Accountable Care Collaborative Program Improvement Advisory - - PowerPoint PPT Presentation

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Accountable Care Collaborative Program Improvement Advisory - - PowerPoint PPT Presentation

Dec 29, 2022 278 likes •495 views

Criminal Justice and the Accountable Care Collaborative Program Improvement Advisory Committee April 19, 2017 1 Our Mission Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial

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Criminal Justice and the Accountable Care Collaborative

Program Improvement Advisory Committee

April 19, 2017

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Our Mission

Improving health care access and

  • utcomes for the people we serve

while demonstrating sound stewardship of financial resources

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Collective Challenge

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Community Justice System

Limited Medicaid Benefits

Full Medicaid Benefits

Education Care Coordination Care Continuity

BHO RCCO MCO DOC HCPF

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SLIDE 4

Collective Challenge

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Binswanger, I. A., Stern, M. F ., Deyo, R. A., Heagerty, P . J., Cheadle, A., Elmore, J. G., & Koepsell, T . D. (2007). Release from prison: A high risk of death for former inmates. New England Journal of Medicine, 356, 157-165.

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Goal

  • To establish a comprehensive care model that

identifies strategic areas of focus and aligns stakeholders and resources to make measureable improvements for members transitioning from the Department of Corrections (DOC)

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Objectives

  • Review the three strategic areas of the care model
  • Review the latest developments related to:
  • Suspend Function
  • Data Sharing Agreement
  • Discuss the implementation and monitoring plan

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Key Questions

  • How well do the three areas combine to create a

pro-active care coordination model?

  • What gaps and barriers continue to exist?
  • Where are other areas of opportunity?

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Care Model

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Community Justice System

Limited Medicaid Benefits

Full Medicaid Benefits

Education Care Coordination Care Continuity

BHO RCCO MCO DOC HCPF

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Care Model:

Education

  • Goal: increase the number of individuals enrolled in

Health First Colorado and health literacy of members and staff

  • Engaged and literate members and staff are critical

foundation for care coordination and long-term success

  • Three key tactics:
  • Suspend function
  • Member “in-reach” events
  • Staff education

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Care Model:

Education

  • Suspend Function
  • Provides limited benefits package
  • Inpatient stays >24 hours
  • Relieves administration burden
  • Allows for systems identification

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Care Model

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Community Justice System

Limited Medicaid Benefits

Full Medicaid Benefits

Education Care Coordination Care Continuity

BHO RCCO MCO DOC HCPF

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Care Model:

Care Coordination

  • Goal: Improve care transition processes between

DOC facilities and Department contractors

  • Syncing internal and external work reduces

duplication and ensures seamless handoffs

  • Three key tactics:
  • Data sharing agreement
  • Transition planning
  • Continuous quality improvement within PIAC sub-

committee

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Care Model:

Care Coordination

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Data

Members, providers and the system receive the data needed to make real-time decisions that improve care, increase coordinated services and improve overall efficiencies.

Regional Coordination

Improved health outcomes and smarter use of state resources requires regional and local coordination that recognizes the need for medical care, behavioral health care and community supports all working together.

Medical Home

Coordinated care means improved health outcomes and a better experience for providers and members as they interact with the system, and wiser use of state resources.

Better Health and Life Outcomes

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Care Model:

Care Coordination

  • Data Sharing Agreement
  • Precipitated by DOC Medicaid Summit in September

2016

  • Creates a single agreement between DOC and HCPF on

behalf of HCPF contractors

  • BHOs initially receive information followed by RCCOs
  • Attribution timeframes and contractual requirements dictate
  • rder of operations
  • Anticipated go-live: May 2017

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Care Model

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Community Justice System

Limited Medicaid Benefits

Full Medicaid Benefits

Education Care Coordination Care Continuity

BHO RCCO MCO DOC HCPF

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Care Model:

Care Continuity

  • Goal: Ensure care continuity between DOC facilities

and community-based providers

  • Uninterrupted care is the best member experience
  • Two key tactics:
  • Medical records upon release
  • Proactive appointment scheduling

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Monitoring and Evaluation

  • Key outcomes include:
  • Education: Health First Colorado suspension and

educational sessions

  • Care Coordination: Transitional planning
  • Care Continuity: PCMP attribution, health care

utilization, and recidivism

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Accountability and Implementation

18 HCPF: Accountable Care Collaborative

Program Improvement Advisory Committee Improving and Bridging Systems RCCOs BHOs DOC Key Stakeholders

Best Practices and Strategies Recommendations Recommendations Technical Assistance

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Future Directions

  • County Jails
  • El Paso Jail Pilot
  • Emerging County relationships
  • Division of Youth Corrections

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Discussion

  • How well do the three areas combine to create a

pro-active care coordination model?

  • What gaps and barriers continue to exist?
  • Where are other areas of opportunity?

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Contact Information

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Alejandro Vera // HIO alejandro.vera@state.co.us Michael Lott-Manier // BHOs michael.lott-manier@state.co.us Ben Harris // RCCOs benjamin.harris@state.co.us