NYeC Monthly Association Call Kick-Off Valerie Grey Executive Director October 12, 2018
Agenda Time Topic 9:30 - 9:40am Welcome, Introductions & Purpose 9:40 - 10:15am NYeC and SHIN-NY: Review & Updates • General SHIN-NY Progress Update • Roadmap Strategies • Other Updates 10:15 - 10:45am Association Roundtable (to include report-outs, updates, and other issues to raise) • Behavioral Health • Clinics • Health Plans • Home Care • Hospice • Hospitals • Nursing Homes • Providers 10:45 - 11:00am Action Items & Next Steps 2
Welcome, Introductions & Purpose
Monthly Association Call Kick-Off • Background: o Importance of a continuous statewide feedback loop became apparent during the development of the SHIN-NY 2020 Roadmap o NYeC is currently forming six Advisory Groups: Provider, Health Plan, CBO/VBC, Consumers, Technology & Innovation, and Quality Measurement o NYeC establishing ongoing, regular contact with our association partners via a monthly call • Purpose: o To help advise us on the intersection of patient care, transformation, and workflow with HIE and HIT, and how that can be harnessed to transform the healthcare system and improve health outcomes and provider experience • Focus: o Updates, hot topic developments, challenges and opportunities for collective advocacy o Advisory Group Updates once they are fully operational o Associations should use this space to raise HIT/HIE issues and concerns to NYeC 4
NYeC and SHIN-NY: Review & Updates
Roles and Responsibilities DOH NYeC QEs • Exercise overall authority for • Provide thought leadership • Partner with DOH and NYeC the SHIN-NY (funding, and statewide management to provide thought regulation, laws, policy to advance, align, integrate, leadership guidance, QE certification and advocate • Deliver core SHIN-NY services requirements,etc.) • Facilitate and propose policy, • Meet performance goals and technical standards, comply with State • Serve as a partner with the functionality, business requirements privatesector operations, and innovation • Directly support healthcare • Utilize state levers to • Oversee delivery of QE core reform initiatives, care promote SHIN-NY services through models, and innovation performance-based contracts • If desired, offer enhanced • Connect QEs statewide and services for additional fees meet performance goals 6
Department of Health SHIN-NY Committees may develop and approve Governance recommendations on policies, technical standards and SHIN-NY services. Recommendations may be submitted for approval to the Board. Planning & Operations STATEWIDE COLLABORATION PROCESS Business Operations Technical • Facilitates a transparent and robust Committee (BOC) governance process to prioritize NYeC Board and drive consensus on policy Implementation development, implementation approaches, and operation support services. Policy Committee Special teams as needed Board may formally propose statewide • Provides a functional structure to Provider Advisory Group convene stakeholders and policy guidance to coordinate the implementation and DOH. DOH may Consumer Advisory Group operation of New York’s health SHIN-NY 2020 accept or reject information infrastructure. Roadmap additional Health Plan Advisory Group proposed statewide groups to inform & • Provides support (thought policy guidance at its provide feedback to Quality Measurement Workgroup leadership, project management, sole discretion. NYeC staff & Board staff, tools and other resources) to Technology Advisory Group streamline, coordinate and document activities. VBC* & CBO Workgroup Monthly Association Calls 7 *VBC: Value-based care
• Performance-Based Contracts 1 • Ambitious targets for participation, consent, data quality* Strong • Enhanced Security Foundation • Additional data & services & participants 2 • Enhanced functionality & integration Value Based • Policy changes including consent Care • Leverage market developments 3 • Discrete data via FHIR Innovation • Patient engagement • New QE payment methodology 4 • Standardization, shared services, mergers Efficiency • Wire once ability • Federal and State funding, policy, legislation 5 • EHR vendors • Feedback via 6 new advisory groups Advocacy 8
SHIN-NY: Current Statistics As of September 30, 2018 Metrics 2020 QE Low High Goal Average (of 8 (of 8 (of 8 QEs) QEs) QEs) Participating hospitals 100% 100% 98% 100% Participating skilled D&TCs, FQHCs, nursing facilities, home care, hospice 70% 78% 60% 93% Participating physicians 70% 68% 52% 91% Unique patient consent for at least one provider 85% 85% 54% 111%~ New data format and fields for hospitals 100% 32% 0% 83% New data format and fields for other regulated entities (ORE)** 70% 15% 0% 34% New data format and fields for physicians 70% 19% 0% 43% ~QE consent rates may exceed 100% if the consent rate exceeds their market share of participants 9
SHIN-NY Performance Based Contracting (PBC) Core Allocation Performance Dedicated Payments Funding Performance Based Contracting Interoperability High Gap & Innovation Closure Pool Pool 10
Ambitious Statewide Goals Used in Performance-Based Contracting • Adoption: o 100% participation by hospitals o 70% participation by other provider types o 100% full data contribution by hospitals Performance payments 2018 - 2020 o 70% full data contribution by other provider types • Consent: o 85% of patients provide consent to at least one provider Share of overall funding • SHIN-NY Utilization Pay-for-reporting for 2018 while work allocated to performance • Enterprise Availability done on measures will increase over time • Customer Satisfaction Performance payments start for these metrics in 2019 and 2020 • All QEs and NYeC must obtain HITRUST certification 11
High Gap Closure Program Focused on Participation & Consent Downstate HGC Healthix NYCIG QEs Subsidy to temporarily reduce Gateway Vendor eConsent or eliminate provider connection fees charged by QEs Hub Connections eConsent 12
Data Exchange Incentive Program – Good News! • The Data Exchange Incentive Program (DEIP) provides up to $13,000 financial incentive payment to eligible providers to help offset costs related to connecting to their QE and the SHIN-NY • DEIP 2-year extension was approved • DEIP eligibility being expanded to EMS and Pharmacy o EMS target – Fall 2018 o Pharmacy target – Late 2018 • NYeC is working with NYS and stakeholders on defining the data that would be required as a condition of DEIP funding • Potential expansion to include labs as eligible participants 13
Supporting Value Based Care • Basic alerts available to Up to 3 additional data & services Up to 3 enhanced functionality those with treating projects, examples include: projects, examples include: relationships without • Medication fills • Single sign-on for Health Commerce written consent • Quality measurement reporting System (I-STOP, others) • Incorporation of SHIN-NY • Standardized data formats • Smarter, actionable alerts consent with other forms • Medical claims (via APD) • MACRA/MIPS compliance • Exploration of opt-out • eMOLST • Care plan exchange • Registries • Data governance • Additional EHR integration • Social determinants of health • Others • Patient-centered data home 14
SHIN-NY Helping PPSs! QEs Assisting with DSRIP Medical Record Review • 25 DSRIP Performing Provider Systems (PPSs) selected projects and each project has performance metrics, 7 of which are measures are obtained via medical record data Screening for Clinical Depression and Follow- Up (CDF): Non-HEDIS • QEs will examine their data and help Controlling High Blood Pressure (CBP): HEDIS supplement medical record information obtained by NYS DSRIP medical record review Comprehensive Diabetes Care (CDC): HEDIS contractors Viral Load Suppression (VLS): Non-HEDIS Prenatal and Post Partum Care* (PPC): HEDIS • Example: When HealtheConnections assisted earlier this year, the additional information Childhood Immunization Status (CIS): HEDIS reduced HbA1C poor control from 61.4% to Lead Screening in Children (LSC): HEDIS 36.4% (lower rate is better) 15
SHIN-NY Helping ROMCs with NYS PCMH! QE Quality Measurement Pilots • 4 QEs* will to support regional oversight • A critical activity for all pilot participants and management committees (ROMCs), will be to share detailed documentation: NYS PCMH practices and health plans with o Will be used to inform consensus building and data contribution and data quality SHIN-NY quality measurement governance, including standardization • Goal is to develop the capability to support quality measurement and transformation activities: o Calculating quality measures for NYS PCMH practices to use for ongoing monitoring and quality improvement o Delivery of data to health plans to use in measurement of NYS PCMH practices * HEALTHeLINK, HealtheConnections, Hixny, Healthix/Bronx RHIO 16
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