Accountable Care Collaborative Program Improvement Advisory - PowerPoint PPT Presentation

Criminal Justice and the Accountable Care Collaborative Program Improvement Advisory Committee April 19, 2017 1

Our Mission Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources 2

Collective Challenge Education Care Coordination Care Continuity Justice System Community Full Limited Medicaid Medicaid Benefits Benefits MCO DOC RCCO BHO HCPF 3

Collective Challenge Binswanger, I. A., Stern, M. F ., Deyo, R. A., Heagerty, P . J., Cheadle, A., Elmore, J. G., & Koepsell, T . D. (2007). Release from prison: A high risk of death for former inmates. New England Journal of Medicine, 356, 157-165. 4

Goal • To establish a comprehensive care model that identifies strategic areas of focus and aligns stakeholders and resources to make measureable improvements for members transitioning from the Department of Corrections (DOC) 5

Objectives • Review the three strategic areas of the care model • Review the latest developments related to:  Suspend Function  Data Sharing Agreement • Discuss the implementation and monitoring plan 6

Key Questions • How well do the three areas combine to create a pro-active care coordination model? • What gaps and barriers continue to exist? • Where are other areas of opportunity? 7

Care Model Education Care Coordination Care Continuity Justice System Community Full Limited Medicaid Medicaid Benefits Benefits MCO DOC RCCO BHO HCPF 8

Care Model: Education • Goal: increase the number of individuals enrolled in Health First Colorado and health literacy of members and staff • Engaged and literate members and staff are critical foundation for care coordination and long-term success • Three key tactics:  Suspend function  Member “in - reach” events  Staff education 9

Care Model: Education • Suspend Function  Provides limited benefits package  Inpatient stays >24 hours  Relieves administration burden  Allows for systems identification 10

Care Model Education Care Coordination Care Continuity Justice System Community Full Limited Medicaid Medicaid Benefits Benefits MCO DOC RCCO BHO HCPF 11

Care Model: Care Coordination • Goal: Improve care transition processes between DOC facilities and Department contractors • Syncing internal and external work reduces duplication and ensures seamless handoffs • Three key tactics:  Data sharing agreement  Transition planning  Continuous quality improvement within PIAC sub- committee 12

Care Model: Care Coordination Better Health and Life Outcomes Coordinated care means improved health outcomes and a Medical better experience for providers and members as they interact Home with the system, and wiser use of state resources. Improved health outcomes and smarter use of state resources Regional requires regional and local coordination that recognizes the Coordination need for medical care, behavioral health care and community supports all working together. Members, providers and the system receive the data needed to Data make real-time decisions that improve care, increase coordinated services and improve overall efficiencies. 13

Care Model: Care Coordination • Data Sharing Agreement  Precipitated by DOC Medicaid Summit in September 2016  Creates a single agreement between DOC and HCPF on behalf of HCPF contractors  BHOs initially receive information followed by RCCOs  Attribution timeframes and contractual requirements dictate order of operations  Anticipated go-live: May 2017 14

Care Model Education Care Coordination Care Continuity Justice System Community Full Limited Medicaid Medicaid Benefits Benefits MCO DOC RCCO BHO HCPF 15

Care Model: Care Continuity • Goal: Ensure care continuity between DOC facilities and community-based providers • Uninterrupted care is the best member experience • Two key tactics:  Medical records upon release  Proactive appointment scheduling 16

Monitoring and Evaluation • Key outcomes include:  Education: Health First Colorado suspension and educational sessions  Care Coordination: Transitional planning  Care Continuity: PCMP attribution, health care utilization, and recidivism 17

Accountability and Implementation HCPF: Accountable Care Collaborative Recommendations Program Improvement Advisory Committee Technical Assistance Recommendations Improving and Bridging Systems Best Practices and Strategies RCCOs DOC BHOs Key Stakeholders 18

Future Directions • County Jails  El Paso Jail Pilot  Emerging County relationships • Division of Youth Corrections 19

Discussion • How well do the three areas combine to create a pro-active care coordination model? • What gaps and barriers continue to exist? • Where are other areas of opportunity? 20

Contact Information Alejandro Vera // HIO alejandro.vera@state.co.us Michael Lott-Manier // BHOs michael.lott-manier@state.co.us Ben Harris // RCCOs benjamin.harris@state.co.us 21