February2008

The Pennsylvania Chronic Care Management, Reimbursement, & Cost Reduction Strategic Plan

Pennsylvania Governor Ed Rendell's Chronic Care Management, Reimbursement, and Cost Reduction Commission has focused on a collaborative chronic care model developed by Edward Wagner, M.D., director of the MacColl Institute for Healthcare Innovation in Seattle, Washington. Dr. Wagner provided input for the Commissions plan. The Wagner model uses a team approach to help patients set goals to improve their overall health and uses health information technology to track patients health system interactions.

Each collaborative will include about 50 physicians or advanced practice nurses, who will meet at least twice per year to train, share experiences, review data, and problem solve. The provider incentives could include payments to help them redesign their systems, enhanced capitation or fee-for-service payments to maintain additional
staffing, and/or performance bonuses for providers that demonstrate superior clinical care. Consumer incentives could include waiving co-payments for disease management care or reducing overall health care premiums.