Board of Trustees Meeting. May 15, 2017

Transcription

1 a Board of Trustees Meeting May 15, 2017

2 Our Role The Pierce County ACH creates collaborative engagement between the community and dedicated community partners Together we learn, share, and act, in order to positively transform our health system 2

3 Agenda Welcome Consent Agenda Board Governance Financials Executive Director Operations Report - Draft Organizational Chart - Website - Finance Department Integration, Councils and Projects - Opioid - Funding Mechanics & Financial Executor - Practice Transformation Hub & ACH Executive Session Adjourn 3

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5 5

6 6

7 Executive Director Operations Report

8 Operations Certification Application, Phase I submitted Manatt (Regional Coordinator); Certification Phase II Leveraging Resources across ACHs - Southwest ACH & Better Health Together work sessions Exploring shared services Human Resources & Benefits Office space Pathways business plan & HUB certification Presentations, Participation & Partnerships - Health Equity Summit - Science of Hope - Foundation for Health Generations, Uncommon Solutions - City Club - Opioid WA State Hospital Association/WA State Medical Association - Pierce County - HRSA, Region 10 - DOH (Practice Transformation and Community Health Workforce) - HCA & Manatt 8

9 DRAFT as of May 10, 2017 tan boxes are phased hires; green boxes are current team members and partnering contractors Organizational Chart Community Voice Council SHARED LEARNING STRUCTURE Regional Health Improvement Plan COUNCIL Provider Integration Panel Executive Assistant & Governance Coordinator Board of Trustees Executive Director Alisha Fehrenbacher Partnering Contractors Executive Committee Finance & Audit Committee Nominating Committee Tribal Collaboration and Communication Committee Appointed Council Liaisons: -CVC to BOT -CVC to PIP -CVC to RHIP -PIP to RHIP Provider Integration Panel Workgroups (Linking to RHIP, CVC and DLT): -Opioid Task Force -Care Coordination -Quality Improvement -Interoperability Data & Learning Team RHIP Director Lena Nachand Director of Clinical Integration Operations Coordinator Vanessa Perdomo Associate Director Alisa Solberg Communications Coordinator Human Resources (Potential Shared Services) CFO Meg Taylor Community Voice Council Coordinator Accountant/Bookkeeping (Potential Shared Services) Tribal Liaison (Potential Shared Services) RHIP Project Manager Community Care Coordination HUB Manager DRAFT Improvement Advisor (Practice Coach) Interim 9

10 Website Launch Jeremy Rolfer & Vanessa Perdomo 10

11 Web Structure 11

12 Finance Department Meg Taylor, CFO - Finalizing Accounting Policies & Procedures - Exploring Shared Services for Bookkeeping - Exploring Shared Services for some Human Resources components - Expanded Operational Budget - 5-year Budget Plan & Funds Flow - Fiscal Integrity - Project Design Funds 12

13 RHIP IN ACTION

14 COMMUNITY DRIVEN STRATEGY FOR SHARED LEARNING AND ACTION GOVERNANCE Share learnings key cohorts are followed in the data so that impacts and savings can be identified and funds redirected into community priorities for financial sustainability EVALUATE LEARN RE-INVEST RHIP DATA DRIVEN STRATEGY Systems and structures for data collection, analysis, reporting. Track suboptimal outcomes. Identify optimal populations, places, or care settings to intervene using multi-sector datadriven strategy. Collective action that supports local solutions through pooled resources, and comprehensive systems and policy change strategies RHIP STRATEGY COMMUNITY VOICE SYSTEM Find out why the patterns you see in the data exist. Leverage local wisdom for solutions POOLED RESOURCES Braiding of diverse resources for one common RHIP

15 Medicaid Transformation Demonstration Project Toolkit Health Systems & Community Capacity Building These required elements are the foundation for transformation projects: Financial sustainability through value-based payment (VBP) Workforce development related to specific initiatives Systems for population health management Care Delivery Redesign Required project: Bi-directional integration of care and primary care transformation Choose at least one: Community-based care coordination Transitional care Diversion interventions Prevention & Health Promotion Required project: Addressing the opioid use public health crisis Choose at least one: Maternal and child health Access to oral health services Chronic disease prevention and control

16 Medicaid Transformation Demonstration Project Toolkit Care Delivery Redesign including Population Health Strategies INITITIATIVE A Bi-directional integration of care and primary care transformation A1. Collaborative Care Model Value Based Payment Workforce Development System for Population Health Management Primary Care Medical Homes Telemedicine A2. Transitional Care TBD Evaluating Models (i.e. Standardized Hospital Discharge Planning) Value Based Payment Workforce Development A3. Opioid Prevention, Treatment Overdose Interventions TBD Evaluating Models Value Based Payment Workforce Development A4. Chronic Disease Prevention & Management TBD Evaluating Models (i.e. Stanford DSM) Value Based Payment Workforce Development A5. Oral Health TBD Evaluating Models (i.e. FQHC, WDSF, other) Value Based Payment Workforce Development INITITIATIVE B Community Care Coordination (and Diversion) B. Community Care Organization Pathways (Standard 20) Plus NEW Opioid Pathway Oral Health Home Visiting Referral (MCH) Re-Entry Referral Value Based Payment Workforce Development System for Population Health Management C. Community Paramedicine TBD Evaluating Models (i.e. EMS) Value Based Payment Workforce Development D. Jail Diversion TBD Evaluating Models (i.e. Pathways, LEEDs) Value Based Payment Workforce Development E. ED Diversion TBD Evaluating Models (i.e. High risk, High cost, crisis/trauma, HET Health Engagement Teams) Value Based Payment Workforce Development F. Maternal & Child Health TBD Evaluating Models Value Based Payment Workforce Development A6. Telemedicine TBD Evaluating Models (i.e. related to disease state) Does it support the Collaborative Care Model & PCMH? Value Based Payment DRAFT in Partnership with SWACH, BHT and

17 (WHAT) Implement Projects to Improve/Align/Expand: Integration of Services Coordination of Services Clinical Guidelines Prevention Services Diversion Services (HOW) Ensure the Process is: Logistically Supported: process, training, tools, workforce, etc. Informed by Community-Voice Informed by Data Incentivizing Value (Pay to Participate and Pay to Perform) AIM System of Services to Promote and Improve Health and Well-Being Value: Services and Outcomes are Sustainable, Equitable, and Whole Person To achieve a Sustainable, Equitable, Whole-Person SYSTEM OF SERVICES we need to: YEARS 1-2: Plan & Implement (Pay to Participate) ACH SUPPORTS 1. Ensure ACH workgroups/committees support project plan development 2. Coordinate and submit project plans 3. Provide project-specific training 4. Provide project-specific tools/technology 5. Provide plan for performance goals and funding for years 3-5. YEARS 3-5: Achieve (Pay for Performance) ACH SUPPORTS Pay for Performance (Years 3-5) PARTICIPANT DOES 1. Formal commitment to participate in project (development and planning) 2. Be trained in project-specific evidence based practices 3. Implement project-specific evidence based approaches 4. Report project progress to ACH 5. Participate in monitoring performance related to measures and targets PARTICIPANT RECEIVES Receive funding for meeting performance targets related to project participation (Years 3-5) 17

18 Investment Strategy Draft Identify the Solution Initiative Sample Projects Investments Outcomes Policy System Intervention / Program PHASE 1 Bi-Directional Integration Program/Intervention(s): Collaborative Care Model Care Transitions ED Diversion Connecting to Pathways HUB Oral Health Access & Utilization Opioid Chronic Disease Epic Expansion to BH IT Interface Solutions Practice Coaching Practice Certification PCMH Payment Change Mgmt Support Overlay of CORE/CCS platforms Integrated and Coordinated Care Common Metrics Aligned Payment Systems (APM/VBP) $ Cultural Competency Population Health System $ Sustainable Workforce $ Policy System Intervention/Program Community Care Coordination Pathways HUB Model Pathways (Standard 20) Plus NEW Opioid Pathway Potential Primary Populations Opioid Utilization in Teen Pop Chronic Disease Pregnant and Parenting Women with BH & SUD Jail Diversion & Recidivisms Others? Opioid Prevention, Treatment & Overdose Related Interventions Pathways Community Hub Institute CHW Workforce Training CCA Certification Hub Development Standardization Overlay of CORE/CCS platforms Certified HUB Standardized Protocols Sustainable CHW Workforce $ Common Metrics Cultural Competency Sustainable & Braided Financing Mechanisms Aligned Payment Systems (APM/VBP) $ Population Health System $ DRAFT in Partnership with SWACH, BHT and 18

19 Thank You, Partners

20 Manatt Funding Mechanics

21 Initiative 1 Funds Will Flow to Participants through Several Distinct Pools 21 Total Initiative 1 DSRIP Transformation Funds ($1.12 billion) State Administration Funding ($52M) VBP Incentive Pools ($169M Max) Design Pool (Y1 Only) ($54M Max) DSRIP Project Pool ($847M Max) Integration Incentive Pool ($70M Max) VBP Incentive Pool funds that remain after Integration Incentive Pool are divvied into Provider pool (2/3 of remaining) and MCO pool (1/3 of remaining) Reinvestment Pool (Partnering Providers) ($113M Max + Un-earned Funds) Challenge Pool (MCOs) ($56M Max) Un-earned Project Pool funding will be available to be re-earned through high performance on statewide quality measures via the Reinvestment Pool Similarly, un-earned Challenge Pool funding could also be redistributed based on exceptional quality performance Source: Working DSRIP Funding and Mechanics Protocol; Special Terms and Conditions; Working HCA and PCG Modeling Subject to Change: Under Negotiation with CMS

22 Funding from DSRIP Pools Flow to ACHs and ACH Partner Organizations, Who Collaborate on Transformation Projects 22 Total Initiative 1 DSRIP Transformation Funds ($1.12 billion) VBP Incentive Pools Design Pool (Y1 Only) DSRIP Project Pool Challenge Pool Reinvestment Pool Integration Incentive Pool Accountable Communities of Health Project Selection, Coordination and Monitoring MCO Partner* BH Provider Primary Care Provider Indian Health Care Providers Hospital Health Center County Govt Community Based Orgs Tribal Govt BHO Partner Sample ACH Partnering Provider Organizations for Transformation Projects * Note that though MCOs are critical project partners, they are not eligible for DSRIP Project Pool incentive funds Source: Working DSRIP Funding and Mechanics Protocol; Special Terms and Conditions; Working HCA and PCG Modeling Subject to Change: Under Negotiation with CMS

23 Potential DSRIP Funding for Pierce County Funding Source ($m) Calendar Year Funding Earned Total Design Pool $6.0 $6.0 DSRIP Project Pool $17.0 $23.0 $23.0 $21.0 $18.0 $102.0 Integration Incentive Pool $4.1 $6.1 $10.2 Key Takeaways: Funding amounts are planning estimates, and subject to change. The only guaranteed amount is $1 million in Design Pool funds, awarded when Pierce County achieves Phase I certification. All other amounts are available based on the performance of the ACH and its partners. Integration Incentive Pool payments are awarded only if Pierce County submits a Letter of Intent before September 1, 2017, and launches an integrated care MCO by January 1, Pierce County can earn Reinvestment Pool and Value-Based Payment (VBP) incentive payments in addition to the funding described in this table. Technical Assistance for Accountable Communities of Health DSRIP Demonstration Funds Flow Pierce County. May 12, Slide 23

24 Practice Transformation Hub & ACH

25 INTEGRATION WHAT HEALTH CARE PROVIDERS WILL NEED Technical Assistance Workflow Redesign Practice Coaching Integration Value Based Payment Practice Transformation Hub Qualis UW Link with ACHs to ensure connectivity and to reduce gaps VBP Technical Assistance Sustainable payment model that meets state s goals for VBP and provides adequate compensation MCOs Assessment and Training Technical Assistance Infrastructure Technology Training Convening Transition Assistance Project Incentives Other ACH SOURCE: Dawn Bonder, CEO Southwest Accountable Community of Health

26 The Hub: A Four-year, State Innovation Model (SIM) Testing Grant Three separate contracts, funded by DOH Qualis Health provides Practice Coaches and Regional Connectors programs Web Resource Portal offered through partnership with UW Department of Family Medicine Primary Care Innovation Lab

27 Hub Goals Help Providers to: To Achieve the Triple Aim Integrate physical and behavioral health Move from volume-based to value-based care Improve population health through clinical and community linkages

28 The Hub: Offering a Menu of Services to Support Practice Transformation Efforts Hub Help Desk Personalized practice assessment Education, tools and resources Support for bi-directional physical and behavioral health integration Finding and coordinating community-based linkages

29 Continuum of Bi-directional Physical and Behavioral Health Integration

30 Public Comment

31 Executive Session

32 Thank you Board of Trustees, Community & Partners