DSRIP Projec ect A t Advisory Committee ee ( (PAC) M ) Mee - PowerPoint PPT Presentation

DSRIP Projec ect A t Advisory Committee ee ( (PAC) M ) Mee eeting March 29, 2017

Welcome! AM AMY L L. . WHITE TE-STORFER ER DIRECTOR, PROJECT MANAGEMENT OFFICE

Project & Workstream Updates Our newsletter is available today! With detailed project updates. http://wnycommunitypartners.org/resources/

Current ent P Projec ect Up Updates a s always o s on-lin line! http://wnycommunitypartners.org/partners/ DSRIP reporting link on right hand navigation (password protected)

Funds Flow Update  Spending Update  By provider category  By project

CPWNY Cumulative Distributed Revenue by PPS Program Category* DY1 to DY2 Q3 PPS Program Category Sum of DY1-DY2Q3 Expense Percentage Case Management $ 1,804,146 18.99% Clinical Transformation $ 87,550 0.92% Community Based Organizations $ 2,470,973 26.00% Hospice $ 754,994 7.95% Hospital $ 1,666,523 17.54% Local Government Unit $ 270,127 2.84% Mental / Behavioral Health $ 289,068 3.04% Physician - Primary Care $ 2,155,605 22.69% Substance Abuse $ 3,214 0.03% Grand Total $ 9,502,201 100.00% *Program category may be different from NYS provider category on MAPP. Total DY2 Budget is $11,020,366.

CPWNY Cumulative Distributed Revenue by PPS ProgramCategory DY1 to DY2 Q3 Partners Receiving Funds PPS Program Category Sum of DY1-DY2Q3 Expense % CHS Care Management Case Management $ 1,208,569 12.72% CHS ED Triage Case Management $ 471,750 4.96% CMP Care Management DY1-DY2 Case Management $ 123,828 1.30% Clinical Transformation Team Clinical Transformation $ 87,550 0.92% Catholic Health System Community Based Organizations $ 396,669 4.17% Catholic Medical Partners (PMO) Community Based Organizations $ 1,872,120 19.70% Chautauqua County Health Network Community Based Organizations $ 42,098 0.44% Compeer Community Based Organizations $ 13,907 0.15% P2WNY Community Based Organizations $ 9,290 0.10% Rural AHEC Community Based Organizations $ 82,484 0.87% Community Health Worker Network Community Based Organizations $ 22,969 0.24% ECCPASA Community Based Organizations $ 31,436 0.33% Chautauqua County Hospice Hospice $ 35,599 0.37% Hospice Buffalo Hospice $ 717,689 7.55% Niagara Hospice Hospice $ 1,707 0.02% Hospital Revenue Loss DY1 Hospital $ 982,378 10.34% Roswell Park Hospital $ 274,711 2.89% WCA Hospital $ 409,434 4.31% Chautauqua County DOH Local Government Unit $ 270,127 2.84% Mental Health Assoc of Erie Cty Mental / Behavioral Health $ 244,615 2.57% Northpointe Council Mental / Behavioral Health $ 6,590 0.07% Spectrum Human Services Mental / Behavioral Health $ 26,359 0.28% Mental / BH Providers P4R Mental / Behavioral Health $ 6,500 0.07% Horizon Health Mental / Behavioral Health $ 5,004 0.05% Provider Payment DY1 Physician - Primary Care $ 1,100,000 11.58% Provider Payment DY2 Physician - Primary Care $ 1,055,605 11.11% Chautauqua Alcohol & Sub Abuse Substance Abuse $ 3,214 0.03% Grand Total $ 9,502,201 100.00%

CPWNY Cumulative Distributed Revenue by PPS Project Category DY1 to DY2 Q3 Project Sum of DY1-DY2Q3 Expense Percentage 2.a.i Integrated Delivery Systems $ 2,801,394 29.48% 2.b.iii Emergency Department Triage $ 972,911 10.24% 2.b.iv Care Transitions $ 1,778,600 18.72% 2.c.ii Telemedicine $ 485,224 5.11% 3.a.i Behavorial Health $ 473,677 4.98% 3.b.i Cardiovascular Health $ 418,018 4.40% 3.f.i Nurse Family Partnership $ 620,593 6.53% 3.g.i Palliative Care $ 1,022,455 10.76% 4.a.i Mental, Emotional, Behaviorial Well being $ 457,693 4.82% 4.b.i Tobacco Use Cessation $ 471,636 4.96% Grand Total $ 9,502,201 100.00%

DY3 Budget Starting April 1, 2017

DY3 Budgeted Expenses 4.a.i MEB, 321,353 4.b.i Tabacco, 566,436 3.g.i Pall Care, 1,035,739 2.a.i IDS, 5,903,116 3.b.i Cardio 3.f.i NFP, 834,245 Hlth, 2.a.i IDS 146,006 2.b.iii ED Triage 2.b.iv Care Tran 3.a.i PC Behav, 2,175,072 2.c.ii Telemed 3.a.i PC Behav 3.b.i Cardio Hlth 3.f.i NFP 3.g.i Pall Care 4.a.i MEB 4.b.i Tabacco 2.c.ii Telemed, 797,511 2.b.iv Care Tran, 1,159,740 2.b.iii ED Triage, 1,547,024

CPWNY DY3 Budget 2.a.i 2.b.iii 2.b.iv 2.c.ii 3.a.i 3.b.i 3.f.i 3.g.i 4.a.i 4.b.i Care PC & Behavioral Cardiovascular Maternal & Palliative Promote Tobacco IDS ED Triage Transitions Telemedicine Health Health Child (NFP) Care MEB Cessation Total Revenue $1,709,221 $1,364,273 $1,309,740 $1,067,181 $2,507,002 $2,168,706 $2,254,605 $654,692 $659,043 $791,779 $14,486,241 Expense Admin & Implementation $2,511,575 $1,547,024 $1,159,740 $797,511 $2,175,072 $146,006 $834,245 $1,035,739 $321,353 $566,436 $11,094,700 Provider Engagement Payments $1,200,000 $0 $0 $0 $0 $0 $0 $0 $0 $0 $1,200,000 Revenue Loss $982,500 $0 $0 $0 $0 $0 $0 $0 $0 $0 $982,500 Contingency $1,209,041 $0 $0 $0 $0 $0 $0 $0 $0 $0 $1,209,041 Total Expense $5,903,116 $1,547,024 $1,159,740 $797,511 $2,175,072 $146,006 $834,245 $1,035,739 $321,353 $566,436 $14,486,241

Value Based Payment (VBP)

CPWNY Value Based Payment Activity In DY2, CPWNY formed a Valued Based Payment (VBP) Work Group  The work group will provide guidance and education around VBP Initial VBP survey sent to partners in DY2 Q3:  Assess partner’s familiarity with VBP/Contracting for VBP  Assess participation (if any) in pay for performance arrangements VBP Education performed at Project Advisory Committee (PAC) meeting Partners encouraged to participate in NYS VBP webinars/seminars VBP Information posted on CPWNY website

CPWNY Value Based Payment Activity Second VBP survey sent in DY2 Q4 with more detailed questions on:  Care Coordination • Are partners providing onsite Care Coordinators, sharing information with partners, collaborating with non-clinical community based organizations, etc. ?  Technology and Data Analytics of Partners • Determining the use and investment in electronic medical records, telemedicine, clinical decision support, etc.  Additional Education needed on VBP • Whether partners have completed any recent VBP education or do they require additional education sessions? What issues around VBP are more concerning to the partners?

CPWNY VBP Follow-up Actions CPWNY will utilize the information collected from both surveys to create a more refined VBP plan for providing education and guidance to include:  Education/training sessions to meet identified needs from provider survey, such as contracting/risk sharing arrangements, VBP data and analytics and performance measurement, etc.  Assistance with interpreting analytic reports and networking to develop relationships between various providers/community based organizations who may have the potential to collaborate in delivering higher value care  Collect and provide feedback on emerging trends, challenges and issues with the transition to VBP to share amongst network providers and community based organizations

Questions?

Workforce Update Valerie Putney Director of Programming WNY Rural AHEC

Milestone Update 1. Target Workforce State: baseline report submitted to State 2. Transition Roadmap: baseline report submitted to State 3. Gap Analysis: baseline report submitted to State Workforce Shortages • Nursing staff (RN, LPN, Nurse Managers, etc) • Mid-levels (PA/NP) • CNAs and Direct Care Staff • PCP • Psychiatrists and Psychologists 4. Compensation and Benefit: First survey result submitted to State 5. Training Strategy: baseline report submitted to State

January 2017 53 Community Partners of Western NY 8%+ Vacancy Rate Non-Licensed Emerging Job Titles Metrics of Key Job Titles and Relevant Reported Data Job Title # Responding Response # Employees # Vacancies Vacancy Rate Organizations Rate Primary Care Physician 24 25% 75 9 12.00% Primary Care Nurse Practitioner 18 19% 40 4 10.00% Psychiatric Nurse Practitioner 9 9% 30 3 10.00% Staff Registered Nurse 47 48% 3,275 128 3.91% Licensed Practical Nurse 52 54% 743 93 12.52% 8.30% RN Care Coordinators/Case Managers/Care Transitions 22 23% 277 23 0.00% Psychiatrist 11 11% 50 0 0.00% Psychologist 9 9% 43 0 Medical Assistant 21 22% 208 14 6.73% Social and Human Service Assistants 11 11% 557 40 7.18% Substance Abuse and Behavioral Disorder Counselors 11 11% 309 9 2.91% Nursing Aide/Assistant 20 21% 1,744 224 12.84% 6.16% Certified Home Health Aide 8 8% 730 45 17.03% Personal Care Aide 8 8% 1,104 188 Licensed Clinical Social Worker 18 19% 92 12 13.04% Bachelor's Social Worker 20 21% 120 1 0.83% Licensed Master’s Social Worker 22 23% 254 25 9.84% Social Worker Care Coordinator/Case Manager/Care Transition 16 16% 144 3 2.08% Care Manager / Coordinator 23 24% 335 15 4.48% 20.75% Care or Patient Navigator 9 9% 53 11 5.94% Community Health Worker 14 14% 219 13 Peer Support Worker 7 7% 55 8 14.55% Most Common Reported Degree Requirement for Non-Licensed Care Coordination Positions: Unreported