Resource Guide for Cost and Value of Care

Practice Facilitators Engaging Physicians to Meet Continuing Certification Requirements

This Resource Guide is intended to assist Practice Facilitators with aligning physicians’ requirements  for Performance Improvement Activity or Maintenance of Certification (MOC) IV credits, and their practices’ quality improvement work. It is particularly useful for the Transforming Clinical Practice Initiative (TCPi) module, Cost and Value of Care.

The sections below provide detailed information and resources about cost and utilization and includes implementation tools to use with practices. Each section lists specific resources, provides a description of the resource, who the resource is best suited for (i.e. practice facilitator, practice manager, etc.), and how and when to best use the resource. 

Topic
Website
Best Suited For
How/When to Use
Description

Clinical Recommendations for Care

Clinicians

Searchable list of treatment recommendations by society.

Clinicians can use to easily locate the treatment recommendations for a vast list of conditions.

Closing the Referral Loop

Practice Facilitators; Practice Medical Director; Practice Manager

Information and tools to use to get leadership/clinician support

This Institute for Healthcare Improvements (IHI) resource provides a 9-step process for closed-loop EHR referral processes.

Cost & Utilization Data

Practice Facilitators; Practice Medical Director; Practice Manager

Provides national and state-wide data on inpatient and ED utilization. May be useful for practice data comparison to national and state data.

HCUP is a family of databases, software tools, and related products developed to enable research on a broad range of health policy issues, including cost and quality of health services. Users can search several databases to determine inpatient and emergency department utilization.

Reducing Medical Overuse

Practice Facilitators; Practice Medical Director; Practice Manager

Information and tools to use to get leadership/clinician support

  • Best Practices Assessment practices can use to assess where they are in the process of reducing overuse
  • Document practices can download that explains the framework for reducing overuse
  • Stories & updates

Unnecessary Medical Care (“Less is More” campaign)

Practice Facilitators; Practice Medical Director; Practice Manager

Provides an overview of unnecessary medical care, with a focus on polypharmacy and education for residents and other learners.

Lown Institute facilitates research, programs, and resources on this issue. Specific resources include:

  • Polypharmacy Project
  • Physician survey on overuse
  • “Right Care” education program for residents
  • Vignette competition which provides students & trainees with the chance to share stories on over-and-under-use

Resouces (Overuse 101; selection of research articles; list of books, movies, blogs on unnecessary medical care)

Topic
Website
Best Suited For
How/When to Use
Description

Continuing Education offering for Cost and Quality

Practice Facilitators, Clinicians, Practice Staff

Provides flexible and on-demand access to learning opportunities, including online courses, webinars, and learning sessions. Can earn CME credits.

Online learning opportunities for practice facilitators, clinicians, and practice staff.

High Value Care

Clinicians

Learn how to eliminate unnecessary health care costs and improve adult and pediatric patient outcomes while earning free CME and MOC through these 30- to 60-minute online interactive cases.

ACP’s High Value Care initiative aims to improve health, avoid harms, and eliminate wasteful practices.

High Value Care

Clinicians and Practice Facilitators

High Value Care Curricula aims to improve health, avoid harms, and eliminate wasteful practices.

Resources to help medical educators teach the principles of High Value Care effectively in order to successfully pass these lessons along to future generation

CU e-Learning Modules

Physicians, Clinicians and Staff

E-Learning modules available for TCPi practices for CME and Performance Improvement Activity (MOC part IV) credits

E-Learning opportunities for physicians, clinicians, and practice staff about practice transformation and credits toward Performance Improvement Activities (MOC Part IV)

AMA Steps Forward Modules

Physicians, Clinicians and Staff

E-Learning modules that offer innovative strategies that will allow physicians and their staff to thrive in the new health care environment.

E-Learning opportunities for physicians, clinicians, and staff to better understand the new health care environment.

Tool
Website
Best Suited For
How/When to Use
Description

Cost and Utilization Toolkit for Practices

Choosing Wisely Tools to Empower Patients:

An Implementation Toolkit for Healthcare Providers

Practice Facilitators; Practice Medical Director; Practice Manager

Excellent resource for practices to use to get started with their work around cost and utilization.

This “how to” toolkit provides practices with information and tools for practice workflow and scripting; how to get started with the conversation with patients; and provides clinical evidence-based lists, information, posters, and wallet cards for 3 focus areas.

Choosing Wisely Patient Resources

Patients and Families

Resources designed to help patients make informed choices about medical tests and procedures. Materials are available in both English and Spanish.

Choosing Wisely is an initiative of the American Board of Internal Medicine that seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures.  This website offers over 150 patient-friendly resources.

High Value Care

Patients and Families

Resources designed to help patients understand the importance of seeking appropriate care in order to maximize value and live a healthy life.

Health literate patient education materials that actively engage patients and families in their own care.

Topic
Website
Best Suited For
How/When to Use
Description

Choosing Wisely Patient Resources

Patients and Families

Choosing Wisely is an initiative of the American Board of Internal Medicine that seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures.  This website offers over 150 patient-friendly resources.

Resources designed to help patients make informed choices about medical tests and procedures. Materials are available in both English and Spanish.

How to Talk to Patients about Cost and Value of Care

Practice Facilitators, Clinicians, Patients and Families

A collection of instructional modules to enhance physician and patient communication around the specialty society recommendations. The modules are designed to help physicians and patients think and talk about overuse of health care resources by providing strategies for physicians to build trust and address patient attitudes and beliefs that more care is not always better care.

Educational tool that can be used by clinicians, patients, and other learners.

High Value Care

Patients and Families

Health literate patient education materials that actively engage patients and families in their own care.

Resources designed to help patients understand the importance of seeking appropriate care in order to maximize value and live a healthy life.

The project described was supported by Funding Opportunity Number CMS-1L1-15-002 from the U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.