CCHP E-Consult Workgroup In-Person Workshop Sierra Health Founda0on - PowerPoint PPT Presentation

CCHP E-Consult Workgroup In-Person Workshop Sierra Health Founda0on October 17, 2017

Welcome and Introduc0ons § Mei Kwong, Center for Connected Health Policy § Rachel Wick, Senior Program Officer, Blue Shield of California Founda0on § Carl BouthilleMe, Senior Program Officer, Health Innova0on Fund, California HealthCare Founda0on § Jana Katz-Bell, MPH, Assistant Dean, Interprofessional Programs, BeMy Irene Moore School of Nursing and UC Davis Medical Center 2 BluePath Health Inc.; Client Proprietary and Business Confiden0al

CCHP E-Consult Workshop Objec0ves The third CCHP E-Consult Workgroup in-person workshop session, supported by Blue Shield of California Founda0on and California HealthCare Founda0on, brings together e-consult stakeholders to determine next steps to gain state-level support for making e-consult programs sustainable across California. Workshop objec0ves include: § Determine next steps for E-Consult following recent telehealth legisla0on (e.g. AB 205) § Present and refine a Fiscal Analysis of E-Consult to share with State leadership § Con0nue coali0on building through the sharing of consistent e-consult messages and posi0ve stories § Define paths forward and near term goals for achieving policy and payment support for e-consult 3 BluePath Health Inc.; Client Proprietary and Business Confiden0al

Agenda Session Facilitator/Speaker Time E-Consult and Moderator: Timi Leslie, BluePath Health, and Reactor Panel: 9:30-10:30 Alterna9ve • Caroline Davis, MPH, Senior Policy Director, Local Health Plans of California Access • Lisa Matsubara, JD, Legal Counsel, California Medical Associa0on Standards • Lyle Smith, Director of OpEx/PMO, and Kelli Cousineau, Program Manager-Telehealth, OpEx/PMO, Partnership Healthplan Break Stories of Pa0ent and Provider Successes with E-Consult 10:30-10:45 E-Consult Fiscal Moderator: MaM Meyanathan, BluePath Health, and Reactor Panel: 10:45-12:00 Analysis, Case • Lisa Murphy, MD, Medical Director, Central California Alliance for Health Studies and • Delphine Tuot, MDCM, MAS, Assistant Professor of Medicine, Discussion Division of Nephrology, University of California San Francisco • Paul Giboney, MD, Director, Specialty Care, Los Angeles County Department of Health Services Lunch • Buffet lunch and networking 12:00-12:45 Paths Forward: Moderator: David Lown, MD, Medical Director, Safety Net Ins0tute/California Associa0on of 12:45-1:30 Op9ons and Public Hospitals, and Panel: Milestones to • Seleda Williams, MD, Integrated Systems of Care Division, Department of Health Care Advance State Services Support of E- • Mary Watanabe, Deputy Director, Health Policy and Stakeholder Rela0ons, Department of Consult in the Managed Health Care Coming Year • Julie Bates, MS, Gerontologist, ASD, AARP • Mike WiMe, MD, Vice President and CMO, and Cindy Keltner, Deputy Director of Health Center Transforma0on, California Primary Care Associa0on (CPCA) Tabletop • Administra0ve Ac0on 1:30-2:15 Sessions • Legisla0on • Leveraging Exis0ng Programs Group Readout • Group leaders present draf Paths Forward for discussion 2:15-2:45 4 Wrap-up • Mei Kwong, Center for Connected Health Policy, presents next steps for workgroup ac0on 2:45-3:00 BluePath Health Inc.; Client Proprietary and Business Confiden0al

eConsult – store and forward provider to provider communica0on is spreading across the state and increasing access to specialty care Telehealth Telehealth is a means for enhancing health care, public health, and health educa0on delivery and support, decreasing the need for physical health care visits using telecommunica0on technologies. Store and Forward Synchronous Remote Patient Monitoring Pa9ent Involved Store and Forward Live Video Remote Pa9ent Monitoring Provider to Patient • Transmission of recorded health history through an • Live, two-way interac0on between a pa0ent • Data collected from an electronic communica0ons system to a prac00oner, and a provider using audiovisual individual in one loca0on via usually a specialist, who uses the informa0on to telecommunica0ons technology. electronic communica0on evaluate the case or render a service outside of a real- technologies, which is 0me or live interac0on. transmiMed to a provider in a different loca0on for use in eConsult (Expert Opinion) Project ECHO care and related support. Provider to Provider • Electronic message exchange (including clinical • Videoconferencing to help urban specialists ques0on and related diagnos0c data) ini0ated by the train primary care doctors in rural sehngs. The primary care physician to a specialist. Specialist can training allows these general prac00oners to convert an eConsult to a referral if necessary. provide specialty care, especially chronic condi0on services, that would otherwise be 5 unavailable to pa0ents in these areas. BluePath Health Inc.; Client Proprietary and Business Confiden0al

Introduc0on: Electronic Consult Defini0on and Benefits An electronic consulta.on is an asynchronous dialogue ini.ated by a physician or other qualified health care professional seeking a specialist consultant's expert opinion without a face-to-face pa.ent encounter with the consultant. To capture the service rendered, the specialist will report a code for inter-professional consulta.on (e.g. 99446). Electronic consults provided by consulta.ve physicians include wriGen report to the pa.ent's trea.ng/reques.ng physician/qualified health care professional. Literature and pilot programs demonstrate long term benefits and improvements for: Pa9ents: More 0mely access to specialty care with improved health outcomes as a result; greater 1 sa0sfac0on with care a result of not having to travel and engage in unnecessary in-person visits. Primary Care Providers: Higher quality coordinated care and enhanced communica0on with 2 specialists, ul0mately expanding the knowledge and scope of prac0ce of the PCP. 3 Specialists: More efficient use of 0me as a result of decrease in unnecessary referrals. Public/Private Health Plans: Increased ability to meet 0mely access requirements, while 4 increasing the efficiency and reducing cost per pa0ent. 6 4 BluePath Health Inc.; Client Proprietary and Business Confiden0al

CCHP and BluePath Health work to facilitate the eConsult Workgroup in parallel with suppor0ng complementary efforts across the state eConsult Defini0on and Incen0ves Engagement and Collabora0on DHCS and DMHC MCPs DPHs CHCs/FQHCs • Provide opportuni0es for BSCF pilot DPHs to share Facilitate CCHP eConsult Workshops to • best prac0ces in eConsult to op0mize Waiver further reimbursement discussions among programs and repor0ng, aligning measures with DHCS, MCPs and DPHs BSCF pilot requirements Discuss rates for eConsult CPT codes based • • Facilitate collabora0on and par0cipa0on in on 0me spent CAPH educa0onal events (e.g. PRIME webinars) Work with MCP stakeholders within pilot • • Facilitate FQHCs, BH/MH and social services in regions to discuss poten0al pilot regions in pursuing GPP programs, u0lizing reimbursement of specialist eConsults eConsult as appropriate to meet program goals With BSCF pilots and MCPs, develop an • • To op0mize available incen0ves, seek incen0ve plan to engage PCPs at FQHCs opportuni0es to engage FQHCs in waiver Consider eConsult to address increased • programs which value alterna0ve (specialty care) specialty care 0mely access requirements touches and avoidable u0liza0on of high-cost following Covered California expansion health care services Acknowledge e-consult in network • • Work with FQHC APM pilots planned to adequacy requirements determine how to incorporate eConsult programs 7 BluePath Health Inc.; Client Proprietary and Business Confiden0al

Key Tenets of Electronic Consult § E-consult directly impacts pa9ent and provider sa9sfac9on. E-consult related surveys report overwhelming improved sa0sfac0on from both pa0ents and providers. § E-consult is the standard of care. E-consult in no longer in pilot stage. There is a significant experience base that has demonstrated las0ng results. § E-consult improves access to specialty care and network adequacy. E-consults op0mize face-to-face visits and sa0sfy specialty access standards. Improved access is demonstrated through: • Decreased wait 0mes for specialty care • Decreased ”repeat” appointments • Decreased “no shows” § E-consult promotes health homes and builds PCP capacity. Over 0me, E-consult is shown to expand the ability of the PCP to care for the pa0ent, keeping him/her within the health home. § E-consult is not an electronic referral. E-consult is separate and dis0nct from an electronic referral. The two processes should not be subject to the same regulatory requirements. 8 BluePath Health Inc.; Client Proprietary and Business Confiden0al

California’s reimbursement for store and forward telehealth services 9 BluePath Health Inc.; Client Proprietary and Business Confiden0al

E-Consult and Alterna0ve Access Standards • Caroline Davis, MPH, Senior Policy Director, Local Health Plans of California • Lisa Matsubara, JD, Legal Counsel, California Medical Associa0on • Lyle Smith, Director of OpEx/PMO, Partnership Healthplan and • Kelli Cousineau, Program Manager-Telehealth, OpEx/PMO, Partnership Healthplan 10 BluePath Health Inc.; Client Proprietary and Business Confiden0al

Break 11 BluePath Health Inc.; Client Proprietary and Business Confiden0al

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