News Briefs

PCPCC primer for physicians and practices: As primary care physicians and other providers struggle to create patient-centered medical home (PCMH) practices, learn about medical neighborhoods, and become adept at using electronic health records, they may appreciate a new report that illustrates how those three activities work together to benefit patients. Managing Populations, Maximizing Technology: Population Health Management in the Medical Neighborhood, which was released in October by the Patient-Centered Primary Care Collaborative (PCPCC), was written for providers who may be suffering from “initiative fatigue.” The report is designed as a primer “on what can be done now, what can be done in the future and what they can build toward.” A population health approach—where stakeholders calculate the health outcomes of a group of individuals—requires collaboration among patients, physicians, insurance companies, the government, the private sector and local communities. The PCMH sits at the center of the model and is surrounded by the larger and more inclusive medical neighborhood. And health information technology (IT) is the foundation of it all. The report recommends ten specific health IT tools and strategies that can help achieve population health management in the medical neighborhood. The ten tools are electronic health records, patient registries, health information exchange, risk stratification, automated outreach, referral tracking, patient portals, telemedicine, remote patient monitoring, and advanced population analytics. The report includes three case studies in population management, including a group of pediatric practices in Winston-Salem, North Carolina; a community health center in New York City; and a multispecialty group practice in Richmond, Virginia. The 23-page report is available on the PCPCC Web site at www.pcpcc.org/resource/managing-populations-maximizing-technology.

AHRQ atlas of integrated care quality measures: Primary care teams are becoming increasingly aware of the need to address patients’ behavioral health problems. As these teams implement interventions and strategies to provide more integrated care, there is a growing need for quality measures. The Agency for Healthcare Research and Quality (AHRQ) has published the Integrated Behavioral Health Care Measures Atlas. The atlas provides measures that will be of interest to individuals in clinical, administrative, accounting, policy, or patient advocacy roles. Researchers can use the atlas to identify existing measures for integration research and may find the atlas useful in identifying gaps where new or improved measures are needed. On the atlas Web site, a quick-start guide allows users to search for measures in three ways: by measure, by functional domain, and by measurement goal. Nine core measures and eight additional measures are presented, along with descriptive data about them and references citing studies in which the measures were developed and used. Downloadable PDFs of the measures are available. To help users understand the importance of the measures and use them effectively, the atlas Web site presents a detailed framework with which to approach the measurement of integrated behavioral health and primary care. The atlas is available on the HRQ Web site at integrationacademy.ahrq.gov/atlas#prepared.

New KFF analyses examine insurance marketplace tax credits and the coverage gap: Key provisions of the ACA provide tax credits to help people with low or moderate incomes afford premiums for insurance bought through the new state marketplaces. Under the law, people with incomes between 100% and 400% of the federal poverty level may be eligible for tax credits. A state-by-state analysis conducted by the Kaiser Family Foundation (KFF) estimates that out of approximately 29 million people who might look to the new marketplaces for coverage next year, 17 million will be eligible for the tax credits, including 2 million in Texas, 1.9 million in California, and 1.6 million in Florida—the states with the largest number of eligible residents. The six-page issue brief, State-by-State Estimates of the Number of People Eligible for Premium Tax Credits Under the Affordable Care Act, is available on the KFF Web site at kff.org/health-reform. Another KFF issue brief looks at the five million people who are living in the 25 states that are not moving forward with Medicaid expansion and who will fall into a coverage gap in which they earn too much to qualify for Medicaid but not enough to qualify for tax credits. Most of these people have very limited coverage options and are likely to remain uninsured. According to the 9-page brief, The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid, more than a fifth of those in the coverage gap live in Texas, 16% live in Florida, 8% in Georgia, 7% in North Carolina, and 6% in Pennsylvania. “Notably, there is no deadline for state decisions about implementing the Medicaid expansion,” the report concludes.

Providers and patients address mental health issues on CFYM blog: As health care reform raises questions and concerns, Care for Your Mind (CFYM), a blog launched in May, helps ensure that the voices of people with mental illness and the clinicians who treat them are being heard—particularly by each other. The online forum for people with mood disorders—along with their families and psychiatrists—is a joint venture of the Depression and Bipolar Support Alliance (DBSA) and Families for Depression Awareness. One goal of CFYM participants is to speak with one voice in providing insight to key stakeholders and lawmakers to help ensure that the needs of individuals living with psychiatric disorders are met. The blog has had more than 5,500 visitors, including 1,500 who arrived at the site via Facebook or Twitter referrals. “We wanted the CFYM blog to be accessible on as many platforms as possible,” said DBSA President Allen Doederlein. He explained that the voices of people with mood disorders as well as the people who care for them need to be front and center in this transition period for the health care system. Access the blog at careforyourmind.org.

APA, AADPRT offer course on professionalism on the Internet: A new course designed to help psychiatrists proactively navigate the Internet and use social media without worry—“Professionalism and the Internet”—is now available on APA’s online learning management system (www.apaeducation.org/ihtml/application/student/interface.apa/index.htm). The course was developed by a task force of the American Association of Directors of Psychiatric Residency Training (AADPRT). Revenue from the course, which costs $19, will be shared by AADPRT and APA. In one vignette used in the course, an early career psychiatrist discovers a highly negative review of himself on a physician-rating site. Worried about its effects on his reputation, he considers whether to fabricate several more positive reviews using pseudonyms. The course had its origins in a workshop on digital technology at the 2010 AADPRT annual meeting at which audience members—residents, training directors, and program coordinators—related story after story about the legal, ethical, and clinical perils associated with online technology in psychiatric practice.