November 5, 2018 1 Agenda Welcome, introductions, meeting goals - - PowerPoint PPT Presentation

HEALTH ASPECTS OF KINDERGARTEN READINESS TECHNICAL WORKGROUP

November 5, 2018

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• Welcome, introductions, meeting goals and agenda overview
• Public comment (10:10 am)
• Affirm components of measurement strategy proposal specific to Metrics and

Scoring Committee

• Discuss future metrics proposal is driving toward
• Discuss CCO Attestation metric
• Finalize measurement strategy proposal
• Next steps for final report and recommendations to Metrics and Scoring

Committee

• Workgroup reflections

Agenda

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Public Comment

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Components of Measurement Strategy Proposal for Metrics and Scoring Committee

Discuss Future Metrics that the Proposal is Driving Tow ards

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Assess level of consensus on concept of driving towards bundled metric in the future

What we’ve heard: PROS What we’ve heard: CONS

Preventive Care: Bundle/Composite Metric Approach

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• Felt to be more “transformational” than separate metrics

because all have to be addressed at once

• Moves towards improved quality in the receipt of

different preventive care services

• Includes different types of health care (e.g. dental and

primary care)

• If a composite: Puts a focus on ensuring individual

children get all appropriate services (vs. a population level measure)

• Concerns from M&S, TAG, and primary care

providers about parsing multi-part bundle

• Bundled metrics can be challenging for use in

driving quality improvement because they have to be unbundled to identify where to focus QI efforts

• Could make the measure so burdensome that

some CCOs might choose to focus their efforts elsewhere

• Depending on CCO/provider payment

arrangements, incentive dollars could get split, meaning less transformation funds to providers

• Bundle could require additional development of

technical specifications

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Additional consideration

• Additional consideration:

– The Metrics and Scoring Committee could choose to further incentivize the components of the strategy, even if they are not bundled in a three- part measure. Examples include:

• Having a ‘bundled’ kindergarten readiness challenge pool requiring that a CCO

meet X number of components to receive challenge pool dollars (**the “challenge pool”

is a subset of incentive measures worth additional dollars if CCOs achieve them)

• Inclusion of some or all of the components as a requirement for a CCO to earn

100% of the quality pool dollars for which it is eligible

• Other possibilities as identified by the Metrics and Scoring Committee

• Purpose is to drive CCOs to address complex system-level factors

that impact the services that kids and families receive and how they receive them, and for which there may be payment or policy barriers that need to be addressed.

• Activities would build capacity within CCOs for enhanced

services, integration of services, cross-sector collaboration, and measurement opportunities.

• Lays the foundation for future child- and/or parent-level metrics.

CCO Attestation Metric

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CCO-Level Metric Focused on Social-Emotional Health

(e.g. CCO Attestation Form).

Examine and expand screening for and identifying factors that impact SE health; Assess capacity and utilization of behavioral health services for children0-5 and their families; Address policies, and payment for Behavioral health services (within primary care and specialty behavioral health care) for children 0-5 and their families.

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Components of a CCO Attestation Metric

• 1. Examine and expand screening for and identifying factors that

impact SE health (including SDOH).

• 2. Assess capacity and utilization of behavioral health services for

children 0-5 and their families.

• 3. Address policies and payment for behavioral health services

(within primary care and specialty behavioral health care) for children 0-5 and their families.

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Example Components of a CCO Attestation Metric

• 1. Examine and expand screening for and identifying factors that impact SE

health (including SDOH).

Examples: a) Conduct cross-sector training on identifying delays in social-emotional health that include follow-up pathways to address delays. b) Develop and implement specific pilots meant to address family-centered access of these services.

• Pilot enhanced assessment of a child’s social emotional health and/or family factors

that impact social emotional development, and evaluate whether enhanced assessments result in increased access of behavioral health services.

• For those that access behavioral health services, assess the impact on child and family

well-being.

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Example Components of a CCO Attestation Metric

• 2. Assess capacity and utilization of behavioral health services for children 0-5 and

their families.

Examples: a) Assess the specific number of trained providers and their capacity to provide behavioral health services for children 0-5. This assessment should include:

• Map of providers and services available across the CCO region, including location,

languages in which these service are available, and race/ethnicity of the provider. Include behavioral health services within primary care and specialty mental health care.

• Capacity of these providers (existing “case load” and potential for expansion).
• Comparison of this capacity to the full population of children 0-5 in the CCO region,

including how this capacity will meet the cultural and linguistic needs of families. b) Examine claims data, using behavioral health penetration metric (to be provided), for utilization

• f behavioral health services for children 0-5. Assess for disparities in the full population, by race

and ethnicity, and by geography within the CCO region.

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Example Components of a CCO Attestation Metric

• 3. Address policies and payment for behavioral health services (within primary

care and specialty behavioral health care) for children 0-5 and their families.

Examples: a) Address payment policies that limit access to services. For example, those that limit access to integrated behavioral health services within primary care including:

• Prior authorization requirements for behavioral health services for children 0-5.
• Prior-authorization requirements for behavioral health services in an integrated

primary care clinic.

• Requirements for specific diagnostic codes to be provided for behavioral health

services based on the location of the provision of the service.

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Workgroup Final Report Outline

What would be the next steps for a CCO Attestation Metric, if included in our proposal to M&S?

• Develop and refine the items that would be included in the

metric.

• Determine how CCOs would demonstrate/attest to the items.
• Determine scoring for the attestation metric.

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Finalize Measurement Strategy Proposal for Metrics and Scoring Committee

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Potential Proposal to Metrics and Scoring Committee

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Potential Proposal to Metrics and Scoring Committee

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Discussion

What do you want to convey to M&S about these three options?

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Next Steps and Closing

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Report and Recommendations

• Finalize workgroup report:

– Planning team will finish a draft of the workgroup report. – Workgroup will review report and provide feedback via survey. – Planning team will incorporate input into final report.

• Present recommendations:

– Planning team will present measurement strategy proposal to Metrics and Scoring Committee on November 16th. Workgroup members are welcome to attend! – Additional recommendations will be delivered to targeted groups.

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Workgroup Reflections

THANK YOU FOR ALL OF YOUR TIME, ENERGY, AND COMMITMENT TO OREGON’S CHILDREN!

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