Measuring Return on Investment for Your Population Health Management Program

Transcription

1 Measuring Return on Investment for Your Population Health Management Program March 1, 2018

2 HITEQ Center The HITEQ Center is a HRSA-funded Cooperative Agreement that collaborates with HRSA partners to support health centers in full optimization of their EHR/Health IT systems

3 HITEQ Services Web-based health IT knowledgebase Workshops and webinars Targeted technical assistance

4 HITEQ Focus Areas

5 Objectives Describe the value of measuring return on investment for population health management (PHM) programs focusing on IT infrastructure. List at least two types of data used in the HITEQ PHM Return on Investment (ROI Matrix tool. Know how to access the HITEQ PHM ROI Matrix tool. Understand who to engage in your ROI Analysis plan to develop process for gathering data and inputs for your ROI calculation

6 Presenters Lynda C. Meade, Director of Consulting Services, Centerprise, Inc., Formerly the Director of Clinical Services and HCCN at the Michigan Primary Care Association Mark S. Rivera, President, Managed Care Consulting, Inc../ MCC Analytics

7 What was the Population Health Management Project Vision for Michigan's HCCN? Why is measuring ROI of interest and important? Lynda C. Meade, MPA Director of Consulting Services Centerprise, Inc.

8 Poll Question #1 What is your current process to gather and analyze data for your population health management program? (select all that apply) A. No process/unable to do this B. Export from EHR into excel C. Module in EHR D. Health center purchased system at a health center level E. Network level purchased system F. Other

9 Poll Question #2 How would you rate the value of your current population health management platform/system? A. N/A- we don't have one B. No value C. Limited value D. High value E. We couldn't work without it

10 Journey to a PHM Program Progressive leadership Early adopters of quality supported with HIT Health Disparity Collaborative developed early version of a registry PCA developed service line to advance and support information technology Awarded OHIT 1 and OHIT 2 funding (HRSA Office of Health Information Technology) HCCN presented opportunities to continue to advance the vision Logical next step - > Statewide Integrated Data System

11 Michigan Quality Improvement Network Health Center Controlled Network 22 MQIN members Seven different EHR platforms in use Limits on allowable spending in year one per HRSA guidance was a barrier PCA hosted PHM tool in limited use year 1 Funding allowed PHM support in year 2 Platform in use underperformed

12 Health Center Controlled Network Opportunity! 38 of 40 Health Centers became MQIN members First funding cycle foundational and set a path for more rapid advancement New Focus Areas: Health IT Implementation and Meaningful Use Quality Improvement Health Information Exchange & Pop Health Management Data Quality and Reporting

13 Challenges Challenges Access to reliable and timely data Workforce to design and manage data while meeting MANY needs Cost of IT/IS platforms Variability

14 Excelling in the Healthcare Environment Success Principles: Need to think and operate as a network Efficiencies/LEAN thinking Group purchase/contracting Alignment of measures/processes/goals Meet HRSA goals (QI and UDS modernization) Value based payments readiness Strengthen position with Medicaid and the MI Health Plans OPERATE FROM A POSITION OF STRENGTH AND CONFIDENCE

15 Member Engagement/ Member Driven Shared and aligned vision Commitment to full transparency and engagement - staff and members Started conversations early and talked to many Shared Support Model HCCN investment funds/staff/process support Member investment time/resources/engagement Opportunities for support and optimization

16 Process Financial Readiness Implementation PCA/HCCN Support Manage the Ad-hoc Integrated Data System Committee Develop proposed tool selection process and timeline Draft Request for Proposals Coordinate legal reviews Provide status reports to the Board Negotiate group pricing HCCN o Annual appx $150,000 for system investment o 6.27 FTE Provide tool to measure health center readiness o Workforce e.g. Staff competencies/capacity o Infrastructure e.g. Connections, security, privacy o Software and analytics EHR version, modules Coordination of training and education for various users System set up Support statewide enterprise system Health Center Support Nominate committee members Make allowance for committee member participation Provide feedback when requested Attend the virtual demonstrations Allocate adequate resources to purchase Allocate adequate resources for system maintenance Participate in assessment Participate in the process to develop a business model Complete self-assessment and provide results to network to support a response strategy Support mitigation strategies Allocation of resources to mitigate gaps Build a strategy for ongoing data validation and reporting Commit staffing level to optimize access to data Participate in the process to prioritize needs Sustainability and on-going Support Manage monthly User Group Support enterprise level system Advocate for optimization of system Utilize the data and information to demonstrate and communicate the value of Health Centers policy makers, etc. Participate in education events Provide point of contact for focus areas Serve as a contributor in Peer Networks Provide feedback through formal and informal processes

17 Process for Selection and Implementation Ad-Hoc Committee chaired by a Health Center CEO Process to build representative committee Committee determined selection criteria by prioritizing functions Approved RFP, scoring tool and demo requirements Participated and scored final four in-person demonstrations Presentations to governing bodies and peer networks Required action by the board of directors to sign contract

18 Members Continue to Drive the Integrated Data System Dashboard reporting on status by health center Advisory group User groups based on role Commitment to measure ROI through member feedback and more advance methods

19 ROI Measurement Local Level and Enterprise Level Process Measures: readiness assessment, implementation, going live Early phase: data validation, access to data, ease of reporting Advanced phase: ability to build high demand reports/functions, project specific support Very advanced phase: ingesting of external data, measuring improvement in value based payments

20 MEASURING ROI IN POPULATION HEALTH MANAGEMENT Mark S. Rivera, MPH, CHTS IM Managed Care Consulting, Inc.

21 Healthcare Industry Trends Consolidation continues, new players investing in healthcare Wal-Mart, CVS/Aetna, Amazon, Facebook, Buffet. Investments in efficiency and quality, fueled by technology, people and processes. Patients continue to seek value, more control, better quality, lower costs. MACRA continues to move as planned. ACOs and HCCNs have been formed, virtual networks prevail. Population health management, care coordination and analytics facilitating accelerated clinical outcomes.

22 Decision Maker Challenges Given the uncertainties of the industry, shall we invest? If so, where? What are the indicators that can guide our decisions? Are investments consistent with our strategic priorities? How do we measure ROI?

23 Poll Question #3 How do you measure ROI of your population management program? A. N/A B. We do not have a process C. Survey members/users for info D. Measure-process/deliverables E. Other

24 Population Health Model

25 PHM ROI Framework Higher Cost Utilization to Lower Cost Utilization. Pathway to Measure Benefit, then ROI. Flexibility to engage initiatives at various levels. Provides references to various financial and clinical indicators. Provides a framework for engaging in advanced/predictive analytics.

26 ROI Tool Consists of two components 1. Narrative 2. Matrices

27 Purpose: Narrative To lend context and clarification on key components of the tool. Discuss the roadmap to ROI calculation. Introduces the matrix, key pages and a brief description of each. Introduces the cost sheets, and resource sheets with clinical and financial indicators.

28 Pathway to Success

29 Tab 1 - Instructions

30 Tab 2 CHC Engagement

31 Tab 3 Alignment and Priorities

32 Tab 4 Control and Refine

33 Tab 5 - Service Line and Support

34 Tab 6 Program Costs

35 Tab 7 Impact Analysis

36 Tab 8 - ROI Calculator

37 Tab 9 - Sample Questions for Feedback

38 Tab 10 - Clinical and Financial Measures

39 Knowing is not enough; we must act. - Johann Wolfgang von Goethe, Writer and Statesman

40 Resources on HITEQ Measuring Population Health Management Return on Investment Framework NNNews/DocumentDownload.ashx?portalid=0 &moduleid=718&articleid=1401&documentid= 216 Population Health Management Return on Investment Matrix Tool NNNews/DocumentDownload.ashx?portalid=0 &moduleid=718&articleid=1401&documentid= 217

41 Comments, Questions, and Discussion Please ask your questions in the chat box.

42 Office Hours Questions on tool or process as you explore the resources? Please join Lynda and Mark for virtual office hours: March 22, 3-4 ET

43 HITEQ Webinar Series Access our archived and upcoming webinars at hiteqcenter.org Please join us for upcoming webinars: Developing Effective Data Dashboards April 5, CFR Part 2 Final Rule and Health Center Compliance May 3, 2018

44 Thank You! Contact Us: Mark S. Rivera, MPH, CHTS IM Managed Care Consulting, Inc.. Lynda C. Meade, MPA Centerprise, Inc.

45 THIS PROJECT IS/WAS SUPPORTED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) UNDER GRANT NUMBER U30CS29366 TITLED TRAINING AND TECHNICAL ASSISTANCE NATIONAL COOPERATIVE AGREEMENTS (NCAS) FOR GRANT AMOUNT $500,000. THIS INFORMATION OR CONTENT AND CONCLUSIONS ARE THOSE OF THE AUTHOR AND SHOULD NOT BE CONSTRUED AS THE OFFICIAL POSITION OR POLICY OF, NOR SHOULD ANY ENDORSEMENTS BE INFERRED BY HRSA, HHS OR THE U.S. GOVERNMENT.