Practice Transformation Academy

Transcription

1 Practice Transformation Academy Kick-off Meeting for Practices in the National Cohort March 16, 2017 National Council for Behavioral Health 1400 K St. NW, #400 Washington, DC 20005

2 Stretch Goal Presentations and Peer Feedback 1. What is your stretch goal? 2. Who will you include on you transformation team and why? 3. What metrics will you use to measure your effectiveness toward this stretch goal? 4. What are your anticipated barriers to meeting your stretch goal?

3 Organization A 3/20/2017

4 What is your Stretch Goal? Improve client outcomes in our outpatient clinic by implementing evidence-based, client specific assessments to be conducted at intake, during treatment, and upon discharge. Our intention is that those assessments will inform and improve client care. 3/20/2017

5 Who will you include on your transformation team and why? Our Transformation Team will include our Executive Director, Clinic Director, Chief Financial Officer, Clinic Office Manager, and our Project Lead, whose responsibilities include our EHR, communications, and quality management functions. We may also include our other Agency Senior Managers/Program Directors on the Team. As we view VBP as the future of human services, we wanted to include all divisions of the agency is this academy. These individuals have been chosen for the team because of their role in agency/clinic leadership. However, we are thinking that our stretch project is too narrow for the agency s management team. We are re-assessing. 3/20/2017

6 What metrics will you use to measure your effectiveness towards this stretch goal? Selection of easy to use and inexpensive assessment tools Train staff; ongoing training Use assessment to guide treatment 3/20/2017

7 What are your anticipated barriers towards meeting your stretch goal? Staff culture Financial and time constraints 3/20/2017

8 Organization B 3/20/2017

9 What is your Stretch Goal? Build a data-driven culture to support performance improvement and risk management for our In Home Therapy service line 3/20/2017

10 Who will you include on your transformation team and why? VP of Performance Improvement COO Senior Director of Behavioral Health VP of Finance Clinic Director 3/20/2017

11 What metrics will you use to measure your effectiveness towards this stretch goal? Family preservation Weekly contact CAFAS data re Family functioning Staff responsiveness to family requests 3/20/2017

12 What are your anticipated barriers towards meeting your stretch goal? Staff investment Cost EHR Redesign Competing priorities Number of staff 3/20/2017

13 Organization C

14 What is your Stretch Goal? Closing the care gap on our community. Developing a risk stratification to assess new business opportunities.

15 Who will you include on your transformation team and why? Director of Community and clinical Programs gain staff support Director of Finance- create financial models Director of Outcomes and Data - gap analysis and environmental survey Manager of Clinical Practice - ensure EBP methodology Executive Director support project, communication,? To reinforce the need for the transformation Director of Administrations steer the process Clinical Supervisors implement the plan

16 Financial Operational What metrics will you use to measure your effectiveness towards this stretch goal? How well it serves consumers Staff response

17 Time What are your anticipated barriers towards meeting your stretch goal?

18 Organization D

19 What is your Stretch Goal? Ability to compile and monitor our data as it relates to those valuebased elements we want to focus on. E.g., hospitalizations, ER visits, cost data, clinical improvement data, etc.

20 Who will you include on your transformation team and why? Executive committee oversight Transformation committee

21 What metrics will you use to measure your effectiveness towards this stretch goal? ER visits, hospitalizations, cost per member, cost per service, diabetes, COPD, CAD, asthma, Time to appt., depression improvement, risk stratification, and more

22 What are your anticipated barriers towards Time, prioritization meeting your stretch goal?

23 Organization E

24 What is your Stretch Goal? Provide BH intervention for patients with high HA1C score and high PHQ9 Score. A1C > 8, PHQ9 >10

25 Who will you include on your transformation team and why? CMO to bridge gap between IM and BH providers IT for template development QI for data collection BH to provide PSA at time on primary care visit\ Care team Pharmacist

26 What metrics will you use to measure your effectiveness towards this stretch goal? PHQ9 A1C PSA

27 What are your anticipated barriers towards meeting your stretch goal? Poor patient engagement Perceived workload increase Staff resistance Possible cost related to EMR/template development

28 Organization F

29 What is your Stretch Goal? Demonstrate value of PTSD/trauma services to community partners and potential payers.

30 Who will you include on your transformation team and why? CEO CFO OD Director Clinical Director Outpatient Administrator IT Technician Psychiatric Nurse Clinicians Consumers Community Partners.

31 What metrics will you use to measure your effectiveness towards this stretch goal? Outcome data: specific consumer goals, measurement of progress over time (ie ), Community partner outcome measures to demonstrate value and partnering opportunities.

32 What are your anticipated barriers towards meeting your stretch goal? Staff buy-in, staff understanding, time constraints & competing priorities, communication, investment, state regulations, IT technical capabilities, costs & indirect expenses, laggards, local politics, unforeseen emergencies.

33 Organization G

34 What is your Stretch Goal? Develop a Value Proposition for a sub-population for a major funder

35 Who will you include on your transformation team and why? Service Area VPs, Representation for Funder, Finance, IT, QI, Middle Managers, Front Line Staff, C-Suite

36 What metrics will you use to measure your effectiveness towards this stretch goal?

37 What are your anticipated barriers towards meeting your stretch goal? Staff resistance, change fatigue, technical challenges in data collection, time limitations, additional resources needed

38 Organization H

39 What is your Stretch Goal? Standardized means of evaluating value based care opportunities.

40 Who will you include on your transformation team and why? Executive Sponsor PTA Lead Finance IT Quality Improvement CCE Center for Clinical Excellence Clinical Operations Data Analytics Learning & Education/HR Marketing & Communications Payer Contracting

41 What metrics will you use to measure your effectiveness towards this stretch goal? Payer Risk Assessment Score (Go/No-Go) Pre & Post Contract Value (ROI & Investment Value) Toolbox of clinical and operational resources to successfully manage and operationalize value based contracts

42 What are your anticipated barriers towards meeting your stretch goal? Multiple financial, EHR, HR and data analytics systems Change Fatigue Nominal Margins Requirements for New Infrastructure Clinical Finance

43 Organization I

44 What is your Stretch Goal? Reduce the % of patients who are deemed high-risk

45 Who will you include on your transformation team and why? CFO VP, Programs VP, Business Development Senior Director, Outpatient Senior Director, Analytics Primary Care Partner, Medical Director Primary Care Partner, Innovation

46 What metrics will you use to measure your effectiveness towards this stretch goal? #/% of PC visits with in-visit BH consultation/ intervention #/% integrated PC-BH clients #/% high risk patients Protective factors score #/% receiving care coordination services

47 What are your anticipated barriers towards meeting your stretch goal? Pace of progress of co-location Complex partnership Incomplete data for patient population

48 Organization J

49 What is your Stretch Goal? Reduce psychiatric readmissions by 10% for high risk patients in the next year. (QUESTION/TBD: what is our population?)

50 Who will you include on your transformation team and why? We have convened a Value Based Steering Committee (Exec Level) that provides oversight to the Stretch Project Transformation Team: Behavioral Health Leadership Exec. Dir of Operations & Operations Resource Group Project Manager Operational/Program Leaders - Clinic Directors for Montgomery Co., Delaware Co., & Philadelphia Information Technology Sr. Dir. of EHR Quality & Compliance Organization Data Analytics designee & VP of QCO Central Business Office Corp. Sr. Dir. Of Business Operations Pharmacy-CEO Office of Strategy & Organizational Advancement- Practice Transformation Lead Trauma Informed Care Implementation Team designee

51 What metrics will you use to measure your effectiveness towards this stretch goal? 90% of individuals will have a follow up contact within 30 days of discharge from a higher level of care (HLOC). 90% of individuals will have follow up treatment or rehab encounter within 7 days of inpatient discharge. 80% of individuals will receive timely (w/in 30 days of d/c from HLOC) follow up with Psychiatrist

52 What are your anticipated barriers towards meeting your stretch goal? Competing departmental priorities (ex.-ehr re-implementation; CCBHC) Full integration of cultural shift toward systemic model of QI Shifting to an outcomes based view from compliance focused view Current limitations around data analysis capabilities FEAR

53 Organization K

54 What is your Stretch Goal? Create a metrics based, service level scorecard

55 Who will you include on your transformation team and why? CFO Director, Quality and Compliance CIO VP IDD VP MH services MH Treatment directors PH director This gives us representation from all services throughout the company. And the representation of executive and senior level director positions reflects the primary use of the scorecard is for the division/department level and leadership.

56 What metrics will you use to measure your effectiveness towards this stretch goal? We are creating the metrics, so the creation of these metrics will reflect the success/failure toward the stretch goal.

57 What are your anticipated barriers towards Resistance to change meeting your stretch goal? Create a compelling reason to prepare for the shift to value-based payment Maintain momentum of initial push Technology integration of clinical and financial data, reporting We tend to get in the weeds, presenting this as a division/department level tool will challenge this

58 Organization L

59 What is your Stretch Goal? To reduce hospitalization by 25% (broader goal of improving health outcomes by 25%)

60 Who will you include on your transformation team and why? CEO TA Lead clinical director program directors front line staff IT director CFO hospital liaison medical director

61 What metrics will you use to measure your effectiveness towards this stretch goal? Baseline hospitalization data (our EMR and outside hospital data feed; Implement a risk stratification tool in order to capture data

62 What are your anticipated barriers towards meeting your stretch goal? How to capture the data lack of a dynamic data capturing system via our EMR; collaboration with the hospitals to receive the data IT cooperation and speed of delivery (lack of staff resources and time)

63 Organization M

64 What is your Stretch Goal? Reduce ED visits and inpatient hospitalizations by 25%

65 Who will you include on your transformation team and why? Executive Director Director of Quality, Risk Management, Compliance and Innovation Director of Rehabilitation Services Medical Director Administrative Manager of Crisis/Outpatient Services Administrative Manager of Care Coordination/Incentive Programs Administrative Manager of Rehab Services IT Database Administrator Utilization and Compliance Review Coordinator Billing Manager

66 What metrics will you use to measure your effectiveness towards this stretch goal? Not completely defined, but we will be utilizing data from our vendor CMT that pulls claims data provided by the state. We also anticipate utilizing more MCO data if we can get them to engage in this endeavor. # of ER visits # of Inpatient Hospitalizations Strive to achieve # of readmissions # of patients who receive care coordination post discharge # of patients who get necessary medical services after discharge

67 What are your anticipated barriers towards meeting your stretch goal? Timely and consistent access to our claim data\ Staff understanding and buy in to changes in work flows Immediate access to medication and other services following discharge Adequate resources for care coordination when not an activity paid for (Our state ended Health Homes) Timely and accurate information from hospitals regarding patients in the ED and admitted for inpatient care

68 Organization N

69 What is your Stretch Goal? Transforming OP services to be ready for VBP

70 Who will you include on your transformation team and why? OP Director, CFO, CSO, QI director (everyone), 3 clinical directors

71 What metrics will you use to measure your effectiveness towards this stretch goal? Need to ID and benchmark what metrics will be used. Access to care/ ease of access Metric for clients in continuum of care Client satisfaction Staff understanding metric TBD

72 What are your anticipated barriers towards meeting your stretch goal? Staff buy in Time for those involved Training/ Time/ Bonus threats productivity