LOOKING AHEAD TO PHASE II

Transcription

1 ONECITY HEALTH PARTNER WEBINAR LOOKING AHEAD TO PHASE II February 14, 2017

2 Today s Presenters Richard Bernstock, Bronx Hub Executive Director Kevin J. Rogan, Esq., CHC, Sr. Executive Compliance Officer Inez Sieben, Chief Operating Officer Marlee Ickowicz, Project Manager, Workforce and Special Projects 2

3 Topics for Today s Webinar OneCity Health Partner Webinar series logistics and dates for DSRIP Year 3 New York State DSRIP compliance requirements Reminders on invoicing, GSI and the OneCity Health Partner Portal Workforce Impact Survey Phase II contracts and metrics Upcoming PAC meeting and final reminders 3

4 Guidance on Participation Metric P_3 Today is the seventh webinar in our monthly OneCity Health Partner Webinar series (referred to as Participation metric P_3 ) As discussed during the December webinar, we recognize that our partners may not always be able to attend these scheduled monthly webinars at the time they are held, so you are able to view a recording of the webinar on the OneCity Health website After the March 14 th monthly webinar, there will be a reporting template available through the OneCity Health Partner Portal for reporting on participation metric P_3 o o The reporting template will provide a record of your organization s attendance at these monthly webinars When submitting the template you will be given an opportunity to attest to having viewed a webinar recording as part of your organization s attendance record Please maintain records of any webinar recordings viewed, including: o o The date and time of viewing; and The name and title of the person who viewed the webinar on behalf of your organization To ensure you receive credit for participating today, please share your organization by chatting to OneCity Health Questions now 4

5 OneCity Health Partner Webinar Series Logistics Good news! The monthly OneCity Health Partner Webinar series will continue past March They will continue to be the second Tuesday of each month, from 2 p.m. 3:30 p.m.: o April 11, 2017 o May 9, 2017 o June 13, 2017 o July 11, 2017 o August 8, 2017 o September 12, 2017 o October 10, 2017 o November 14, 2017 o December 12, 2017 To help guide who from your organization should attend, we will continue to publish the webinar agenda on our website by the Friday prior to each webinar 5

6 OneCity Health Partner Webinar Series Logistics General partner questions and comments will be addressed today via the chat function. We ll stop and ask for questions when you see the following symbol: o If we are unable to answer a general question, we will address it in a future newsletter o For questions unique to you, we recommend you contact our support desk o To ask a question, send a message to OneCity Health Questions You can find slides from our previous webinars in the News section of our website, or by clicking the Webinars tab under Partner Resources. Slides are posted immediately after the webinar, and the recording as soon as it s available To ensure our s and newsletters are not trapped in your spam filters, please add our addresses (DSRIPSupport@nychhc.org and ochsupportdesk@nychhc.org) to your address book 6

7 Topics for Today s Webinar OneCity Health Partner Webinar series logistics and dates for DSRIP Year 3 New York State DSRIP compliance requirements Reminders on invoicing, GSI and the OneCity Health Partner Portal Workforce Impact Survey Phase II contracts and metrics Upcoming PAC meeting and final reminders 7

8 Reminder on DSRIP Compliance Training Required of OneCity Health Partners As we described in last month s OneCity Health Partner Webinar, under New York State law and requirements of the Office of Medicaid Inspector General (OMIG), all OneCity Health partners need to provide their workforce with DSRIP compliance training On Friday, February 3, 2017, we ed you and posted to our website additional guidance and materials to help you meet the training and other compliance requirements. The materials included: o A second memorandum from the NYC Health + Hospitals/OneCity Health Office of Corporate Compliance (OCC) with details on how to attest to meeting the compliance training requirements, adhering to the Principles of Professional Conduct and meeting OMIG compliance certification requirements, if any o An attestation form that we need you complete, sign and submit We have extended the deadline to submit the attestation to March 20,

9 How do OneCity Health Partners Attest to Completing all Requirements? We ed to you and posted to our website an attestation form to ensure you meet the requirements of OneCity Health s compliance program. The form contains three parts: 1. Completion of DSRIP compliance training (described in last month s OneCity Health Partner Webinar) 2. An acknowledgment that your workforce members are familiar with and adhere to the NYC Health + Hospitals Principles of Professional Conduct; and 3. Proof of OMIG compliance certifications if you are required by law and/or OMIG policy to certify the same. Scroll to the bottom of the page: 9

10 What are the Principles of Professional Conduct? The NYC Health + Hospitals Principles of Professional Conduct ( POPC ) is a guide that sets forth NYC Health + Hospitals compliance expectations, describes standards of professional conduct, as well as efforts to prevent fraud, waste, and abuse All partners must adhere to the POPC, which is Attachment B within the memorandum (to view the latest memorandum, click Download the Memorandum on the Attestation on our website), and requires our partners to: o o o Adopt the POPC or their own code of conduct that includes the POPC s core objectives or substantially similar compliance goals; Not engage in unprofessional conduct (e.g., improperly using DSRIP funds; or hiring or contracting with persons or entities excluded from participating in Federal health care programs such as Medicare and Medicaid) as described in Section VI of the POPC; and Timely report to the OCC any violation (related to the partner s participation in the DSRIP program and/or the use of DSRIP funds) of the POPC of which a partner becomes aware In the attestation, you are asked to confirm whether or not you have met the foregoing requirements of the POPC 10

11 What are the OMIG Compliance Certifications? The attestation asks a series of questions to determine whether you are required to submit to OMIG one or both of the following certifications, and if so, whether said partner has actually carried out this requirement: o The New York Social Services Law 363-d Certification; and o The Deficit Reduction Act of 2005 Certification Remember, not all partners are required to complete these OMIG compliance certifications Rather, only partners that meet certain criteria are required to annually file such certifications The memorandum (click the link Download the Memorandum on the Attestation on our website) describes the criteria for both of the above-mentioned certifications Partners who are required to complete one or both of the OMIG Certifications should include a copy of the electronic confirmation filing receipt from OMIG 11

12 Where Should Completed Attestations be Sent? An authorized representative of each partner is required to complete, sign, and return the attestation form by , fax, or regular mail to: Kevin Rogan NYC Health + Hospitals/OneCity Health Senior Executive Compliance Officer Office of Corporate Compliance 160 Water Street, Suite 1129 New York, New York Kevin.rogan@nychhc.org Office number: (646) Fax number: (646) The certifications are due by March 20, 2017 We will answer questions now, but if you continue to have questions, please contact Kevin at the contract information listed above Thank you in advance for meeting this New York State requirement 12

13 Topics for Today s Webinar OneCity Health Partner Webinar series logistics and dates for DSRIP Year 3 New York State DSRIP compliance requirements Reminders on invoicing, GSI and the OneCity Health Partner Portal Workforce Impact Survey Phase II contracts and metrics Upcoming PAC meeting and final reminders 13

14 Don t Forget to Invoice us to Receive Payment for Completed Metrics Once a metric is approved for payment by OneCity Health, you will be able to submit an invoice through the Portal to request payment associated with that metric In the Notifications window in the Portal, you will see a Submit Invoice notification each time you have an invoice available for submission. You will also receive a notification from the OneCity Health support desk about available invoices Each metric has its own invoice which will be available in the Portal for review and submission when a metric has been approved 14

15 Submitting Invoices is a Quick Process! Information in the invoice will be pre-filled based on your organization s individual Schedule B. All you need to do is: o o o o Verify the invoice for accuracy and completeness Click the attestation check box Enter required contact information: Name, Phone Number, Address Submit to OneCity Health so we can process payment for your completed metrics 15

16 Reminders on GSI Training and Resources For those of you who have received GSI training, please remember we have scheduled a webinar for February 22 at 10 a.m. to detail the latest changes and improvements. Please visit the Events Calendar on our website to view the login instructions for the webinar o This webinar is for both provider staff and community health workers, as well as for supervisors o The content in this webinar will be the same as the two sessions we hosted in January. Those webinars are available to watch on our website If a colleague that has been trained in GSI leaves your organization, please alert our support desk right away so we can deactivate the account If you have additional GSI questions, please make sure to direct them to the correct place: o Provider staff and community health workers should first speak with their supervisor o If the question is programmatic, supervisors should contact the OneCity Health support desk o If the question is technical, supervisors should contact the GSI support desk Telephone Number: (888) Address: Help@GSIHealth.com Hours of Operation: Monday Friday 7 a.m. to 10 p.m. EST 16

17 Reminders on the OneCity Health Partner Portal It can take up to 72 hours to complete registration on the OneCity Health Partner Portal If you are new to your organization and will be responsible for completing metrics, or if you have assigned metrics to a colleague to complete, please register for the Portal well in advance of the metric deadline If a colleague with a Portal account leaves your organization, please alert us right away so we can deactivate the account Don t forget, if you have questions on metrics, deadlines, invoicing or any other Comprehensive Schedule B requirement, our support desk is available from 9 a.m. to 5 p.m.: o ochsupportdesk@nychhc.org o Phone Number:

18 Topics for Today s Webinar OneCity Health Partner Webinar series logistics and dates for DSRIP Year 3 New York State DSRIP compliance requirements Reminders on invoicing, GSI and the OneCity Health Partner Portal Workforce Impact Survey Phase II contracts and metrics Upcoming PAC meeting and final reminders 18

19 We Initiated the Workforce Impact Survey in Fall 2016 As you may recall, in September - October 2016, we asked you to complete a Workforce Impact Survey (Survey) This Survey tracks the number of staff by partner, by site(s), across New York State designated job titles who have been hired, redeployed or retrained during DSRIP implementation We are required to collect this type of information by New York State at least twice per year For the upcoming reporting requirement, we are planning to distribute a slightly modified version of the Survey during the week of February 20 th o The Survey is now a process metric in the Phase II contract, so you will be paid for completing it o We are asking that you send it back to us in early April, which gives you nearly two months to gather the necessary data to complete the Survey 19

20 What s New in the Upcoming Survey? The upcoming Survey collects DSRIP-related staffing information using a very similar template to the Survey we distributed in September October 2016 For this Survey, the State requires you to report on DSRIP staffing changes for the following periods: o October 1, 2016 to March 31, 2017 (DY2Q3 and DY2Q4) o April 1, March 31, 2016 (DY1) New items include: o Additional request to report partner trainings that advance DSRIP goals Note, this is a standalone feature of the Survey It comes in the form of an additional Tab on the Excel template The main reporting section of the Survey still requires that you report only on retrained staff who are DSRIP-funded and trained for the purposes of redeployment or to avoid lay-off 20

21 Important Definitions to Keep in Mind for the Survey A DSRIP related workforce is one that meets the New York State Department of Health's definitions across the categories of New Hires, Redeployed Personnel, and Retraining In addition, DSRIP jobs are those that: o are explicitly funded through DSRIP; o support DSRIP projects and infrastructure; AND o comport with DOH-defined job titles These definitions are further described in the forthcoming Survey template instructions DEFINITIONS New hires New hires are all personnel hired as a result of DSRIP, exclusive of personnel who are redeployed (see definition below). New Hires include all new employees who support the DSRIP projects and PPS infrastructure, including but not limited to executive and administrative staff, professional and para-professional clinical staff, and professional and para-professional care coordination staff. Redeployed Personnel Redeployed employees are people who are currently employed by any OneCity Health partners in DSRIP Year 1 and who transition into another job title, including those who transition to another job with the same employer. Retraining Retraining is defined as training and skill development provided to current employees of PPS partners for the purpose of redeployment or to employees who are at risk of lay-off. Skill development includes classroom instruction whether provided by a college or other training provider. It can include, particularly for at-risk employees, longer term training to support transition to high demand occupations, such as Care Manager or Nurse Practitioner. 21

22 How to Submit the Workforce Survey to OneCity Health During the week of February 20, 2017 we will send you an Excel template to record this information o We will include instructions on how to complete the form and categorize the data o We will also hold an Office Hours session, which is an opportunity for you to call in and ask questions that you may have about the instructions and the mechanics of completing and submitting your completed report The Office Hours session is Thursday, March 9, 2017 from 10:00 a.m. 11:00 a.m. Call-in details are on our website, in our Events Calendar Please submit a completed Survey to the OneCity Health support desk by ing it to ochsupportdesk@nychhc.org This process is different than other surveys and reports, which you normally complete on the OneCity Health Partner Portal 22

23 How to Submit the Workforce Survey to OneCity Health The Workforce Impact Survey is the first process metric in the Phase II contract; this means you will be paid for completing it To ensure your report aligns with the Phase II contract, we ask that you not send the completed Survey to the OneCity Health support desk before April 1, 2017, but as soon as possible after In your upcoming Phase II Comprehensive Schedule B, you will see the deadline for completing the Survey is listed as April 20, which is the absolute latest you can send it to us We understand this timeline is complex, but by submitting the completed Survey as soon as possible after April 1, it ensures: o We can review the data and submit a report to New York State by April 28, Aggregating the data can be complicated, so we appreciate your efforts o You can submit an invoice and be paid during the correct contracting period We know that this is a labor-intensive effort for you as well, and we ask that you complete this survey to the best of your abilities Thank you in advance for your collaboration! 23

24 Topics for Today s Webinar OneCity Health Partner Webinar series logistics and dates for DSRIP Year 3 New York State DSRIP compliance requirements Reminders on invoicing, GSI and the OneCity Health Partner Portal Workforce Impact Survey Phase II contracts and metrics Upcoming PAC meeting and final reminders 24

25 What Will We Cover Today Regarding the Next Round of Contracts? As we ve discussed on previous webinars, the next round of contracts (which we refer to as Phase II) are scheduled for release in mid-march with April 1, 2017 effective date Today, we will cover: o Important reminders on Phase II contracts o Process metrics and outcome measures o Funds flow to partners o Phase II contract structure 25

26 Important Reminders on Phase II Contracts Before proceeding further with today s discussion on Phase II contracts, there are a number of important aspects to keep in mind: o The basic Comprehensive Schedule B structure will remain the same: Single schedule for partners with identified projects Metrics to earn eligible funds o Refinements in Phase II will include: Metrics more targeted to partners services, including non-medicaid billing organizations Introduction of outcomes-based measures (subset of NYS identified measures) 9-month contract term: April 1, 2017 December 31, 2017 Level of partner engagement will be a consideration in offering Phase III contracts 26

27 Process Metrics & Outcome Measures Last month we described that your next Comprehensive Schedule B will include both process metrics and outcome measures However, you will only need to report on process metrics; outcome measures are our goals as an overall Performing Provider System, and do NOT require reporting by partners We have developed 29 process metrics, and we have selected 14 outcome measures for our PPS o Process metrics and outcome measures in your Comprehensive Schedule B are based on project selection and service type 27

28 How do Process Metrics Support an Outcome? Many of the process metrics are incremental steps in driving transformation activities, which drive the PPS success in achieving outcome measures Demonstrate that at least one provider at each participating site has successfully completed Physician Asthma Care Education (PACE) training by submitting certificates of completion Pediatric Quality Indicator #14 Pediatric Asthma (reduction of pediatric asthma admissions) Demonstrate that 20% of patients enrolled in the Asthma Program have a completed home visit Potentially Preventable Emergency Room Visits Develop a consistent process to assign Emergency Severity Index (ESI) levels for all patients that present in the Emergency Department and a process to educate all ESI level 4 and 5 patients of more appropriate care settings (i.e., primary and urgent care) 28

29 What is the Partner Share of Funds for Phase II Contracts? The total payments our partners are eligible to receive in Phase II is $85M for first 9 months of DSRIP Year 3, which is a significant increase over the $55M allocation for Phase I The largest portion is for the Comprehensive Schedule B Distinct Schedules B will include partner agreements for social services, technical assistance and other activities 29

30 How Does the Total Share Flow to a Partner? PPS Payment from DOH Total PPS Partner Payment Allocation Individual Partner Total Eligible Allocation Sign Comprehensive Schedule B Process Metrics Outcome Measures Individual Partner Total Eligible Allocation Partner Completion of Process Metrics PPS Achievement of Outcome Measures Partner Payments* * Partners will be eligible to earn funds above their partner total allocation based upon their reported contribution to Patient Engagement metrics 30

31 Contracting & Metrics Approach Early Funds Flow to Partners Partners will receive 10% of their total eligible partner allocation upon signing of the Comprehensive Schedule B (CSB) The Schedule must be signed by May 15 th in order to participate in this contracting period Payment for Process Metrics Of the remaining dollars (90% of the total eligible partner allocation), 75% will be allocated to process metrics Partners must sign their CSB and successfully achieve process metrics in order to earn the associated dollars Payment for Outcome Measures Of the remaining dollars (90% of the total eligible partner allocation), 25% will be allocated to outcome measures Partners will only be eligible to earn dollars associated with the outcomes measures if the following three criteria are met: o Partner must sign their CSB by May 15 th o PPS must successfully achieve the outcome measure as determined by NYS DOH o Partner must successfully achieve 50% or greater of their process metrics 31

32 Total Package of PPS Support to Partners: CBO Example Borough Social Services, Inc. Illustrative Only (CBO Partner) Funding Within Comprehensive Schedule B Borough Social Services is a non-medicaid billing CBO participating in three projects; Integrated Delivery System (2.a.i), Project 11 (2.d.i), and Asthma Home Based Self- Management (3.d.ii) Total eligible allocation under their Comprehensive Schedule B equals $28,079 and can be earned upon performance of metrics and measures listed in their Comprehensive Schedule B 10% signing bonus = $2,808 75% process metrics = $18,954 25% outcome measures = $6,317 Unlike other project payments which are quarterly, Project 11 CBOs will be paid monthly for participation and reporting In addition to the total eligible allocation, the partner is also eligible to earn funds for reporting on Patient Engagement metrics Technical Assistance Access to software platform that allows for sending and/or receiving of referrals for non-clinical services Access/training on care management software platform for creation and review of care plans VBP readiness/sustainability: Technical assistance from four contracted CBO strategic advisors To improve partner experience and quality, participation in collaborative CBO specific workgroups Service Specific Contracts Select partners will receive service specific contracts (distinct Schedules B) for nonclinical services 32

33 Total Package of PPS Support to Partners: PCP Example Doctors, Inc. Illustrative Only (PCP Partner) Comprehensive Schedule B Doctors, Inc. is participating in four projects: Integrated Delivery System (2.a.i), Health Home At-Risk (2.a.iii), Primary Care Behavioral Health integration (3.a.i), Cardiovascular Disease Management (3.b.i) Total eligible allocation equals $63,899 and can be earned upon performance of metrics and measures listed in their Comprehensive Schedule B 10% signing bonus = $6,390 75% process metrics = $43,132 25% outcome measures = $14,377 Partner is also eligible to earn funds above their total eligible allocation for reporting on Patient Engagement metrics Technical Assistance Access to care management and referral platforms PCMH certification: technical assistance for transformation and financial support for PCMH license fee Support connecting to a RHIO and EMR access Training and support for successful network integration (e.g., VBP training) Support clinical transformation through the use of evidence-based care models and toolkits Support implementation of PCBH colocation Participation in PCMH learning collaborative to share best practices Service Specific Contracts Select partners will receive distinct contracts (distinct Schedules B) for specific services (technical assistance, capacity building, etc.) 33

34 What Does the Comprehensive Schedule B Look Like? A. Participating Projects This section outlines the projects for which the partner is participating in and has applicable process metrics in the Phase II Schedule o Partners project selection was reviewed and compared against defined participation criteria developed by the OneCity Health clinical staff The Comprehensive Schedule B includes 10 of the 11 projects that OneCity Health is participating in 34

35 What Does the Comprehensive Schedule B Look Like? B. Total Eligible Allocation Total Eligible Allocation represents the total dollar amount a partner could earn Partners can earn their Total Eligible Allocation by: o o o Signing their Comprehensive Schedule B by May 15 th Successful completion of the process metrics PPS achievement of outcome measures (please note these won t be earned until the end of the contracting period) 35

36 Comprehensive Schedule B Section 4. Patient Engagement Speed & Scale OneCity Health has specific Patient Engagement Speed & Scale commitments that must achieved each quarter to earn related DSRIP funds Definitions for Patient Engagement were established by DOH and are available on OneCity Health s website Partners eligible to report Patient Engagement will have related metrics in their Comprehensive Schedule B o Partners for whom this does not apply will not receive this metric in their Comprehensive Schedule B The same approach that was utilized in Phase I for Patient Engagement will be utilized for Phase II A partner s ability to earn Patient Engagement funds is relative to the PPS achieving project specific speed and scale targets Dollars earned per partner are calculated at the end of the performance period based on PPS performance, and partner performance relative to other partners 36

37 Comprehensive Schedule B Sections E H. Payment and Terms This section contains information on invoicing, payment, and the contract effective dates Comprehensive Schedules B will be sent to the signatory currently identified for each partner o o Please notify OneCity Health as soon as possible if the signatory for your organization has changed If your organization has not received its Comprehensive Schedule B by March 31, 2017, please notify OneCity Health immediately 37

38 Questions Regarding Phase II Contracting We will continue to answer questions and provide details on our next OneCity Health Partner Webinar (March 14, 2017) as we finalize Phase II contracts If you have questions, please type them to us; if we cannot answer them now we will incorporate them into our March presentation A sample contract and final metrics will be posted to our website this afternoon (click the news post that includes the recap of this webinar) As we did in Phase I, we will be providing a OneCity Health Reporting Manual and templates for Phase II 38

39 Topics for Today s Webinar OneCity Health Partner Webinar series logistics and dates for DSRIP Year 3 New York State DSRIP compliance requirements Reminders on invoicing, GSI and the OneCity Health Partner Portal Workforce Impact Survey Phase II contracts and metrics Upcoming PAC meeting and final reminders 39

40 Our Next PAC Meeting is March 8 Our next OneCity Health City-Wide Project Advisory Committee (PAC) meeting is: Wednesday, March 8, 2017 from 3 5 p.m. It will be held at the Brooklyn Public Library 22 Linden Blvd at Flatbush Avenue (located on Flatbush and Linden Blvd) Public transit: approx. 8 minute walk to the B/Q at Church Ave and a 10 minute walk to the 2/5 at Church Ave PAC meetings are for partners to share their experiences with project implementation, provide input into our planning, design and evaluation activities, and get to know fellow OneCity Health partners 40

41 Final Reminders Due Tomorrow, February 15, 2017: We ve been recommending to our primary care partners that they submit an application for the Mental Health Service Corps to support behavioral health integration. The deadline to do so is tomorrow. Details are on our website. Click the News post from Jan. 26. On March 8, 2017: Attend our next City-Wide Project Advisory Committee (PAC) meeting at the Brooklyn Public Library On March 9, 2017: Call in to Office Hours if you have questions about the Workforce Impact Survey On March 14, 2017: Attend our next monthly OneCity Health Partner Webinar. We will share final details regarding Phase II contracts. The webinar will be held from 2 3:30 p.m. Due March 20, 2017: Satisfy your DSRIP training and compliance requirements. Complete and submit the Attestation form to Kevin Rogan, and contact him if you have questions If colleagues that have been trained in GSI or have accounts on the OneCity Health Partner Portal have left your organization, please alert our support desk right away so their accounts are deactivated If you have questions about completing metrics or submitting reports, please contact our support desk Stay up to date and informed! 1. Make sure your contact information is up to date 2. Check the OneCity Health website regularly 3. Read the OneCity Health newsletter for important announcements 41

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