From Underserved to Better Served: Leveraging Payment Reform to Improve Care Heather Adams, EMT Russell Dexter, MBA Kelly Halkyard, MPA
Session Objectives ✓ Learn how using data drives patient care ✓ Demonstrate how using risk stratification leads to increased engagement for patients at high risk ✓ Discuss how establishing a strong medical neighborhood meets patient's comprehensive needs
Community Health Center Association of Connecticut ✓ Primary Care Association of Connecticut ✓ Represents 94% of all Federally Qualified Health Centers (FQHCs) in Connecticut ✓ State-wide geographic coverage
9 4 % o f a l l F Q H C s i n C T b e l o n g t o C T - P T N Patients at Connecticut FQHCs 75.6% Racial/Ethnic Minorities 78% Medicaid or Uninsured 90% Below 200% FPL 26.5% are best served in a language other than English
Transforming Clinical Practice Initiative ✓ $700 million grant ✓ National Scope ✓ Prepare Primary and Specialty Care practices for value-based payments
ans ed clinicians Hospitalizations PTN Savings/ clinician PTN reduced/ clinician $ 94,379 BHSALA UMass 20.9 CHCACT CT: : $43,9 3,962 62 CHCACT $ 43,962 14.2 AZHEC saved ed per clinici ician an $ 41,954 MQC 12.6 CHCACT rolled IHC $ 38,620 PBGH 10.0 $ 37,223 AZHEC NYeC 4.8 enro CHCACT CT: : 12.9 .9 hospital spital NatCouncil $ 34,644 4.8 Mayo $ 34,205 Vand er of e NYU 4.7 utiliza ut zati tions ons per clinic icia ian WDOH $ 31,153 4.6 HQI $ 30,579 NYU MQC 4.2 #2 #2 mber PBGH $ 29,969 ed by numb Vand 4.2 $ 28,817 3.3 NYeC CCNC RIQI $ 23,294 RIQI 2.5 #3 #3 $ 23,012 2.2 IU WDOH Leader in TCPi PeaceHealth $ 22,141 Colorado 2.0 alized Colorado $ 21,843 2.0 Vizient UMass $ 18,657 1.7 CHOC son normal $ 14,983 NJII COSEHC 1.4 NRACO $ 12,569 0.7 IHC $ 12,523 LA IU 0.5 arison HQI $ 11,788 0.4 PeaceHealth $ 11,324 0.3 UofWash HPD e compar Vizient $ 11,065 CarePoint 0.3 $ 11,009 0.1 COSEHC BHSALA Mayo $ 10,373 UofWash 0.1 $ 10,290 0.1 CHOC NJII nce HPD $ 4,999 NatCouncil 0.1 manc AIM 3 AIM 4 $ 4,952 VCSQI 0.1 CarePoint forma 0.0 VHS $ 3,967 NRACO Reduci ucing ng Un Unnecess ecessar ary Genera erate e savin ings gs to the $ 3,713 APA2 - VCSQI Q11 Perfo Hospit ital al Ad Admissio issions ns & federal al governmen ernment t & - CCNC $ 2,016 LA $ - VHS - Utilizati ization commer merci cial al payer ers s APA2 TOTAL 2.9 TOTAL 20,755
3,815 Lives es Imp mproved ed 146 6 An Antibio ibiotic tic Rxs Saved ed CT-PTN Results $47.6 .6 million ion in cost t 13 13,63 ,631 1 Avoide ided d Ho Hospi spita tal savings ngs Admission issions s & ED ED Visits ts
Using Data to Drive Patient Care ✓ Monthly data reports to providers ✓ Dashboards ✓ Huddles/Pre-visit planning
What Happens When You Share Data? Shared current performance data and expectations with providers
Other Examples
Why Risk Stratification? ✓ Is the foundation of population health ✓ Directs appropriate resources to patients most in need ✓ Holistic view of the patient to improve outcomes
How Does Risk Stratification Impact Care? ✓ Empanelment to a Care Team ✓ Appointment time length ✓ Pre-visit planning ✓ Care Coordination ✓ Integration of Care
Community Specialty Based Health Care State & Federal Organizations Center Agencies Hospital Partners Medical Neighborhood
Questions?
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