OneCare Vermont provides regular, unifying forums for practices within our network to learn from one another, develop relationships among providers, and improve the quality of patient care throughout Vermont. One such example of these forums is OneCare’s quarterly Population Health Model (PHM) webinar which spotlights the successes of individual practices in improving specific quality measures.
One of OneCare’s Population Health Model priority quality measures is aimed at increasing the rate of annual wellness visits for those aged 40 and up, as well as a similar annual wellness visit measure for children and adolescents. These two quality measures incentivize utilization of primary care in support of OneCare’s strategy to decrease health care costs and improve health outcomes by shifting health care spending into prevention. At the spring PHM webinar, Green Mountain Pediatrics was spotlighted because of its success in exceeding the goal for the child and adolescent well visits measure, as well as achieving 100% participation in the depression screening tool for eligible patients.
Though their practice is small, Green Mountain Pediatrics consistently meets and exceeds their quality improvement goals. Using a team-based approach with an emphasis on a “culture of wellness” for both the staff and patients, the practice ensures wellness visits are at the forefront of their strategy for delivering the highest level of care. Dr. Orton, the independent practice’s owner and solo pediatrician, describes the “culture of wellness” as ensuring everyone—from staff to patient—believes in the importance of wellness visits, collectively setting staff goals around high completion rates. In the clinic, this means the importance of wellness visits is discussed at every opportunity. For example, when patients come in for a sick visit or a parent calls in for a prescription refill, wellness visits are discussed and scheduled if needed. Additionally, the practice utilizes social media and print materials to reinforce the importance of wellness visits to their patients and their parents/guardians/caregivers.
The meaning of a wellness visit has evolved for me in my 34 years in this practice, adding and changing elements as well as adhering to evidence-based guidance for preventive care. As an independent practice, I made the decision long ago to adjust timeframes for visits based on age and the individual patient—for example, I could not in good conscience do an older child/teen visit in 15-minutes. Time studies helped [us] hone the average time needed to facilitate scheduling, while chart ‘flags’ allow staff to add time to those that consistently need extra. This is how we have built a system that supports our dedication to delivering high-quality care, the foundation of which is preventive care.
In addition to achieving their goals in the child and adolescent wellness measure, Green Mountain Pediatrics also managed to ensure 100% of their eligible patients receive and fill out the depression screening tool. Fifteen plus years of screening experience has allowed this practice to perfect their strategy: they have had great success by flagging children who may need more time taking the survey, administering the questions verbally, and ensuring each child has privacy so they feel comfortable answering the questions.
OneCare’s Population Health Model, which ties quality performance to payment, aligns with providers to support them in delivering the high-value care they want to see in their communities. Furthermore, the team at OneCare provides customized quality improvement support and various other offerings to aid in being successful in the PHM, including the PHM webinar series. Green Mountain Pediatrics’ story illustrates the greatest value of the webinar series being the convening of practices to share their successes and discuss how they can replicate the strategies and results in their own practices.
To learn more about our quality performance management, visit our website. You can also view the entire Q1 webinar series here.