Hudson Valley DSRIP Project Advisory Committee Webinar November 19, 2014 10:00 – 10:45 am Dial-in: 1-855-749-4750 Access code: 573 568 484 Confidential – Not for Distribution
Housekeeping • Please mute your phone line • Submit questions via the “chat” function • Presentation will be available for download at the end of the webinar Confidential – Not for Distribution 2
Agenda Introductions and Objectives 10:00 – 10:05 am Final Project Selection 10:05 – 10:15 am Next Steps 10:15 – 10:25 am Q&A Session 10:25 – 10:45 am Confidential – Not for Distribution 3
Meeting Objectives • Review the final projects selected for inclusion in the DSRIP application. • Discuss next steps and information needed from partners for completion of the DSRIP application. • Provide a forum for questions and discussion. Confidential – Not for Distribution 4
DSRIP Timeline Moving Forward November 14 • December 22 Updated Project Plan Application released • Project Plan Application Prototype released Project Plan Application due* • Capital Restructuring Financing application April 1 released (delayed) • 3 rd round of initial attribution results DSRIP Year 1 begins published *Delayed from original due date of December 16 November 20 Financial Stability Test results made available November 2014 December 2014 January 2015 March 2015 April 2015 Mid-December • Capital Restructuring November 24 Financing application due March 1 • Scope and Speed of Application template released Implementation Plan due* • Leads to submit final partner lists in Network Tool *Changed from original due Confidential – Not for Distribution date of April 1 5
Revised Application Highlights Compared to the September 29 th draft application, the revised version makes: Minimal changes to the organizational section Some structural changes to the project plan section of the application, particularly with regards parameters around the scale and speed of implementation Refinements or clarification to some of the project requirements and/or associated metrics The application will be used to determine project valuation. The follow up “implementation plan” will further outline operational milestones. Confidential – Not for Distribution 6
Agenda Introductions and Objectives 10:00 – 10:05 am Final Project Selection 10:05 – 10:15 am Next Steps 10:15 – 10:25 am Q&A Session 10:25 – 10:45 am Confidential – Not for Distribution 7
Anticipated Project Selections Emerging Guidance on Metrics and Structure Necessitated Changes in Project Selection Project Description Domain 2: Systems Transformation Projects 2.a.i Create an Integrated Delivery System Focused on Evidence-Based Medicine and Population Health Management 2.a.iii Health Home At-Risk Intervention Program 2.a.iv Create a Medical Village Using Existing Hospital Infrastructure 2.b.iv Care Transitions Intervention Model to Reduce 30-day Readmissions for Chronic Health Conditions 2.b.vi Transitional Supportive Housing 2.d.i Implementation of Patient Activation Activities to Engage, Educate and Integrate the uninsured and low/non-utilizing Medicaid populations into Community Based Care Domain 3: Clinical Improvement Projects 3.a.i Integration of Primary Care and Behavioral Health Services 3.a.ii Behavioral Health Community Crisis Stabilization Services 3.b.ii Implementation of Evidence-Based Strategies in the Community to Address Chronic Disease – primary and secondary prevention projects (adult only) (Cardiovascular) 3.f.i Increase Support Programs for Maternal and Child Health (including High Risk Pregnancies) Domain 4: Population-Wide Prevention Projects Increase access to high quality chronic disease preventive care and management in both clinical and community settings 4.b.ii (focus on chronic diseases not in Domain 3, such as cancer) 4.b.i Promote tobacco cessation, especially among low SES populations and those with poor mental health Confidential – Not for Distribution 8
Example: Project Selection Using HHP Data as a Proxy QARR Mid- Hudson Perinatal Care Measures Performance Hudson Health Plan Goal Prevention Quality Indicator # 9 Low Birth Weight ± TBD 7.3 Prenatal and Postpartum Care—Timeliness of Prenatal Care 93.90% 92% Prenatal and Postpartum Care—Postpartum Visits 81.60% 75% Frequency of Ongoing Prenatal Care (81% or more) 81.40% 81% Well Care Visits in the first 15 months (5 or more Visits) 92.90% 86.1% 87% Childhood Immunization Status (Combination 3 – 4313314) 88.90% 81.7% 78% Lead Screening in Children 97.80% 86% PC-01 Early Elective Deliveries ± TBD QARR Mid- Hudson State Asthma Measures Performance Hudson Health Plan Avg Goal Prevention Quality Indicator # 15 Younger Adult Asthma ± 100 135 Pediatric Quality Indicator # 14 Pediatric Asthma ± 155 319 Asthma Medication Ratio (5 – 64 Years) 78.60% 64.7% 56% Medication Management for People with Asthma (5 – 64 Years) – 50% of 76.90% 50.2% 60% Treatment Days Covered Medication Management for People with Asthma (5 – 64 Years) – 75% of 51.20% 28.1% Treatment Days Covered We can do the project (score is 10% of 1.5 SD below goal) We cannot do the project (score is better than 10% of 1.5 SD below goal) We do not know if we can do the project (score is unknown or close) 9 Confidential – Not for Distribution
Example: Project Selection Using HHP Data as a Proxy Hudson Performance Mid- Statewide Cardiovascular Disease Measures Health Goal Hudson Average Plan Prevention Quality Indicator # 7 (HTN) ± 0.00 (2012 Data) 82 104 PQI # 13 (Angina without procedure) ± 0.00 (2012 Data) 24 27 Cholesterol Management for Patients with CV Conditions – LDL-C Testing 95.80% 87% Cholesterol Management for Patients with CV Conditions – LDL-C > 100 mg/dL 62.50% 52% Controlling High Blood Pressure 73.3% (2012 Data) 64% Aspirin Use TBD Discussion of Risks and Benefits of Aspirin Use TBD Medical Assistance with Smoking Cessation – Advised to Quit TBD 78% Medical Assistance with Smoking Cessation – Discussed Cessation Medication TBD 58% Medical Assistance with Smoking Cessation – Discussed Cessation Strategies TBD 48% Flu Shots for Adults Ages 18 – 64 TBD 42% Health Literacy Items (includes understanding of instructions to manage chronic condition, ability to carry out the instructions and instruction about when to return to the doctor if condition gets worse TBD We can do the project (score is 10% of 1.5 SD below goal) We cannot do the project (score is better than 10% of 1.5 SD below goal) We do not know if we can do the project (score is unknown or close) 10 Confidential – Not for Distribution
Example: Project Selection Using HHP Data as a Proxy Hudson Performance Mid- Statewide Diabetes Mellitus Measures Health Goal Hudson Average Plan Prevention Quality Indicator # 1 (DM Short term 0.00 (2012 Data) 85 113 complication) ± Comprehensive Diabetes screening – All Four Tests (HbA1c, lipid profile, dilated eye exam, nephropathy 61.20% 49% monitor) Comprehensive Diabetes Care: Hemoglobin A1c 24.00% 34% (HbA1c) Poor Control (>9.0%) ± Comprehensive diabetes care - LDL-c control 54.80% 41% (<100mg/dL) Medical Assistance with Smoking Cessation – Advised TBD 78% to Quit Medical Assistance with Smoking Cessation – Discussed TBD 58% Cessation Medication Medical Assistance with Smoking Cessation – Discussed TBD 48% Cessation Strategies Flu Shots for Adults Ages 18 – 64 TBD 42% Health Literacy Items (includes understanding of instructions to manage chronic condition, ability to TBD carry out the instructions and instruction about when to return to the doctor if condition gets worse We can do the project (score is 10% of 1.5 SD below goal) We cannot do the project (score is better than 10% of 1.5 SD below goal) We do not know if we can do the project (score is unknown or close) 11 Confidential – Not for Distribution
Final DSRIP Projects Project Description Domain 2: Systems Transformation Projects Create an Integrated Delivery System Focused on Evidence-Based Medicine and Population Health 2.a.i Management 2.a.iii Health Home At-Risk Intervention Program 2.a.iv Create a Medical Village Using Existing Hospital Infrastructure 2.b.iv Care Transitions Intervention Model to Reduce 30-day Readmissions for Chronic Health Conditions Implementation of Patient Activation Activities to Engage, Educate and Integrate the uninsured and 2.d.i low/non-utilizing Medicaid populations into Community Based Care (Project 11) Domain 3: Clinical Improvement Projects 3.a.i Integration of Primary Care and Behavioral Health Services 3.a.ii Behavioral Health Community Crisis Stabilization Services 3.c.i Implementation of Evidence-Based Strategies in the Community to Address Chronic Disease – Diabetes 3.d.iii Implementation of Evidence-Based Guidelines for Asthma Management Domain 4: Population-Wide Prevention Projects Promote Tobacco Use Cessation, Especially Among Low SES Populations and Those with Poor Mental 4.b.i Health Increase Access to High Quality Chronic Disease Preventive Care and Management in Both Clinical and 4.b.ii Community Settings - Cancer Confidential – Not for Distribution 12
Agenda Introductions and Objectives 10:00 – 10:05 am Final Project Selection 10:05 – 10:15 am Next Steps 10:15 – 10:25 am Q&A Session 10:25 – 10:45 am Confidential – Not for Distribution 13
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