H OW DO YOU KNOW YOU ARE READY FOR VBP? E VIDENCE B ASED P RACTICES AND N EW Y ORK F OUNDLING
T HE F OUNDLING Founded by the Sisters of Charity in 1869 as a home for abandoned children, The Foundling today offers an expansive array of preventive, behavioral health, foster care juvenile justice and educational services for underserved children, families, and adults with developmental disabilities. Whether it’s an abused child in need of a foster home, a young mother who lacks the skills to care for her child, or a young person lost in the juvenile justice system, The Foundling provides the resources necessary to rebuild lives and rebuild families. The Foundling reaches about 7,000 families/27,000 individuals each year in all five boroughs of New York City, surrounding counties, and Puerto Rico.
Credentials: The New York Foundling (The Foundling) is recognized as the industry pioneer with the largest portfolio of evidence based public health interventions in the world. 2016 2013 • Health Home Care • IFS (BSFT) Mgmt. 2012 • Partners for Change • Satellite Clinic • Families Rising (FFT) (FFT-CW) • School Based • Close to Home 2010 • FAST (MST-CANS) Mental Health (MTFC) • Family Foster Care • Arrow (MST- • Blues Program (CSNYC ) Psych) • Incredible Years • KEYS (FFT, MST, MTFC) 2007 • STEPS (FFT-CW) • Bluesky (FFT, MST, MTFC)
Credentials cont’d: Over the past 145 years, The Foundling has grown to an agency that provides effective, direct reimbursable services to over 7,000 families or 27,000 individuals. Treatment Completion Rate Case Completed Case Not Completed 20.5% 79.5%
Less than 1% of all government spending is based on impact what does impact look like?
NYC F OSTER C ARE P LACEMENTS REDUCED BY 53% Foster Care Placements 18,000 16,000 14,000 12,000 10,000 Foster Care 8,000 Placement 6,000 4,000 2,000 0
M EDICAID S AVINGS FROM FOSTER CARE PLACEMENT REDUCTION 50% FEDERAL /50% L OCAL * USING MIDRANGE MEDICAL / MENTAL HEALTH PER DIEM Base Line year 2007 2008 ($51,428.50) 2009 $1,182,855.50 2010 $3,959,994.50 2011 $9,370,272.70 2012 $12,671,982.40 2013 $19,383,401.65 2014 $25,559,964.50 2015 $27,278,421.00 2016 $31,649,719.40 2017 $32,763,641.00
Data Analytics are a Modern Day Crystal Ball ▪ Making business decisions without properly utilizing and analyzing data can impede a company from reaching its full potential. ▪ Clearly-Defined Problems Lead to Better Decisions ▪ Replication is possible with data ▪ Data is Neutral and That’s a Good Thing
P ARTNERSHIP FOR I MPROVING C OMMUNITY H EALTH O UTCOMES P ROGRAM (PICHO) NY FOUNDLING IIBHS Discharges # of IP/RTC # IP/RTC # ED # PHP # IOP Days Admits Days Admits Days 1 year pre-IIBHS 38 348 47 15 0 During IIBHS 2 11 20 33 0 % Variance 94.74% 96.84% 57.45% -120.00% #DIV/0! 0-180 Days Post IIBHS 1 8 9 0 0 % Variance 97.37% 97.70% 80.85% 100.00% #DIV/0! 181-365 Days Post IIBHS 6 30 13 0 0 % Variance 84.21% 91.38% 72.34% 100.00% #DIV/0! Brad Witte, Ph.D. I Care Management Director I Anthem – Behavioral Health 108 Leigus Road, Wallingford CT 06492 I 203.677.8117
R IGOR M ATTERS While the term evidence-based is commonly used, the actual level of scientific evidence supporting a given program varies widely, often lacking any credible research standards. To truly be “evidence - based,” programs must demonstrate evidence of a deterrent effect, sustained effect, multiple site replications, cost- benefit analysis, and other prescribed factors.
Investing with Evidence and Confidence Evidence Confidence Type of Evidence Continuum Continuum Multiple RCT’s High Evidence-based RCT Moderate Experimentally Quasi-Experimental Proven (Control Groups) Correlational Study Research Low Pre-Post Outcome Survey Informed Post-Test Outcome Survey Satisfaction Survey Personal Experience Opinion Very Low Informed Testimonials Anecdote
VBP I NVESTING Investing limited resources where there is absolutely no proven ROI would be considered negligent in most areas of business and practice, so why do we allow it with taxpayer-funded programs for children and families? There exists in the world today “blue - chip” social investments with proven ROI. These investment opportunities have high-quality, well-designed, experimentally proven prevention and intervention models that meet the highest standards of scientific scrutiny.
W HAT W ORKS AND W HAT DOES NOT: W ASHINGTON I NSTITUTE P UBLIC P OLICY , F EBRUARY 2015 What Does Not: Scared Straight programs deliver -$13,491 total benefits (tax payer, victims, court and police related costs) toward crime prevention. The benefits to cost ratio of Sacred Straight is -$204.33 and there is a 1% chance that benefits will exceed the costs. What Works: Functional Family Therapy for youth on probation delivers $29,944 total benefits (tax payer, victims, court and police related costs). The benefits to cost ratio of FFT is $8.94 and there is a 99% chance that benefits will exceed the costs.
L AYING THE F OUNDATION FOR THE E XPANSION OF W HAT W ORKS IN NYC L EGEND : JJI – J UVENILE J USTICE I NITIATIVE : FAP – F AMILY A SSESSMENT P ROGRAM : PINS – P ERSONS IN N EED OF S UPERVISION : JD – J UVENILE D ELINQUENTS
NYC P LACEMENT R ATES NYC 2003 2007 2014 Placements Rate of youth 11.0 8.9 6.5 in care ages 0- 18 (per 1000) # of youth in 21,554 16,911 11,511 placement (total) Residential: 1,043 Foster Boarding Home: 6,694 Kinship: 3,746 As of July 2016 there were 9,134 children in foster care Medicaid Savings $63,874,197
Between 2007 and 2011, 223 youth were diverted from placement in NYC at an average placement cost of $210,000 (USD)* each, approximately $46,830,000 in placement costs were averted. After subtracting the program cost (program start-up and annual costs) the financial savings to NYC totaled more then $35,928,360. *(Charting a New Course: A Blueprint for Transforming Juvenile Justice in New York State. (2009). Vera Institute)
F UNCTIONAL F AMILY T HERAPY B ENEFIT - COST ESTIMATES ( U PDATED J ULY 2015). F UNCTIONAL F AMILY T HERAPY (FFT) IS A STRUCTURED E XPERIMENTALLY P ROVEN FAMILY - BASED INTERVENTION THAT USES A MULTI - STEP APPROACH TO ENHANCE PROTECTIVE FACTORS AND REDUCE RISK FACTORS IN THE FAMILY . ANALYSIS ONLY INCLUDES EFFECT SIZES FROM PROGRAMS THAT WERE DELIVERED COMPETENTLY AND WITH FIDELITY TO THE PROGRAM MODEL . Benefit – Cost Summary* Total $30,378 Costs ($3,405) Benefits minus cost $26,973 Summary Statistics: Benefit to cost ratio $8.92 Benefits minus costs $26,973 Probability of a positive net present value 99 % *Washington State Institute for Public Policy, July 2015
M ULTISYSTEMIC T HERAPY FOR SUBSTANCE ABUSING JUVENILE OFFENDERS B ENEFIT - COST ESTIMATES ( UPDATED J ULY 2015) M ULTISYSTEMIC T HERAPY FOR SUBSTANCE ABUSING (MST-SA) IS A FORM OF THE EXPERIMENTALLY PROVEN MST THAT IS TARGETED TOWARD YOUTH WHO ARE ABUSING DRUGS AND ALCOHOL . T HE ESTIMATES SHOWN ARE PRESENT VALUE , LIFE CYCLE BENEFITS AND COSTS . Benefit-Cost Summary* Total $30,646 Costs ($7,689) Summary statistics: Benefit to cost ratio $3.99 Benefits minus costs $22,958 Probability of a positive net present value 70 % *Washington State Institute for Public Policy, July 2015
E NGAGING MMCO
E NGAGING WITH MMCO S & PPS Know your data – Who is your number 1 and 2 payer What is your cost per slot, encounter, individual, no show rates, high producers, low producers, number of non-billable hours/staff What is your threshold for making money, Are you confident with PYSCKES Know you processes Know your areas for potential efficiencies and savings Know your unique value in the field and to MMC Know your peers value What separates you from the field What is your model and what are mediators of sustained change Collaborate, collaborate, collaborate Push, push, push And then: Collaborate, collaborate, collaborate
Recommend
More recommend
