Performance Measurement & Data Committee August 13, 2018 - - PowerPoint PPT Presentation
The Accountable Community of Health for King County Performance Measurement & Data Committee August 13, 2018 Meeting Agenda 10:30 10:40 Welcome and Introductions Mattie Osborn, Amerigroup 10:40 10:55 HealthierHere Update Thuy
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No matter where people enter the system… they receive the appropriate care and community supports to live healthier lives. System is more cost effective and sustainable.
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Identified Needs Ability to share data electronically
Consent process standardization Ability to stratify and track patient risks (registries) Population health management best practices Screening and collection of social determinants of health (SDOH) EHR use and best practices Referral database Improve data sharing through data standardization Telehealth Based on the HIE/HIT survey, PMD discussions, state ACH meetings, state AIM and HIE/HIT meetings, 1:1 conversations
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Identified Needs Ability to share data electronically
Consent process standardization Ability to stratify and track patient risks (registries) Population health management best practices Screening and collection of social determinants of health (SDOH) EHR use and best practices Referral database Improve data sharing through data standardization Telehealth Shared care plan platforms (EDIE/PreManage) Community information exchange (CIE) solutions Guidelines/framework for evaluating software options Scope alignment for population health management capacity building and technical assistance Identify & coordinate with other groups/stakeholders working on HIE/HIT topics (Telehealth, CIE, etc.) Current Areas of Exploration
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August 13, 2018
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Overview Key Components
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Catalytic Investment Framework is a tool to evaluate investment opportunities relative to their expected impact and costs. The Catalytic Investment Framework consists of four components:
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Vision, Principles, & Goals
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Implementation Strategy
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Resources Needed
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Investment Plan
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Steps Deliverables (1) Define Vision HealthierHere vision “By 2020, the people of King County will experience significant gain in health and well-being because
and social problems, to one that focuses on prevention, embraces recovery, and eliminates disparities.” (2) Identify Investment Principles Transformative Prioritize solutions that promise the greatest impact for improving health, health system coordination, and health equity in King County. Systemic Support the development and/or diffusion of infrastructure solutions that address system-wide needs. Leverage Focus on the solutions that leverage available resources in the most effective and efficient manner. Equitable Extend funding to address the areas of greatest need, health disparities, and under investment as determined by authentic community engagement. Opportunistic Provide targeted investments that maximize return on investments and build momentum for rapid scaling.
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Steps Deliverables (3) Identify measurable goals (4) Map anticipated goal achievement
Identify the anticipated ability to achieve the pay-for-performance gap-to-goal targets year by year to inform the forecasted funds flow.
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(1) Patient enters ED and is triaged by nurse for emergent or non- emergent needs
(2) (a) Emergent needs follow standard ED process; (b) Non- emergent needs follow EMTALA-compliant screening, receive needed Tx and Rx
(3) Determine care management needs (4) PCP appt and education on appropriate use of ED and primary care (5) Patient is discharged from ED Resources Needed:
documented in screening tool & captured in population health system Resources Needed:
Resources Needed:
staff
system to create & manage care plan Resources Needed:
materials
Resources Needed:
discharge to care manager using ADT- based alert tool
ED Pathway
Steps
ED Care Triage Example from New York DSRIP Steps
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Expense Category DY1 DY2 DY3 DY4 DY5 All Years Personnel $0 $631,596 $1,691,414 $2,278,205 $2,346,551 $6,947,766
Supplies, Equipment $10,000 $58,000 $114,000 $82,000 $42,000 $306,000 Purchased/Leased Services $55,990 $211,965 $6,881,666 $10,464,919 $10,778,567 $28,393,107
Other $700,000 $700,000 $700,000 $700,000 $784,384 $3,584,384 Total Expenses $765,990 $1,601,561 $9,387,080 $13,525,124 $13,951,501 $39,231,257 Number of Patients Engaged 32,636 54,394 54,394 54,394 195,818
ED Care Triage Example from Medicaid DSRIP Key Assumptions Outstanding Questions
➢ Personnel: 16 new FTEs by DY5 (one “intake” RN at each of 12 sites, one project manager at each of 4 hubs) ➢ Purchased/Leased Services: 3 care management teams at each of 12 sites by DY5, operating a “care transitions” model; teams comprised of 1 RN and 2 Care Navigators ➢ Other: space reconfiguration ➢ How will Population Health System be deployed and used to manage a shared care plan? ➢ Are three care management teams at each site sufficient? To achieve the patient engagement targets, each team would touch an average of 6 ED patients per weekday ➢ How many intake RNs are necessary to staff the 24- hour triage line?
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Steps
screening and risk stratification tools; registries; shared care plan platforms)
We will assess proposed Domain 1 investments in Population Health Tools and Training Programs against a Prioritization Model that includes three variables: ▪ Value… i.e., importance relative to principles and impact on gap-to-goal measures ▪ Viability... i.e., likelihood it will deliver intended results in the near term and be sustainable in long term ▪ Significance of HealthierHere Funding... i.e., extent to which other funding sources are available
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Calibrate Budgets with Project Required Resources Develop Preliminary Budget Caps for Projects Assess Costs
Resources
clinical team estimate costs (fixed and variable)
clinical project budgets
project budget for review
budgets and negotiate project budgets with partners, if required
preliminary allocation of Domain 2 budget to clinical projects
for each project and define distribution of effort
costs required for implementation
that could be deployed or redeployed to support projects
August September October
Finalize Project Budgets & Funding Schedules
preliminary funding schedules by partner
reviews partner funding schedules for PSAs
Nov/Dec
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