C OMMONWEALTH OF M ASSACHUSETTS H EALTH P OLICY C OMMISSION Care Delivery and Payment System Transformation Committee April 1, 2015
Agenda Approval of Minutes from the March 4, 2015 Meeting (VOTE) Discussion of Registration of Provider Organizations Data Submission Manual for Initial Registration: Part 2 Discussion of HPC Certification Programs Schedule of Next Committee Meeting (May 5, 2015)
Agenda Approval of Minutes from the March 4, 2015 Meeting (VOTE) Discussion of Registration of Provider Organizations Data Submission Manual for Initial Registration: Part 2 Discussion of HPC Certification Programs Schedule of Next Committee Meeting (May 5, 2015)
Vote: Approving Minutes Motion : That the Care Delivery and Payment System Transformation Committee hereby approves the minutes of the Committee meeting held on March 4, 2015, as presented. Health Policy Commission | 4
Agenda Approval of Minutes from the March 4, 2015 Meeting (VOTE) Discussion of Registration of Provider Organizations Data Submission Manual for Initial Registration: Part 2 Discussion of HPC Certification Programs Schedule of Next Committee Meeting (May 5, 2015)
Structure of Program Self- Uniform reported Linkable Public Health Policy Commission | 6
Purpose of the Program RPO contributes to a foundation of information needed to support health care system monitoring and improvement. Regularly reported information on the healthcare delivery system is necessary to support: • Care delivery innovation 1 • 2 Evaluation of market changes • Health resource planning: assessing capacity, need, utilization 3 • Tracking and analyzing system-wide and provider-specific trends 4 Health Policy Commission | 7
Summary of Applicants Submitted Applications 62 Applications received on or before the 11/14 deadline 16 Applications received after the 11/14 deadline 4 Outstanding applications expected Total applications received or expected as of 3/30 82 Applications Deemed Not Active or Otherwise Complete Corporate Affiliates of Registrants 15 RBPO Applicants Deemed Complete 4 Total applications deemed complete or not active 19 Total Anticipated Applications Moving to Part 2 Total Anticipated Applications Moving to Part 2 63 Health Policy Commission | 8
Summary of Applicants: Organization Types Behavioral Other Health 3% 8% Integrated System Physician 51% Group 38% Disclaimer: The HPC has not completed its review of Part 1 materials. The information above is not considered final, is subject to change, and is not intended for use beyond discussion purposes. Health Policy Commission | 9
Summary of Applicants: Corporate Affiliates Approximately Half of Provider Organizations Reported Having Either Zero or Ten or More Corporate Affiliates 16 14 12 Number of Registrants 10 8 6 4 2 0 0 1 2 3 4 5 6 7 8 9 10+ Number of Corporate Affiliates Disclaimer: This graph includes 59 of 63 final applicants. The HPC has not completed its review of Part 1 materials. The information above is not considered final, is subject to change, and is not intended for use beyond discussion purposes. Health Policy Commission | 10
Summary of Applicants: Risk-Bearing Provider Organizations and Abbreviated Applications 56% 37% Of registrants applied for a Of registrants applied to file Risk Certificate or a Risk an abbreviated application Certificate Waiver in Part 2 Disclaimer: The HPC has not completed its review of Part 1 materials. The information above is not considered final, is subject to change, and is not intended for use beyond discussion purposes. Health Policy Commission | 11
Part 2 Anticipated Process 2015 Jan Feb Mar April May June July Aug Sept HPC completes review of Part 1 materials HPC uploads final Part 1 materials to web portal Small group stakeholder meetings on Part 2 DSM Written public comment period on Part 2 DSM Present updated Part 2 DSM to CDPST Present Part 2 DSM to the Board HPC releases final DSM for Part 2 Part 2 training sessions and 1-on-1 meetings Part 2 Registration Window All dates are approximate. Health Policy Commission | 12
Information about Corporate Affiliations Any Updates from 2014 Description Value Proposal • • • • The Provider No significant changes The file will provide No significant changes Organization completes were made to this file. insight into: questions in the • The types of services Corporate Affiliations file for each entity that it that Provider owns or controls, Organizations create whether fully or partially. internally rather than purchase externally • The Provider • Relationships between Organization provides identifying information organizations (e.g., about each entity, such joint ventures between as tax status, otherwise independent organization type and corporate entities) level of ownership. • Non-healthcare service offerings Health Policy Commission | 13
Information about Contracting Relationships Any Updates from 2014 Description Value Proposal • • • • The Contracting Staff have removed a These files provide No significant changes Affiliations file asks for number of questions and insight into which identifying information shifted several questions medical groups, about each entity that the from the Contracting hospitals, and other Provider Organization Affiliations file to the providers are aligning does not own or control, Contracting Entity file their contracting to but on whose behalf it due to Provider achieve efficiencies, care establishes contracts. Organization concerns delivery improvements, about burden and and other goals. • The Contracting Entity availability of information. • file asks for identifying These files will track information about each changes to the entity owned or contracting landscape controlled by the over time, including Provider Organization which entities have that establishes contracts adopted global budgets. with payers. Health Policy Commission | 14
Information about Facilities and Physicians Any Updates from 2014 Description Value Proposal • • • • The Facilities File asks Requests for FTE The Facilities file and No significant changes for information about the calculations by facility Physician Roster will location, type and and/or site have been support health planning available services at the replaced with a physician efforts by providing key Provider Organization’s roster requirement, information about the licensed facilities. based on public location of physicians, comment from Provider facilities and services • The Physician Roster Organizations. across the asks for identifying Commonwealth. information for each physician, whether employed or affiliated, who gets his or her contracts through the Provider Organization. Health Policy Commission | 15
Information about Clinical Affiliations Any Updates from 2014 Description Value Proposal • • • • The Clinical Affiliations The Clinical Affiliations This information provides No significant changes file asks for identifying file has been significantly insight into how care is information about the pared down based on being delivered and clinical relationships that Provider insight and coordinated between acute care hospitals feedback. The following providers. have with other topic areas have been Providers. removed from the current draft DSM: • Compensation • Service lines • End date Health Policy Commission | 16
Agenda Approval of Minutes from the March 4, 2015 Meeting (VOTE) Discussion of Registration of Provider Organizations Data Submission Manual for Initial Registration: Part 2 Discussion of HPC Certification Programs – ACO Program: Overall program design framework – PCMH Program: Model payment approach Schedule of Next Committee Meeting (May 5, 2015)
Agenda Approval of Minutes from the March 4, 2015 Meeting (VOTE) Discussion of Registration of Provider Organizations Data Submission Manual for Initial Registration: Part 2 Discussion of HPC Certification Programs – ACO Program: Overall program design framework – PCMH Program: Model payment approach Schedule of Next Committee Meeting (May 5, 2015)
Principles for developing the ACO program ACO certification standards will: Be compatible with existing Medicare ACO programs and MA commercial global budget contracts Be aligned with MassHealth ACO program development timeline and requirements Maintain flexibility for market innovation while ensuring minimum standards for an efficient and high quality care delivery system Be evidence-based Minimize unnecessary administrative burden on providers Health Policy Commission | 19
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