CCM for FQHC Initiative 2018 Application

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Great Lakes Practice Transformation Network (GLPTN)
CCM for FQHC Initiative 2018 Application

Are you a participating member of the Great Lakes Practice Transformation Network (GLPTN) based in Indiana? *

Yes

Not sure

Are you a member of the Indiana Quality Improvement Network (IQIN) through the Indiana Primary Health Care Association (IPHCA)? *

Yes

Not sure

Are you and your organization willing to commit to a 3-1/2 month engagement aimed at implementing Chronic Care Management (CCM) billing codes while focusing on improving diabetes A1c compliance? *

Yes

Need more information

Does your EHR have Chronic Care Management (CCM) templates currently available? *

Yes

Not sure

Approximately how many Medicare patients do you see annually? *

Estimates acceptable

Approximately how many Dual Eligible patients do you see annually? *

Estimates acceptable

Applicant Name *

Organization Name *

Applicant Email *

Applicant Phone *

Are you or any members of your organization trained in Lean thinking (i.e. Lean Yellow, Green or Black Belts; Lean Practitioners; etc.)? If so, how many and what kind of certifications?

For the project to be successful, participants should commit 4 to 6 hours per week to it for the duration of the 3-1/2 month engagement. Two-hour training sessions will be held twice weekly over a two-week period (for a total of four sessions per each cohort group).

Choose a Cohort Group

Cohort Group 1 – Morning Sessions Only
• Session 1 - August 14 - 1-3 p.m. (EST)
• Session 2 - August 21 - 1-3 p.m. (EST)
• Session 3 - August 24 - 9-11 a.m. (EST)
• Session 4 - August 27 - 9-11 a.m. (EST)

Cohort Group 2 – Afternoon Sessions Only
• Session 1 - August 15 - 1-3 p.m. (EST)
• Session 2 - August 20 - 1-3 p.m. (EST)
• Session 3 - August 22 - 1-3 p.m. (EST)
• Session 4 - August 27 - 1-3 p.m. (EST)

Cohort Group 3 – Morning Sessions Only
• Session 1 – September 5 - 9-11 a.m. (EST)
• Session 2 - September 13 - 9-11 a.m. (EST)
• Session 3 - September 18 - 9-11 a.m. (EST)
• Session 4 - September 25 - 9-11 a.m. (EST)

Cohort Group 4 – Afternoon Sessions Only
• Session 1 – September 6 - 1-3 p.m. (EST)
• Session 2 - September 14 - 1-3 p.m. (EST)
• Session 3 - September 19 - 1-3 p.m. (EST)
• Session 4 - September 24 - 1-3 p.m. (EST)

Please choose a cohort group based on the group's anticipated session dates/times listed above. *

Cohort Group 1

Cohort Group 2

Cohort Group 3

Cohort Group 4

Comments

Any barriers to your training that we should discuss?

Next Steps

Once you submit this application, you will be included a pool of GLPTN and IPHCA members interested in participating in the CCM for FQHCs Initiative. A representative from Purdue Healthcare Advisors will get back to you shortly regarding your interest.

If you have specific questions about the CCM for FQHCs Initiative, please contact your assigned Quality Improvement Advisor (QIA).

Purdue University, West Lafayette, IN 47907 (765) 496-1911

If you have trouble accessing this page because of a disability, please contact Purdue Technical Assistance Program taphelp@purdue.edu.

Choose a Cohort Group

Next Steps

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