Leveraging Person-Driven Outcomes

June 28, 2022

Leveraging Person-Driven Outcomes, Standardized Measurement, & Provider Championship to Improve Health Performance

It has been demonstrated in a statistically significant way that patients of primary care practices embracing a "performance improvement champion" have better health outcomes. Key aspects of success include leveraging person-driven outcomes and using standardized measurement. In a study of patients on care planning and self-care support, patients with uncontrolled blood pressure patients were asked to select meaningful functional/ practical achievements tied to an activity (e.g., reaching a healthy BMI could help a patient to fit into a wedding dress). Standardized HEDIS® measure specifications for hypertensive BP control ensured that the denominator included only active patients who met clinical criteria for hypertension.

Through identification of and effective responses to barriers to change and respectful communication, embedded provider champions (physician, physician assistant, nurse practitioner) became advocates of chronic condition management best practices specifically and of the PCMH framework in general. Principal findings included: 1.) BP control rates differed between champion and nonchampion practices and between levels of champion practice engagement; 2.) champion practices demonstrated significantly lower “no-read” rates; and 3.) mean systolic BP readings were statistically significantly different in patients of champion vs. nonchampion practices. Analysis also highlighted the beneficial effect for Black non-Hispanic patients. Cerebralvascular accident, coronary heart disease and all-cause mortalities were positively affected by the BP control achieved by champion practices. This work provided an important foundation for addressing more complex aspects of condition management, such as stage 2 hypertension.

Target Audience

•    health care professional
•    health care decision maker
•    consultants
•    Health plans
•    Health systems
•    Hospitals
•    Managed behavioral healthcare organizations
•    Population health organizations
•    Wellness organization leverages within federal, states, and employers
•    Community-based organizations
•    Health systems
•    Outpatient providers

Learning Objectives

•    Define, understand the benefit, and be able to operationalize person-driven outcomes
•    Define, understand the benefit, and be able to operationalize standardized measurement of a key performance indicator
•    Define, understand the benefit, and be able to operationalize provider performance improvement championships


HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Course summary
Available credit: 
  • 1.00 Participation
  • 1.00 PCMH CCE
Course opens: 
Course expires: 
Event starts: 
06/28/2022 - 1:00pm EDT
Event ends: 
06/28/2022 - 2:00pm EDT

Dr. Thomas Arnone, DO

Thomas Arnone has a demonstrated history of working at a high level in the community and in the health care industry. Skilled in Clinical Medicine, Healthcare Management, Managed Care, Population Health. Strong healthcare services professional with a Doctor of Osteopathic Medicine (D.O) from New York College of Osteopathic Medicine, solid community based postdoctoral training leading to board certification in Family Medicine.and a broad range of clinical and leadership positions at Unity/Rochester Regional Health. Served as Associate Medical Director of Hypertension Initiative for Finger Lakes Health Systems Agency during a novel collaborative program with Greater Rochester Chamber of Commerce and other important community shareholders. Data from over 100,000 patients was tracked while multifaceted interventions took place leading to significant improvements in blood pressure. Also, new ways to track outcomes were developed and targeted interventions for at-risk patients (Stage 2 hypertensive patients in particular) were undertaken.

R. Anthony Minervino, Jr., MPA, MSHCM, PCMH CCE  

R. Anthony Minervino, Jr. is a health care administrator and NCQA PCMH consultant. He has spent the last few years working in direct operations with inpatient and specialty care and is currently with the University of Rochester Medicine as Administrative Director of Movement Disorders. His innovative work in the PCMH environment includes a project to increase tobacco use screening and effective brief non-billable cessation counseling (which was featured in a published work by the University of Rochester), developing referral management standards with specialists prior to NCQA standards inclusion and mobilizing champion providers to advocate for performance improvement in their practices.  

He holds an MPA from the State University of New York at Brockport and an MSHCM from the University of Rochester. Anthony also earned certificates in non-profit and healthcare management from SUNY Brockport. He is a Lean Six Sigma Black Belt, an Institute for Healthcare Improvement Advisor and an NCQA PCMH Certified Content Expert. 






In support of improving patient care, the National Committee for Quality Assurance is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC) to provide Interprofessional Continuing Education for the healthcare team. 

This activity was planned by and for the healthcare team, and learners will receive 1.0 Interprofessional Continuing Education (IPCE) credit for learning and change. 

This educational activity is approved for: 1.0 AMA PRA Category 1 CreditTM.

This educational activity is approved for 1.0 nursing contact hours.*

This live course grants 1.0 Continuing Education Unit (CEU) points for PCMH Certified Content Experts.  

* Please note – You must attend the entire program to be eligible for total number of contact hours.

Disclosure of Relevant Financial Relationships

The National Committee for Quality Assurance (NCQA) endorses the Standards of the Accreditation Council for Continuing Medical Education which specify that sponsors of continuing medical education activities and presenters at and planners for these activities disclose any relevant financial relationships either party might have with commercial companies whose products or services are discussed in educational presentations.

For sponsors, relevant financial relationships include large research grants, institutional agreements for joint initiatives, substantial gifts, or other relationships that benefit the institution.  For presenters or planning committee members, relevant financial relationships include the receipt of research grants from a commercial company, consultancies, honoraria, travel, or other benefits, or having a self-managed equity interest in a company; or having an immediate family member or partner with such a relationship.

Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

Relevant financial relationships exist with the following companies/organizations:

Thomas Arnone: None
R. Anthony Minervino, Jr.: None

Additional Planning Committee Members:
Wanda Ali: None
Cathy Beckner: None
Joseph Stankaitis: None

This program was developed in part by NCQA staff.

This program received no commercial support.

Available Credit

  • 1.00 Participation
  • 1.00 PCMH CCE


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