JamesLHollyMD.com

	James L. Holly, M.D.

About SETMA Joint Commission Contact Information History Mission Statement Medical Home Scope of Services I-CARE Initiative Infusion Center The SETMA Way - What is it? SETMA's Model of Care Patient-Centered Medical Home The SETMA Approach to Patient Care	In The News Letters Vital Signs - Examiner Publication SETMA's Providers as of January, 2015 SETMA Knows - Abraham Lincoln and Healthcare Analytics SETMA – 1999 – Four Seminal Events PC-PCC Award January, 2015 Vital Signs Spring 2015 Vital Signs Q&A for PC-PCC Award Links to SETMA 2012 eHealth Innovator Award for LESS initiative Handout for Attendees eHealth Conference January 12, 2012 eHealth Initiative 2012 Award Program Application The eHealth Initiative's 2012 Award Letter 2012 National Quality Forum National Healthcare Improvement Award Effective prioritization of performance improvement goals Dashboard to Measure and Manage Whole System Performance Commitment to transparency Date-driven improvement of NQS priorities Demonstration of readiness to assume responsibilities of an ACO Demonstrated results on publicly reported performance measures Public Reporting Quality Metrics for 2009, 2010, 2011 Internally Tracked Reporting Quality Metrics for 2009, 2010, 2011 Complete Application in PDF Format SETMA's Medical Home Pilgrimage 2009 Medical Home Series I 2010 Medical Home Series II 2011 Medical Home Series Two 2009, 2010, 2011 Medical Home Miscellaneous Articles The Dr. and Mrs. James L. Holly Distinguished Professorship Universal American Letter of Transmittal for Support Dr. Holly's Acceptance Address for the 2012 Distinguished Alumnus Award CMS Medical Home Feedback Report Qualify & Cost SETMA questions Influenza Data SETMA I - October 2011 SETMA II - October 2011 Mark A. Wilson Clinic SETMA West - October 2011 SETMA and Fox 4 News - Healthy Living Videos SETMA Advertisements - Display and Video SETMA Announcements Featured Content Archive	Syllabus PC-MH Externship SETMA's MS4 Patient-Center Medical Home Selective Syllabus Introduction to SETMA's Senior Externship and Syllabus An Introduction to the Origins and Beginnings of Southeast Texas Medical Associates, LLP Patient-Centered Communication PC-MH Health Affairs August 15, 2013 Policy Brief -- Health Gap SETMA 8.20.13 Provider Training -- Health Affairs 2.14.13 -- Patient Engagement SETMA Provider Training 8.20.13 during First Senior Medical Student PC-MH Externship Medical Home Coordination Review Tutorial 2011 Medical Home Series Two Teaching Tool for PC-MH Course - Patient Care Activation, Engagement, Shared-Decision Making	Patient Information What Does Patient-Centered Medical Home Mean to You? What Does Patient-Centered Medical Home Mean to You? Health information exchange Patient Rights and Responsibilities Patient Directions Contact SETMA – Secure Texting What is HIPAA? Authorization To Release or Obtain Medical Records Complete Privacy Policy Website Privacy Policy	Presentations Invited Presentations SETMA Provider Training
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One form of Care Coordination HCAHPS - Hospital Consumer Assessment Of Healthcare Providers and Systems CAHPS - Consumer Assessment of Health Care Provider and Systems Teaching Tool for PC-MH Course – Patient Care Activation, Engagement, Shared-Decision Making Display & Explanation of PC-MH Tools SETMA's Medical Home Pilgrimage Concierge Medicine not Medical Home Medical Neighborhood Security & HIPPA Referrals Patient Web Portal Health Information Exchange Medication Reconciliation The Automated Team Coordination of Care Medical Home Description & Standards AAAHC Joint Commission NCQA Planetree URAC NCQA Interview February 14, 2014	Facebook	Letters

Letters - Carlos Rosende, MD, Letter in anticipation of Primary Care Center Leadership Group meeting, May 5, 2014

Dear Dr. Holly,

We appreciate the material that you have forwarded to us regarding SETMA. Our institution is impressed with your remarkable success in creating a sustainable patient-centered medical home recognized internationally for the delivery of compassionate, high quality and cost-effective health care. We are delighted that you will be able to spend some time with us during your upcoming visit to San Antonio to discuss how you were able to achieve this goal.

I would like to offer some background information about UT Medicine and its Primary Care Center. As you know, UTHSCSA is divided into five separate schools, each with its own dean and administrative structure. The School of Medicine has three primary missions: education, research and clinical service. The education mission is primarily supported by state funds, but research is mainly dependent on grants and philanthropy. The clinical mission must be completely self-supporting, with the clinical revenue covering all costs of the of the clinical FTE of the faculty, the clinical infrastructure, well as providing for investments in education and research.

Over the last several years, the clinical practice of the School of Medicine has been transitioning from the traditional department-based “silos” of specialty care into an integrated, multi-specialty clinical group practice under the umbrella of “UT Medicine”. We have nearly 700 physicians and about 200 non-physician providers representing over 100 different clinical specialties and disciplines. Many of our physicians continue to have major roles in teaching students and residents as well as in conducting research. Most of the clinical education is performed at facilities owned and operated by the VA system and the Bexar County health district, University Health System. The clinics of UT Medicine, however, are considered the “private practice” of the School of Medicine with the emphasis on superb clinical care and outstanding customer service. Our practice is headquartered at the Medical Arts and Research Center (MARC), but we have other locations throughout the area. UT Medicine has a senior leadership team composed of an executive director, chief administrative officer and directors of revenue cycle, clinical IT, clinical operations and other key positions. UT Medicine is governed by the Medical Services, Research and Development Plan (MSRDP) Board, comprised of the clinical chairs and center directors of the School of Medicine. Incidentally, the School of Dentistry and the School of Nursing each have totally independent clinical practices with similar governance structures, but on a considerably smaller scale than UT Medicine.

As with most medical schools, our clinical practice developed around specialties concentrating on tertiary and quaternary medical care. To fulfill our vision of becoming a truly integrated health system, it became evident that we needed to develop and expand our primary care base. We chose to combine our fragmented primary care servicesâ€”Family Medicine, General Internal Medicine, Family Medicine Geriatrics and General Medicine Geriatricsâ€”into a single operational organization, the Primary Care Center (PCC) with its own director. The faculty, however, keep their academic appointments in their respective departments. The PCC will seek PCMH recognition for its current sites and future facilities as it expands to other locations.

All of UT Medicine is being directed to increase access for patients, operate more efficiently, maintain a patient-centered approach, and ensure superior quality of care. It is also asked to focus on a myriad of metrics that are essential to demonstrating value and pursue alternative reimbursement models. Nevertheless, we cannot lose track that most third party payers and employers are still functioning in a fee-for-service world. This presents a special challenge for our PCC providers: In a fee-for-service environment where the emphasis is on a production model and reimbursable activities, how can we create a PCMH model of care that is viable and sustainable? And how do we transition from FFS to alternate reimbursement systems?

We are looking forward to learning your perspective and listening to how you and SETMA have navigated these waters.

Respectfully,

Related Letters

	Letter from Participant in the Primary Care Center Leadership Meeting May 5, 2014 UTHSCSASOM – Primary Care Center Leadership Group – Making Primary Care Profitable, April 25, 2014

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