PCMH Southeastern PA Learning Session 4.20.21

April 20, 2021

The Patient Centered Medical Home (PCMH) practices are well on their way to screening patients for Social Determinants of Health issues that could affect patient health but they continue to have challenges around effective techniques for these screenings, documentation, referral after SDOH concerns raised and follow up. The PCMHs are not aware of the Integrated Care Plans (ICPs) that exist at the Managed Care Organization level and these may be helpful to the practices in the care and treatment of their patients with complex care issues.

Target Audience

Nurse

Physician

Social Worker

Learning Objectives

1. Identify effective practices for SDOH screening, documentation, referral, and follow-up.

2. Describe how your practice can engage with the state-wide resource and referral tool, RISE PA.

3. Describe how each MCO develops Integrated Care Plans and how your practice can engage with the plans for your patients.

Course summary
Available credit: 
  • 3.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 3.00 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 3.00 ASWB
  • 3.00 Attendance
Course opens: 
04/20/2021
Course expires: 
07/31/2021
Event starts: 
04/20/2021 - 8:30am
Event ends: 
04/20/2021 - 1:00pm
Rating: 
0

8:30 - 8:45am Welcome and Overview of Agenda including PCMH requirement focus

8:45 - 9:30am Report outs by PCMH practices:

Facilitator: Laura Line, Health Federation.

 PCMH Questions:

  • What have been your successes recently in collecting and reporting SDOH data, and what have been your major challenges?

 9:30am – 10:10am Social Determinants: Assessment, Coding, Reporting and Closing the Loop with Referrals (15 min each plus 10 min discussion)

Facilitator: Suzanne Cohen, Health Federation

Panelists:

Charles Walker, Project Manager, Temple University Health System

Kiera Kenney, Integrated Peer Models for Health Project Manager and Ethan Gutmann-Goldstein, Community Engagement Coordinator, Health Federation; representative from New Kensington CDC (invited)

 10:10am - 10:40am Q & A: Resource Information and Services Enterprise (RISE) PA

Facilitator: Suzanne Cohen, Health Federation

Speaker: Nora Carreras, Special Advisor to the Secretary, PA Department of Human Services

 10:40am – 11:25am Integrated Care Plans: What are ICPs and how can you support your patients with ICPs?

Facilitator: Laura Line, Health Federation

Speaker: Bridget Gill-Gibson, Acting HSPS Supervisor, Quality Accountability (15 min)

Panel of ICP representatives from each MCO (30 min)

11:25 - 11:30am          Wrap-up                   

Zoom Meeting
Pittsburgh, PA
United States

Laura Line, Health Federation

Suzanne Cohen, Health Federation

Charles Walker, Project Manager, Temple University Health System

Kiera Kenney, Integrated Peer Models for Health Project Manager

 Ethan Gutmann-Goldstein, Community Engagement Coordinator, Health Federation; representative from New Kensington CDC (invited)

Nora Carreras, Special Advisor to the Secretary, PA Department of Human Services

 Bridget Gill-Gibson, Acting HSPS Supervisor, Quality Accountability (15 min)

 

In support of improving patient care, this activity has been planned and implemented by the University of Pittsburgh and The Jewish Healthcare Foundation. The University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


As a Jointly Accredited Organization, University of Pittsburgh is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. University of Pittsburgh maintains responsibility for this course. Social workers completing this course receive 3.0 continuing education credits.

Available Credit

  • 3.00 AMA PRA Category 1 Credit™
    The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
  • 3.00 ANCC
    UPMC Provider Unit is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation
  • 3.00 ASWB
  • 3.00 Attendance
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