Metrics & Scoring Committee October 21, 2016 Waiver Renewal - PowerPoint PPT Presentation

Metrics & Scoring Committee October 21, 2016

Waiver Renewal Updates Waiver renewal application was resubmitted on August 14 th with some technical and language revisions: https://www.oregon.gov/oha/OHPB/Pages/health-reform/cms-waiver.aspx CMS public comment period was open through October 1: https://www.medicaid.gov/medicaid-chip-program-information/by- topics/waivers/waivers_faceted.html Community Health Partnership Advisory Council to be convened in October. Reach high level agreement with CMS on specific policy areas by Winter 2016 • Health related services concept paper • Extension of the tribal uncompensated care program • Dual eligible opt-out auto enrollment • Medical policy proposals Finalize the waiver renewal in early 2017 with implementation beginning July 1, 2017. 3

PCPCH Weighting 4

Recap • With new PCPCH program standards for 2017, CCO incentive measure formula needs to be adjusted to reflect the new tiers of recognition. • The Committee initially discussed formula options in August, then referred the question to the technical advisory workgroup. • Today, asking for the Committee’s recommendation for the 2017 measure formula, based on TAG feedback, PCPCH program feedback, and a new proposal. 5

Option 5 (proposed via email after Committee meeting) (Tier 1 members *0) + (Tier 2 members *2) + (Tier 3 members *3) + (Tier 4 and 5 STAR members *4) + 5 STAR members (Total CCO enrollment *4 (not including the tier 1s)) 6

Previous Committee Discussion • Tier 1 should not count toward the PCPCH measure in 2017 • The measure formula should still give weight to higher tiers of recognition • The measure formula should give the most benefit to moving clinics to 5 STAR status, with the caveat that it may take time for all site visits to be completed. 7

PCPCH Program Feedback Option 2 (Tier 1 members *1) + (Tier 2 * 2) + (Tier 3 *3) + (Tier 4 * 4) + (5 STAR *5) (Total CCO enrollment * 5) Rationale • 5 STAR should remain a separate, heavier part of the numerator, given the effort required to reach this level of certification. • It would be inconsistent to have separate Tier 4 and 5 STAR certifications, but then lump them together in the metric (option 1). 8

TAG Feedback Fielded survey after September TAG meeting. Received responses representing 14 CCOs 7.5 “…Our recommendation is for Option 4. Options 1 and 3 do not give the desired weight to achieving 5 STAR, and option 2 lowers the rate too drastically and does not give a true impression of PCPCH performance...Option 4 3.5 gives the appropriate weight to achieving 5 STAR while not lowering the rates and threshold too greatly.” 2 1 0 Option 1 Option 2 Option 3 Option 4 Other 9

TAG Feedback cont. The survey also asked CCOs about whether the 60% threshold should be revised to accommodate any changes in the measure formula. Responses varied: • Benchmark should either remain the same or be lowered depending on if the denominator is increased to x5. • Don’t change the threshold until we can look at performance under the new formula (i.e., CY 2019 measurement) • Do not change if selecting option 2; could maybe increase if selecting option 4 (potentially set at 80%). • Maintain current threshold. • Lower threshold to 40 or 50%, as new formulas (particularly option 2) will drastically reduce performance scores. 10

New Proposal Adopt a phased in approach that eliminates the inclusion of Tier 1 and 2 in the formula, and provide a gradual, but meaningful path to improvement by modifying the denominator, and then target over time. Year Formula Threshold 2017 (Tier 3 members *3) + (Tier 4 members *4) + (5 STAR members *5) 60% (Total CCO enrollment *4) (Tier 3 members *3) + (Tier 4 members *4) + (5 STAR members *5) 2018 60% (Total CCO enrollment *5) (Tier 3 members *3) + (Tier 4 members *4) + (5 STAR members *5) 2019 65% (Total CCO enrollment *5) 11

MEASURING SUCCESS IN THE EARLY LEARNING SYSTEM David Mandell, Acting Early Learning System Director Tom George, Research Specialist, Early Learning Division October 21, 2016

Measuring Success Charter Advise the Early Learning Council on the issues, challenges, successes and priorities related to measuring the success of the early learning system and ensuring equitable outcomes for all children, including but not limited to the Early Learning Hubs.

Early Learning System Goals 14  Early Learning System is aligned, coordinated and family ‐ centered  Children arrive at school ready to succeed  Children live in healthy, stable & attached families Focus Populations: Children under the age of six and their families who are furthest from opportunity

Measuring Success Committee Membership  Early Learning Council members (2 ‐ 3)  Hub leadership (2)  Hub operational staff (2)  Individuals from local early learning programs that partner with Hubs (2)  Individuals with expertise in early learning data (including EI/ECSE) and early learning programs (2)  Individual with expertise in health data and health system (1)  Individual with expertise in human services data and state human services system (1)  Individual with expertise in k12 education data and system (1)  Individuals with expertise in program evaluation and/or design and implementation of performance metrics (2)

Measuring Success Committee Membership ELC members: Pam Curtis, Bobbie Weber  Hub leadership: Cade Burnett, Umatilla ‐ Morrow Head Start;  Dorothy Spence, NW Regional ESD; Kristi May, Linn ‐ Benton ‐ Lincoln Early Learning Hub Hub operational staff: Vacant  Early learning Hub partners: Mellie Bukovsky ‐ Reyes, educational consulting;  Emily Berry, Healthy Families, teen parents, youth services Expertise in early learning data: Debby Jones, Wasco Co. YOUTHINK  Expertise in health data & systems: Collen Reuland, OR Pediatric Improve. Partner.  Expertise in human services data & systems: Sylvia Gillpatrick, SGE  Expertise in k12 education data & systems: Brian Reeder, OR Dept. of Education  Expertise in program evaluation and/or metrics: Andrew Mashburn, PSU;  Jennifer Matheson, NW health foundation

Key Early Learning System Policy, Evaluation & Research Questions 17 1) Impact of the Early Learning System on Children and Families 2) Access to Early Learning Services 3) Early Learning System Coordination

Impact of the Early Learning System on Children and Families 18 Key Question: Are state ‐ funded and affiliated services improving healthy development for young children and families furthest from opportunity? Sub Questions: 1.1 How have early learning services impacted children’s developmental progress? Has the developmental progress of children under six improved? 1.2 Are all young children needing developmental supports receiving services, and is it improving the lives of children and families? 1.3 How have early learning services impacted children and families from the parents’ perspective, and are parents actively engaged? 1.4 Are early learning services delivered in a culturally relevant manner? 1.5 How have early learning services differentially impacted children and families furthest from opportunity and have disparities been reduced? 1.6 What are the processes for programs’ continuous quality improvement? What is the quality of programs, and is quality improving? 1.7 How can technical assistance by the ELD be improved to enhance early learning services?

Transformative potential of hubs to positively impact children and families  Coalescing collective ownership of a shared vision and outcomes for a defined population of children and families.  Convening partners from across sectors, working together towards a common vision, based on shared strategies and data.  Coordinating effective and aligned systems.

Access to Early Learning Services 20 Key Question: Are early learning investments improving the lives of children and families furthest from opportunity? Sub Questions: 2.1 What state funded and affiliated early learning services are available for children and families furthest from opportunity? 2.2 Are early learning investments prioritized to reach those furthest from opportunity? 2.3 Are state funded and affiliated early learning services located in communities with high concentrations of children and families furthest from opportunity? 2.4 How are early learning services engaging children and families furthest from opportunity? 2.5 Are children and families able to seamlessly transition among early learning services? 2.6 What are the barriers that prevent some children and families furthest from opportunity from participating in state ‐ funded services?

Early Learning System Coordination 21 Key Question: Are early learning services aligned, coordinated, and family centered? Sub Questions: 3.1 How do early learning organizations align and coordinate family services? 3.2 Are children and families able to navigate and seamlessly transition among early learning services? 3.3 What are the barriers to an effectively coordinated and aligned early learning system? 3.4 How are resources blended and braided to achieve collective impact within the early learning system? 3.5 Are culturally ‐ specific community ‐ based organizations and services effectively integrated partners in the early learning system?