2018 Learning Collaborative Series CBOs: Positioning For Value Based Payment June 5, 2018 10:00-12:00PM
Welcome/Introductions • CBOs Role in Value Based Payment: Overview • Partnerships between Healthcare and CBOs: Building Capacity • How CBOs can add value in a VBP world: Pilot Overview • Group Discussion • Wrap Up • Next Meeting August 7, 2018 10:00AM-12:00PM
CBOs: Positioning For Value Based Payment CBOs are uniquely positioned to address root causes of poor health due to: • Their understanding of community needs. • Their community focus, coupled with the clinical services of other health care providers (Hospital, ACO, IPA, etc.) can make a significant positive impact on population health and generate savings for entities involved. • They are in a strong position to impact social determinants of health.
Introduction: Value Based Payment for Providers Video Content: https://www.youtube.com/watch?v=_mvfd5GXvvs
Social Determinants of Health 101 Educat ion • Early Childhood Education and Development • High School Education • Enrollment in Higher Education • Language and Literacy Economic Stability Social Determinants of Health: Structural conditions in • Poverty Social and • Housing Security and Community Context which people are born, grow, live, work and age. These Stability • Social Cohesion • Employment circumstances are shaped by the distribution of money, SDOH • Civic Participation • Food Security • Perceptions of • Transportation Discrimination and Equity power and resources at global, national and local levels. • Incarceration/Institutionali zation Health and Health Neighborhood and Care Environment • Access to Health Care- • Affordable/Quality Housing gaining entry into Health System Environmental Conditions • Access to Health Foods • Access to Primary Care/Trusted Provider • Crime and Violence • Health Literacy Video Content: https://www.youtube.com/watch?v=qmsYfouVwtQ&feature=youtu.be Source: NYS DOH VBP Bootcamp Social Determinants of Health & Community Based Organizations
Social Determinants of Health, CBOs, and VBP Video Content: https://www.youtube.com/watch?v=pdnAiLdeQGw&feature=youtu.be
Social Determinants of Health, CBOs, and VBP • Addressing social determinants can have a significant impact on health outcomes • Social determinants of health interventions can be less costly than traditional medical interventions • Under VBP the aim is to realize cost savings while achieving high quality outcomes Picture Source: http://www.bridgewater.nhs.uk/haltonsthelens/healthforthehomeless/ Source: NYS DOH VBP Bootcamp Social Determinants of Health & Community Based Organizations
CBOs: Positioning For Value Based Payment Healthcare Systems Managed Care Organizations Community Based Organizations Addressing SDOH, Better Health Outcomes, Lowering Healthcare Cost, Better Coordinated Care
Source: NYS DOH VBP Bootcamp Social Determinants of Health & Community Based Organizations
Source: NYS DOH VBP Bootcamp Social Determinants of Health & Community Based Organizations
Health Foundation for Western and Central New York Children (birth Community to 5 years) Older Adults Health Capacity impacted by poverty Advocating for improved health and health care.
Health Foundation Regions Central New York Counties Western New York Counties • Cayuga • Allegany • Cortland • Cattaraugus • Herkimer • Chautauqua • Madison • Erie • Oneida • Genesee • Onondaga • Niagara • Oswego • Orleans • Tompkins • Wyoming
Partnerships Between Healthcare and CBOs: Building Capacity
“Change of any kind requires courage” 勇
Healthcare Reform in NYS Value Based Payments Performance based payment strategies that link financial incentives to provider performance on a set of defined measures Goal is to improve quality and slow growth in healthcare spending DSRIP requires all Medicaid MCOs to employ VBP systems for 80% – 90% of provider payments
A National Imperative • A growing number of human services CBOs are not financially strong or sustainable • ~ 1/2 run persistent operating deficits • ~ 1/3 have less than one month of operating expenses in reserve • CBOs often lack access to capital for investment in tech, staff development and evaluation
Partnerships Make Sense • Healthcare costs are high • Healthcare providers not trained in SDoH • Limited time during medical visit/episodic • Human service CBOs focus on SDoH • CBOs often have longstanding relationships in/with community – therefore, more opportunity to engage • CBOs and HCOs have shared goals
Social Determinants of Health Image by: vaeenma
“A growing body of evidence reveals that investment in selected social services and partnerships between health care and social services can lead to substantial health benefits and reduce health care costs for targeted populations.” ~ The Commission on Value-Based Care
Benefits of Partnering • For CBOs: – Training and Professional Development – Expanded Services for Clients – Increased Access to Funding • For HCOs: – Training and Professional Development – Quality Services for At-Risk Populations – Improved Access to Care for Patients
Challenges of Partnering • Knowing who to talk to • Speaking a different language • Defining, agreeing on, and measuring outcomes • Funding/regulatory Issues • Service value/ROI and cost • CBO capacity • HCO complexity • Data sharing/privacy concerns
Creating Successful Partnerships – Setting the Stage • Be Strategic – Mission and Goals – Areas of Expertise • Build Trust • Sharing Risk • Communicate • Recognize Value
Creating Successful Partnerships – Digging Deeper • Identify a project/partnership leader • Formalize the partnership • Assess capacity • Address imbalances • Technology and data collection • Funder and regulatory requirements • Establish funding and payment structures • Develop a referral process
Building Capacity – Setting the Table • The legs of the table: – Management – Governance – Financial Resources – Administrative Systems • The top of the table: – Programs • The decorative centerpiece: – Organizational Mission
Capacity Building 101 • Ready or Not/Get Set – Health Foundation and other funders – Help health and human service organizations improve their ability to respond to needs in the community and improve population health outcomes by providing grant funding and organizational development consultation in the areas of program, governance, financial, and administrative processes • StoryGrowing – Health Foundation, CNY Community Foundation & Gifford Foundation – Helps non-profits strengthen their storytelling culture and skills through intensive workshops, group training, and one on one coaching • ADVANS (Advancing and Developing the Assets of Nonprofits in Syracuse) – Gifford Foundation – Strengthen nonprofit’s operating capacity to sustain mission-critical programs
Capacity Building 201 • Social Determinants of Health • Value-based and other payment structures • Mentoring/Coaching • Building networks • Learning collaboratives • Developing successful partnerships across sectors
Health Foundation for Western and Central New York • Program & organizational sustainability – Advocacy • Access to high quality care • Healthy communities
References • A National Imperative: Joining Forces to Strengthen Human Services in America, Alliance for Strong Families and Communities, 2018 • Partnerships Between New York City Health Institutions and Community Based Organizations, Greater NY Hospital Association and NY Academy of Medicine, 2018 • Integrating Health and Human Services: A Blueprint for Partnership and Action, Human Services Council of New York, 2018
Marnie Annese, MPH, CPH Program Officer 431 East Fayette St, Suite 250 Syracuse, NY 13202 315-671-0057 ext. 200 mannese@hfwcny.org
How CBOs can add value in a VBP world: Pilot Overview and Data Dive June 4, 2018
Agenda • Salient Interactive Miner Overview • Medicaid Population Demographics • 13202 Zip Code Performance Overview • CBO/Behavioral Health Performance Overview • Questions
Recommend
More recommend
