New York Hospital Queens PPS Governance Structure

Transcription

1 New York Hospital Queens PPS Governance Structure Webinar Presentation November 12, 2014

2 Operational Governance Options NYS/KPMG A B C Collabora've Delegated Contrac'ng Model Fully Incorporated Model Each partner remains autonomous Partners form a jointly owned LLC PPS partners combined into a single legal en6ty Each PPS partner contracts with Lead En6ty Lead En6ty retains ul6mate decision making authority Execu6ve Commi>ee role is limited to oversight of Financial, Clinical and IT ac6vi6es Key Governance responsibili6es delegated to LLC Execu6ve Commi>ee is representa6ve of all partners and directly oversees Finance, Clinical and IT ac6vi6es Full ownership of the care delivery system except where contracted out to specialty providers Unified governance in a corporate structure Single management team Adapted from NYS/KPMG guidance 1

3 Collaborative Contracting Key Components No new legal en'ty created Partners and affiliates conduct the work of the PPS and retain their own decision making authority on all maders except those addressed in the contracts Each partner or par'cipa'ng en'ty retains its financial and opera'ng autonomy; not financially responsible for one another outside of the terms of the contracts Par'cipa'on agreement/contracts include scope of services driven by NYS and project requirements 2

4 Governance Organizational Structure PMO Lead Applicant Project Advisory CommiDee Execu've CommiDee Finance CommiDee IT / Data Governance Projects Clinical/Opera'ons CommiDee Governance is focused at the Program level, rather than at the individual project or local levels Partner Partner Partner Execu6ve Commi>ee will include Partner representa6ves Audit CommiDee Ad- Hoc CommiDees 3

5 Governance Partner Types PPS requires a Lead Partner responsible for fiduciary and project management Governance Partners - members of the Execu6ve Commi>ee and/or sub- commi>ees including some, but not necessarily all, members of the Finance, Clinical, or IT/Data Governance commi>ees Par'cipa'ng Partners - Partners by nature of beneficiary a>ribu6on or project contribu6on but are not members of the Execu6ve Commi>ee. These Partners may be represented on the Clinical or IT/Data Governance Commi>ees, PAC or other advisory bodies. Affiliates who might be providers or community based organiza6ons that do not, by themselves, a>ribute lives, but are otherwise important for the success of the PPS. Affiliates may be represented on the Clinical or IT/Data Governance Commi>ees, PAC or other advisory bodies. 4

6 Governance Executive Committee Develops consensus around PPS goals and strategy Sets the high- level standards for contracts Ensures appropriate representa'on and stakeholder engagement Provides setng for structured decision- making and dispute resolu'on Approves funds flow and budget Establishes progressive process for non- performing partners 5

7 Governance Clinical & Operations Committee Set the standards of clinical care delivery (structures, processes and outcomes) needed to accomplish NY DSRIP goals Determine, within the project areas selected, which care delivery areas should be the focus of improvement efforts Priori'ze the crea'on, implementa'on, oversight and con'nuous improvement of evidence based medical prac'ces that will most contribute to closing the iden'fied clinical performance gaps and improving clinical and financial results Develop and oversee the crea'on of the infrastructure (commidees and subcommidees) necessary to implement evidence based prac'ces 6

8 Governance IT / Data Governance Committee Work to ensure the interoperability of PPS partner pla]orms in order to share data Standardize data defini'ons to facilitate 'mely, accurate, and informed clinical and business decision making Priori'ze alloca'on of IT resources and joint IT investments Recommend the selec'on of applica'ons and IT approaches Provide oversight of: Security and compliance Data storage and usage The appropriate use of data at the individual and organiza'onal levels The cost of IT and data services 7

9 Governance Finance Committee Reviews the annual opera'ng and capital budgets and makes recommenda'ons to the Execu've CommiDee Develops policies and procedures for the financial management of PPS Advises the Execu've CommiDee on maders rela'ng to the financial performance of PPS Develops recommenda'ons regarding the financial aspects of any proposed vendor arrangements Engages auditors and oversees annual audits and required repor'ng Undertaking other tasks related to the finances of the PPS requested by the Execu've CommiDee such as the funding of new ini'a'ves 8

10 Governance Summary Simple Able to Evolve Transparent Accountable Consensus Driven Representative 9

11 Governance Next Steps Revisit and finalize partner type and solicit interest ADesta'on statement comple'on Finalize adribu'on process and ensure partners are aligned Par'cipa'ng partners must serve on a commidee Plan for opera'onalizing commidees post- applica'on submission 10

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