Self-Management Workshops: Surviving to Thriving · 2019-02-04 · Surviving to Thriving Jamie...

Self-Management Workshops:

Surviving to Thriving

Jamie Hunter-Mitchell and Lisa Packard

Health Promotion Consultants & CDSME Master Trainers

February 27, 2018

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Qualis Health

• A leading national population health

management organization

• The Medicare Quality Innovation Network - Quality

Improvement Organization (QIN-QIO) for

Idaho and Washington

The QIO Program

• One of the largest federal programs dedicated to

improving health quality at the local level

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Why are we here?

• Understand the value and potential of

self-management workshops

• Recognize the limits of current

workshop delivery structures

• Imagine other models

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NCOA Video

• https://www.ncoa.org/healthy-

aging/chronic-disease/

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Prized resources: Workshop Leaders and Program Coordinators

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CDSME Evidence

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The Triple Aim

• Healthier PeopleSymptom management

Activity

Depression

Quality of life

• Better CareCommunication with health care

team

Medication compliance

Health literacy

• Smarter SpendingER visits

Hospitalizations

Ory MG, Ahn S, Jiang L, Smith ML, Ritter PL, Whitelaw N, Lorig KL. Successes of a national

study of the chronic disease self-management program: Meeting the triple aim of health

care reform. Med Care: 51(11):992-8, 2013 Nov

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CDSMP: Evidence Based

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Evidence

• Self-Management Resource Centerhttps://www.selfmanagementresource.com/resources/bibliography/

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CDSME Value

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Value

• For participants• Patient-centered

• Engagement activities

• Peer-group support

• Confidence building

• For providers• Improved health

outcomes

• Improved quality

performance outcomes

• Patient attraction and

retention

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Value

Number of Chronic Conditions Average Annual Spending

1 or fewer (32%) $2,025

2 or 3 (32%) $5,698

4 or 5 (23%) $12,174

Six or more (14%) $32,658

*Medicare beneficiaries. Source: CMS, “Chronic Conditions Among Medicare Beneficiaries: 2012

Chartbook Edition,” 10.2012.

The Cost of Chronic Conditions*

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Value

Estimated cost savings

$714 per person savings emergency room visits and hospital utilization*

- $350 CDSME estimated program costs

$364 per person net savings

Ahn S, Basu R, Smith ML, Jiang L, Lorig K, Whitelaw N, Ory MG: The Impact of Chronic Disease Self-

Management Programs: Healthcare Savings through a Community Based Intervention. BMC Public

Health, 2013, 13 (1):1141

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Sustainability

Chronic disease prevalence

CDSME

workshops

Community Participatory Approach

Multi-sector/cross-sector and public-private partnerships

Sustainability

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Our Regional Success Story

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Chronic Disease Self-Management Workshops in NCACH Region

supported with ACL grant and Older American Act funding

through AACCW

Growth of CDSME 2014-2017

Offer 5 self-management programs:• Chronic Disease Self-Management

• Tomando Control de su Salud

• Chronic Pain Self- Management (English/Spanish)

• Diabetes Self-Management

• Manejo Personal de la Diabetes

Workshops offered in:

Chelan, Douglas, Grant & Okanogan Counties

456 attendees

356 completers -attended 4 or more sessions

3 year Implementation grant 2013-2016

In 2013 identified two community partners:

▪ Community Choice

▪ Moses Lake Community Health Center

ACHIEVEMENTS

1. Sent two people from each organization for Master training.

2. Each program completed 2 CDSM workshops with a total of 31 completers.

3. Each program facilitated Lay Leader Training…

THEN

Received an AG grant to implement Chronic Pain program

Community Choice received an AG grant to implement DSM & Manejo

Received ACL sustainability grant Aug, 2016- June, 2018

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Workshop Data

0

2

4

6

8

2014 2015 2016 2017

Types and number of workshops

CDSM Tomando

CPSM DSM

Manejo

47%

38%

9%6%

Age Range

60+ 40-59 25-39 18-24

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Sustainability Innovations: Funding

• Medicare and Medicaid billing

• Payment reform quality measures• Diabetes: DSMP

• Chronic Disease: CDSMP

• Insurance carrier billing

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Estimated Medicare reimbursement

• Conditions for reimbursement

• Medicare, Part B

• Recognized Medicare provider

• Up to 10 hours of DSMT per 12 month

• AADE recognition/ADA accreditation

• G0109: DSMT Grp $14.71 (1.1.2017)

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SustainabilityTrends

• State

• Regional opportunities

• Federal

• Significant investment

• “Experienced, licensed organizations

exist throughout the country—partner

with them!”

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Potential Sustainability Solution

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Community-Based Approach

Affordable Housing

Senior Apartments

Libraries

Community Colleges

Senior Centers

Service Clubs

Churches

Faith-Based Organizations

Volunteer Organizations

Hospitals

First Responders

Clinics

District Health Departments

Pharmacies

Area Agencies on Aging

Tribal Governments

State Departments of Health

Accountable Communities of Health

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Learning Community

A group of individuals with a common

goal who create and participate in

opportunities to share and learn from

each other for the purpose of taking

action on what they learn in order to

achieve the common goal

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CDSME

Intentional Partnering

• Program quality

• Program efficiency

• Program coordination

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Sustainability

Chronic disease prevalence

CDSME

workshops

Community Participatory Approach

Multi-sector/cross-sector and public-private partnerships

Sustainability

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Q & A

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Contact

Jamie Hunter-Mitchell

Health Promotion Consultant

CDSME Master Trainer

jamieh@qualishealth.org

206-288-2351

Lisa Packard

Quality Improvement Consultant

CDSME Master Trainer

lisap@qualishealth.org

206-288-2565

For more information: www.Medicare.QualisHealth.org/DSMP-

Washington

This material was prepared by Qualis Health, the Medicare Quality Innovation Network - Quality Improvement Organization (QIN-QIO)

for Idaho and Washington, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department

of Health and Human Services. The contents presented do not necessarily reflect CMS policy. WA-EDC-QH-3388-02-18

Gwen Cox

Practice Transformation Coach

gwenc@qualishealth.org

(206) 288-2422