ACO comprised of 10 FQHCs and three health systems serving 125,000 Chicago-area Medicaid recipients. MHN is completely delegated for care management, successfully operated under a shared savings arrangement on total cost of care for three years, and transitioned to shared risk two years ago. He is helping MHN work with the local public health system to launch a Medicare Advantage plan that went live on January 1, 2020, and includes ISNP, IE SNP, and a CSNP for HIV-impacted individuals.
Dr. Jones is a principal at Health Management Associates, where he focuses on advancing clinically and financially integrated provider organizations. He is a sought-after national expert in creating FQHC APMs, having assisted model development in Washington State, Washington DC, New York, Delaware, Connecticut, Michigan, and Georgia. He was part of the HMA team that worked with the State of Idaho Medicaid Agency to develop their shared savings program. He has consulted with several other primary care associations, other FQHC integrated delivery systems, and individual FQHCs nationally to negotiate APMs and to improve performance on those value-based payment arrangements.
Dr. Jones is a graduate of the University of Illinois Medical School and completed his internal medicine residency, chief residency, and a cardiology fellowship at the University of Chicago.
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This program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under award U58CS06816 State and Regional Primary Care Associations. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsement be inferred by HRSA, HHS, or the U.S. Government.