Region 15 Regional Healthcare Partnership 6th Public Meeting

1
Region 15Regional Healthcare Partnership6th
Public Meeting

• Wednesday, September 26, 2012
• University Medical Center of El Paso
• Anchor Hospital

2
Confirmation of Participants

• Role Call

3
UMC Projects

1. Refer to RHP Website
2. DSRIP Projects
3. Parallel Universe Projects
4. Questions
5. Next Steps

4
HHSC Webinar
UpdatesRHP Planning Protocol Webinar 9/25/12

• Project options
• Continuous Quality Improvement
• QI Milestones are included with each project that
  requires QI under Process Milestones. For
  example, for Project 1.3 Implement a Chronic
  Disease Management Registry you can find these
  process milestones on pg 35 starting with P-12
  P-14
• Category 3 13 Outcome Domains (OD)
• 1 stand alone measure
• 1 stand alone measure and 1 non-stand alone
  measure
• 3 non-stand alone measures
• Or create a measure that meets the definition of
  outcomes measure
• Or To Be Determined TBD
• We will report on Category 3 Measures on an
  annual basis
• Category 4 5 Required Reporting Measures
• One was just added as optional Adult or Child
  Core Measures for CHIP/Medicaid Population
• Non-Hospital Performing Providers No Category 4
  Reporting Requirements

5
HHSC Webinar
Updates RHP Plan Template Webinar
9/26/12
6
Final DSRIP MenuCategory I Project Areas

• Expand Primary Care Capacity
• Increase Training of Primary Care Workforce
• Implement a Chronic Disease Management Registry
• Enhance Interpretation Services and Culturally
  Competent Care
• Collect Valid and Reliable Race, Ethnicity and
  Language (REAL) Data to Reduce Disparities
• Expand Access to Urgent Care and Enhance Urgent
  Medical Advice
• Introduce, Expand, or Enhance Telemedicine /
  Telehealth
• Increase, Expand, and Enhance Dental Services

7
Final DSRIP MenuCategory I Project Areas (cont.)

• Expand Specialty Care Capacity
• Enhance Performance Improvement and Reporting
  Capacity
• Implement technology-assisted services
  (telehealth, telemonitoring, telementoring, or
  telemedicine) to support, coordinate, or deliver
  behavioral health services
• Enhance service availability (i.e., hours,
  locations, transportation, mobile clinics) to
  appropriate levels of behavioral health care
• Development of behavioral health crisis
  stabilization services as alternatives to
  hospitalization.
• Develop Workforce enhancement initiatives to
  support access to behavioral health providers in
  underserved markets and areas (e.g.,
  psychiatrists, psychologists, LMSWs, LPCs and
  LMFTs)

8
Final DSRIP MenuCategory II Project Areas

• Enhance / Expand Medical Homes
• Expand Chronic Care Management Models
• Redesign Primary Care
• Redesign to Improve Patient Experience
• Redesign for Cost Containment
• Implement Evidence-based Health Promotion
  Programs
• Implement Evidence-based Disease Prevention
  Programs
• Apply Process Improvement Methodology to Improve
  Quality / Efficiency
• Establish / Expand a Patient Care Navigation
  Program
• Use of Palliative Care Programs
• Conduct Medication Management

9
Final DSRIP MenuCategory II Project Areas (cont.)

1. Implement / Expand Care Transitions Programs
2. Provide an intervention for a targeted behavioral
   health population to prevent unnecessary use of
   services in a specified setting (i.e., the
   criminal justice system, ER, urgent care etc.)
3. Implement person-centered wellness
   self-management strategies and self directed
   financing models that empower consumers to take
   charge of their own health care
4. Integrate Primary and Behavioral Health Care
   Services
5. Provide virtual psychiatric and clinical guidance
   to all participating primary care providers
   delivering services to behavioral patients
   regionally
6. Establish improvements in care transition from
   the inpatient setting for individuals with mental
   health and / or substance abuse disorders
7. Recruit, train and support consumers of mental
   health services to provide peer support services
8. Develop Care Management Function that integrates
   primary and behavioral health needs of individuals

10
Sample Project Milestones and Metrics

• Choose Category 1 or 2
• Choose Project within that Category
• Choose Project Option
• Include all elements from RHP Plan DSRIP
  Narrative Section (pg 7-15)

11
Category 1 and 2 Process Milestones

• Choose minimum of One Process Milestone for the
  first two years (you can choose more) P-1, etc.
• You must choose the metric associated with the
  chosen process milestone to assess or implement
  within the first two years. P-1.1, etc.
• You can also keep process milestones through the
  4 years if you want (not sure if thats
  beneficial)

12
Category 1 and 2 Improvement Milestones

• Choose minimum of One Improvement Milestone for
  the last two years (you can choose more) I-1,
  etc.
• You must choose the metric associated with the
  chosen improvement milestone to assess or improve
  upon in the last two years. I-1.1, etc.
• You can choose the same measure and metric to
  improve more upon in the last year.

13
Category 3 Process Measures to fit with Category
1 and 2 Projects

• In years DY 2 and DY3, we must choose a Category
  3 Process Milestone for each project and provide
  a narrative of goals and rationale
• Category 3 Process Milestones
• P-1 Project Planning engage stakeholders,
  identify current capacity and needed resources,
  determine timelines and document implementation
  plans
• P-2 Establish Baseline Rates
• P-3 Develop and Test Data Systems
• P-4 Conduct PDSA Cycles to Improve Data
  Collection and Intervention Activities
• P-5 Disseminate Findings, including Lessons
  Learned and Best Practices, to Stakeholders
• P-7 Other activities not described above
• These Milestones may be redundant / complimentary
  to Category 1 and 2 Milestones

14

Category 3 Improvement Measures or Outcomes
Domains to fit with Category 1 and 2 Projects

• Outcome Improvement Targets
• DY4 and DY5 Outcomes/Improvement Targets
• OD-1 Primary Care and Chronic Disease Management
• OD-2 Potentially Preventable Admissions
• OD-3 Potentially Preventable Readmissions (30 Day
  Readmission Rates)
• OD-4 Potentially Preventable Complications and
  Health Care Acquired Conditions
• OD-5 Cost of Care
• OD-6 Patient Satisfaction
• OD-7 Oral Health
• OD-8 Perinatal Care
• OD-9 Right Care in Right Setting and Patient
  Centeredness
• OD-10 Functional Status
• OD-11 Health Disparities
• OD-12 Primary Care and Primary Prevention
• OD-13 Palliative Care
• Can also Propose Outcomes not included in the
  list, i.e. outcomes that fit the outcomes
  definition

15
Category 4 Reporting Measures

• Hospital Performing Providers Only
• Pay for Reporting
• 5 Required Domains
• RD-1 Potentially Preventable Admissions (PPA)
• RD-2 30 Day Readmissions
• RD-3 Potentially Preventable Complications (PPC)
• RD-4 Patient Centered Healthcare
• RD-5 Emergency Department
• 1 Optional Domain
• Initial Core Set of Health Care Quality Measures
  for Children (CHIP) or Adults (Medicaid) eligible

16
Performing Provider Workbooks

• Walk-through
• Questions

17
UC ToolDue 10/26/12 to HHSC

• Walk-through
• Questions

18
Medicaid Waiver Timelines

• As of 9/24/12, HHSC has formal approval from CMS
  for
• PFM Protocol
• RHP Planning Protocol
• RHP Plan Template
• As of 9/25/12, the final UC Tool was released for
  Provider Input
• Due to HHSC 10/26/12
• Two weeks after approval IGT Entities and
  Private Hospitals submit their final Chapter of
  Projects to Anchor
• Due to Anchor 10/12/12
• October 31, 2012 Submit RHP to HHSC (4 year
  plans)
• December 15, 2012 - CMS completes review
• RHPs returned for revisions during the 30 day
  period
• January 15, 2013 - Revised RHP Plans to CMS

19
Roundtable
20
Contact Information

• Waiver Website Email Address
• http//www.hhsc.state.tx.us/1115-waiver.shtml
• TXHealthcareTransformation_at_hhsc.state.tx.us
• UMC Website
• http//www.umcelpaso.org
• Region 15 - RHP
• Paso del Norte Blue Ribbon Committee Needs
  Assessment
• http//www.elpasotexas.gov/health/_documents/BRCGa
  pBook.pdf