NEODESHA—Dr. Bradley Barrett is so focused on his patients that he hadn’t raised his fees in 10 years. His wife Mary, administrator of the clinic, knew they were low, but not by just how much.
"We found out we were charging less than half of what Medicare allows in our area,” Mary Barrett said. “My husband has a feeling for those with less means. But we weren’t even charging insurance enough."
Mary said all that changed upon beginning work with the Kansas Healthcare Collaborative in 2017. Jill Daughhetee is the clinic’s KHC quality improvement advisor.
“Jill came in and helped us make our practice more financially sustainable immediately,” Mary said. “And at the same time, we’ve put practices into place that have helped us demonstrate the quality of care our patients receive.”
Dr. Barrett’s clinic has been recognized as a “Pinnacle Practice,” one of just five physician organizations in Kansas to receive the distinction in 2019, which comes with a $12,000 award.
Performance Story Snapshot
Pinnacle Practices have excelled in efforts to steadily improve health care quality, safety, and value with patient-centered, evidence-based interventions. For example, they have employed person and family engagement, encouraging the patient and their family to partner with the medical staff in their care. Pinnacle Practices also have incorporated additional quality metrics and utilization metrics for national comparison and evaluation.
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Much of the work Dr. Barrett’s clinic has done with their KHC quality improvement advisor has been taking a bit more time to document the work they are already doing.
"We haven't changed the care that much. The difference is now we document that we've done it in our electronic health record," Mary said, estimating that it takes the nurse an additional eight hours a month to do so.
“Just charting things the way Jill has advised us has made an additional 12% difference in our Medicare payment,” she said.
Over the last two years, the clinic has improved upon several measures, including 12.35% improvement in Colorectal Cancer Screening rates, 54.51% in Tobacco Screening and Cessation, 64.04% in Pain Assessment and Follow-Up Care, and 31.01% improvement in Blood Pressure Screening and Follow-Up.
These early improvements persuaded them to put additional trust in suggestions from their quality improvement advisor, Jill.
"For example, I had poopooed the idea of chronic care management, which is an area Jill has been leading us to go,” Mary said. “But then I went to update our chronic care list after about three months, and several had died. That impressed upon my heart that chronic care management is indeed very important. So that’s where we’re going.”
Another example happened recently when the clinic’s electronic health record representative did not want to do more data extractions, Mary said.
“But Jill insisted. And, sure enough, that allowed us to identify several more places where we already qualified for (quality improvement) points. Jill has just been persistent and talked me through things and going through our data. I could not be more thankful for her help.”
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Dr. Barrett is among 180 practices in the Kansas Practice Transformation Network (PTN), which is administered by KHC and awarded the distinction.
Rosanne Rutkowski, Program Director at KHC, said the Pinnacle Practices exemplify—each in their way—scalable successes in improving health care quality, safety, and value.
“Dr. Barrett and our state’s other Pinnacle Practices are among the leaders in Kansas working on patient-centered initiatives that improve quality, safety, and value,” Rutkowski said. “Their experience is scalable and worth emulating.”
The Kansas PTN is part of a regional network called Compass PTN, which is one of 29 regional PTNs nationwide. Together they are part of the Transforming Clinical Practice initiative (TCPi), a program of the federal Centers for Medicare & Medicaid Services aimed at:
- Promoting broad payment and practice reform in primary care and specialty care;
- Promoting care coordination between providers of services and suppliers;
- Establishing community-based health teams to support chronic care management; and
- Promoting improved quality and reduced cost by developing a collaborative of institutions that support practice transformation.
PTNs are peer-based learning networks designed to mentor and assist practices in improvement in the broad areas. A “Pinnacle Practice” is among the top 5% of enrolled practices based on reporting and phase progression.
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Founded in 2008 by the Kansas Hospital Association and the Kansas Medical Society, KHC embodies the commitment of these two provider groups to act as a resource and continuously enhance the quality of care provided to Kansans. For more information visit KHConline.org/clinical-quality-improvement.