Access to Care via Telehealth: An Accountable Care Organization - - PowerPoint PPT Presentation

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Access to Care via Telehealth: An Accountable Care Organization - - PowerPoint PPT Presentation

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Access to Care via Telehealth: An Accountable Care Organization examines application of telehealth services in a high poverty, transient population CANDACE S SHAW AW SR. T TELEHEAL ALTH TH C CONSU SULTAN ANT BLUE C CIRRUS C S CONSU

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Access to Care via Telehealth:

An Accountable Care Organization examines application of telehealth services in a high poverty, transient population

CANDACE S SHAW AW

  • SR. T

TELEHEAL ALTH TH C CONSU SULTAN ANT BLUE C CIRRUS C S CONSU SULTI TING

APHA 2019 ANNUAL MEETING AND EXPO

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Presenter Disclosures

(1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Candace Shaw No relationships to disclose

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My Care Family Main Service Area

Communities in Massachusetts

  • Lawrence
  • Methuen
  • Haverhill
  • Lowell
  • Andover
  • North Andover

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GLFHC Main Site GLFHC North Site GLFHC South Site GLFHC West Site Methuen Site

Lawrence General Hospital Lawrence Family Medicine Residency

GLFHC Community based Center GLFHC Lawrence High School GLFHC Greater Lawrence Technical School

Primary Care Partners Hospital Partner

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APHA 2019 ANNUAL MEETING AND EXPO

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About My Care Family

ACO Partners

  • Greater Lawrence Family Health Center
  • Lawrence General Hospital
  • Neighborhood Health Plan > Allways Health Partners

Care Team

  • 130 Primary Care Physicians/16 practices

Nurse Care Manager(s)

  • Clinical Pharmacist

Social Worker(s)

  • Social Care Manager(s)

Community Health Worker(s)

  • Population Health Manager

Patient Population:

  • 33,880 +/- Medicaid patients

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Patient Population

Transportation Lack of easy access to transportation options Language 70% Hispanic (multiple dialects, primarily Dominican Republic) Culture Traditionally seek primary care at hospital/ED Homelessness Transient population/ displaced by explosions Illegal Housing High cost of housing/shared domiciles Fearful of Immigration enforcement Aversion to video due to status Communication Lack of access: cell phone, mail, computer, etc

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Telehealth Goals

  • ACO – Reduce costs & maintain quality of care
  • Lawrence General Hospital – Reduce Emergency

Room visits that were low acuity

  • Greater Lawrence Family Health Centers – Maximize

care when patient with provider

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Project Overview

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Clinical Priorities

My Care Family Stakeholder Feedback

28%

  • Physician to specialist access

Provider-to-Provider Provider-to-Patient 15%

  • Chronic disease management

Provider-to-Provider Provider-to-Patient 13%

  • Access to primary care providers

Provider-to-Patient 13%

  • Access to Care

Patient-to-Provider 13%

  • Coordination of Care / Transitions of Care

Provider-to-Provider 8%

  • Triage / follow-up (home, homeless shelter, other)

Provider-to-Patient 8%

  • Decrease no show

Patient-to-Provider 5%

  • Community Outreach

Provider-to-Patient

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Clinical Priorities

Access to Specialists When Needed - Detail

29%

  • Behavioral Health

16%

  • Dermatology

15%

  • Endocrinology

9%

  • Neurology
  • Pediatrics

7%

  • Rheumatology

4%

  • Cardiology
  • Emergency Department
  • Hematology

2%

  • Infectious Disease
  • Nephrology

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Legislating Telehealth

Parity Laws require that insurers reimburse telehealth providers exactly as they would for an in-person visit. As it stands, 29 states and the District of Columbia have parity Laws.

Telemedicine Parity Law Partial Parity Law Proposed Parity Bill No Parity Legislative Activity

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Telehealth Programs

CHNAs and Analysis Onsite Surveys Corporate Strategy Cost and Competition

Decision Model Blueprint

APHA 2019 ANNUAL MEETING AND EXPO

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New program recommendations are based on data obtained during My Care Family’s Needs Assessment, stakeholder interviews, research and industry experience.

Program Meeting MCF’s Needs Meeting LG and/or GLFHC

Telebehavioral Health*

  • Behavioral Health ranked 1st as specialist need
  • Reduce costs with greater access to specialist

LG - Assists with patient care when psychiatrist not at hospital GLFHC – Access to psychiatrist/behavioral health provider when patient in clinic Urgent Care Kiosk

  • Reduces cost through reduction of inappropriate use of

ER for primary care visits LG – Reduces use of ER for primary care visits GLFHC – Provides after hours/weekends primary care access Virtual Visits – Primary Care

  • Assists with access to care, continuity of care, improved
  • utcomes

GLFHC - Reduces ‘no show’ rates GLFHC - Expands capacity and outreach

* selected for proforma cost benefit analysis

APHA 2019 ANNUAL MEETING AND EXPO

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New Telehealth Programs

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Total ROI:

$1.57M+

Year 1 Reaching

$6.21M+

Year 5

  • All results based on best available estimates of program costs and service fees.
  • Additional benefits based on published studies. However, final program enrollment and growth estimates still needed.
  • This template is only a guide for ROI assessment. Actual program data to be determined by My Care Family.

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Telebehavioral Health Proforma

Estimated Total 5 Year ROI

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Recommendations

√ Form the Telehealth Steering Committee √ Create a Telehealth Governance structure inclusive of clinical leadership √ Develop centralized internal translation service √ Develop Telebehavioral Health Service √ Integrate Telehealth into Community-based Service team collaboration and support √ Make Telehealth services mobile:

  • Homeless shelters
  • Drop in centers/ Churches
  • Mobile Clinic – parks & gathering places
  • Food Banks/Food Kitchens

APHA 2019 ANNUAL MEETING AND EXPO

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My Care Family Telehealth

Telehealth Project

MAVEN Project

  • Strengthened and expanded the usage of MAVEN Project (specialist telehealth visits)
  • Exploring the expansion of new specialty services

Home-Based Telehealth

Virtual Visits –

  • Pharmacist with patients in their home
  • Asthma Intervention with pediatric population/ prescription delivery

Telebehavioral Health

Optum

  • Collaborate with behavioral health provider OPTUM

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Thank you

Candace Shaw

  • Sr. Telehealth Consultant

Blue Cirrus Consulting Candace.Shaw@Blue-Cirrus.com @bcirrus (Twitter) BlueCirrusConsulting (FB) Blue Cirrus Consulting (LinkedIn) Sign up for the FREE webinars in our Knowledge Tsunami

NETRC REGIONAL CONFERENCE 2019

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