Regional Health Improvement Plan Council March 17, 2020 1 Meeting - - PowerPoint PPT Presentation

Regional Health Improvement Plan Council

March 17, 2020

1

Meeting Objectives

• SWACH updates
• Learn about clinical transformation work

and P4P measures and advise for improvement

Review Meeting Minutes and Action Items

• Vote on Co-Chair
• Approve Minutes from

January meeting

SWACH Updates

• Key Updates
• Board and RHIP Ad Hoc Committee
• Legislative Luncheon and Session Recap

Partner Reporting

Overview

• Partner reporting
• Successes & barriers
• Examples
• Discussion

Organization Type # Clinical 18 Community Serving 7 Total 25

Partner Reporting

2A – Integration 2B – Care Coordination 3A – Opioid 3D – Chronic Disease

Project Type # Whole Person Care (WPC) 20 Community-Clinical Linkages (CCL) 22 Other 8

Quarterly Reports

• Milestone progress based on scope of work
• Success, barriers, technical assistance

Whole Person Care: Successes

Partnerships

• Creating opportunities for collaboration
• Finalizing MOUs, policies and procedures

Capacity building

• Hiring of staff
• Training
• Physical space

Leadership and staff engagement

• Buy-in, enthusiasm, collaboration towards common goal

Whole Person Care: Successes

Systems change & patient/client impact

• Increased access to services for clients
• Expanding types of services available
• Implementation or increased use of assessment and

screening tools

• Increased communication and coordination between
• rganizations

Community-Clinical Linkages: Successes

• Identifying new & strengthening relationships with

community partners

• Program piloting and implementation
• Expanding resources to community
• Increasing community engagement
• Aligning priorities

Other: Successes

• Increased buy-in and engagement of staff
• Increased capacity
• Implementing PreManage (CMT)
• Training
• Program implementation

Partner-Identified Barriers by Project in Q4

2 4 6 8 10 12 14 Workforce Financial Policy Partnership Technology WPC CCL Other

Examples

• Brief overview of project area(s)
• How has the work moved forward?
• What impact have you seen? (systems / outcomes)
• Key successes
• Challenges

Discussion

• How would RHIP like to see partner successes

captured and/or disseminated?

• What gaps and challenges can be addressed

by RHIP?

• Other questions?

Thank you!

Kim.lepin@ southwestach.org

P4P Measures

Measure SWACH Rate Statewide Rate 2019 Target 2020 Target

 Acute Hospital Utilization per 1000 Members 70.8 69.8

• 66.3

 All Cause ED Visits per 1000 MM: Ages 0-17 Years 25.9 34.2 28.2 26.1  All Cause ED Visits per 1000 MM: Ages 18-64 Years 53.4 66.4 52.9  51.8  All Cause ED Visits per 1000 MM: Ages 65+ Years 40.2 49.9 39.9  37.1 Antidepressant Medication Management: Acute 55.9% 50.7% 55.5% 56.2% Antidepressant Medication Management: Continuation 39.8% 36.2% 41.1%  40.9% Asthma Medication Ration: 5-64 Years 59.1% 52.9%

• 59.4%

Child and Adolescents’ Access to Primary Care Practitioners: 12-24 Months 95.6% 96.8% 95.0% 96.0% Child and Adolescents’ Access to Primary Care Practitioners: 25 Months-6 Years 84.0% 87.9% 85.0%  85.4% Child and Adolescents’ Access to Primary Care Practitioners: 7-11 Years 88.3% 92.3% 88.5%  88.9% Child and Adolescents’ Access to Primary Care Practitioners: 12-19 Years 88.4% 92.2% 88.4% 88.7% Comprehensive Diabetes Care: Eye Exam (Retinal) Performed 47.2% 44.1%

• 50.0%

Comprehensive Diabetes Care: Hemoglobin A1c Testing 83.7% 83.5% 83.8%  84.0% Comprehensive Diabetes Care: Medical Attention for Nephropathy 86.6% 85.9% 87.7%  86.3%

Pay-for-Performance (P4P) Measure Dashboard

Measurement Period: Apr 1, 2018 – Mar 31, 2019

17

Feb 2020

Data Sources

Measures are calculated using ProviderOne claims and enrollment data and

• ther administrative and

public health data sources. Measure performance and targets are provided by the Washington Health Care Authority via the Healthier Washington Measures Report.

Legend

Lower rate indicates better performance Current SWACH performance is worse than 2019 target



Measure SWACH Rate Statewide Rate 2019 Target 2020 Target

Follow-Up After ED for Alcohol and Other Drug Abuse or Dependence: 7 Days 25.4% 15.6%

• 25.3%

Follow-Up After ED for Alcohol and Other Drug Abuse or Dependence: 30 Days 33.0% 25.3%

• 34.8%

Follow-Up After ED for Mental Illness: 7 Days 53.4% 62.8%

• 57.9%

Follow-Up After ED for Mental Illness: 30 Days 68.3% 73.6%

• 73.9%

Follow-up After Hospitalization for Mental Illness: 7 days 63.7% 61.1%

• 70.0%

Follow-up After Hospitalization for Mental Illness: 30 days 80.6% 79.2%

• 86.4%

Medication Management for People with Asthma: 75%, 5-64 Years 41.8% 34.5% 37.7%

• Mental Health Treatment Penetration: 6-17 Years

67.0% 68.2% 67.8%  68.1% Mental Health Treatment Penetration: 18-64 Years 48.0% 49.9% 47.7% 48.9% Mental Health Treatment Penetration: 65+ Years 20.0% 36.6% 14.6% 13.3%  Patients Prescribed Chronic Concurrent Opioids and Sedatives 19.8% 19.7% 21.2% 19.7%  Patients Prescribed High-Dose Chronic Opioid Therapy: ≥50mg MED 31.9% 35.4% 27.1%  30.1%  Patients Prescribed High-Dose Chronic Opioid Therapy: ≥90mg MED 16.3% 17.1% 14.1%  15.6%

Pay-for-Performance (P4P) Measure Dashboard

Measurement Period: Apr 1, 2018 – Mar 31, 2019

18

Jan 2020

Legend Data Sources

Measures are calculated using ProviderOne claims and enrollment data and

• ther administrative and

public health data sources. Measure performance and targets are provided by the Washington Health Care Authority via the Healthier Washington Measures Report. Lower rate indicates better performance Current SWACH performance is worse than 2019 target



Measure SWACH Rate Statewide Rate 2019 Target 2020 Target

 Percent Homeless: 0-17 Years 0.4% 0.7% 0.5% 0.4%  Percent Homeless: 18-64 Years 4.3% 5.8% 3.7%  4.1%  Percent Homeless: 65+ Years 0.0% 1.3% 2.0% 0.9%  Plan All-Cause Hospital Readmission Rate (30 days) 12.0% 11.5% 11.1%  11.3% Statin Therapy for Patients with Cardiovascular Disease (Prescribed) 83.1% 82.3%

• 86.6%

Substance Use Disorder Treatment Penetration: 12-17 Years 39.7% 33.6% 37.2% 39.8% Substance Use Disorder Treatment Penetration: 18-64 Years 37.2% 35.8% 34.4% 37.9% Substance Use Disorder Treatment Penetration: 65+ Years 0.0% 6.7% 0.0% 0.0% Substance Use Disorder Treatment Penetration (Opioid): 18-64 Years 52.3% 54.0%

• 51.2%

Substance Use Disorder Treatment Penetration (Opioid): 65+ Years 0.0% 20.0%

• 0.0%

Pay-for-Performance (P4P) Measure Dashboard

Measurement Period: Apr 1, 2018 – Mar 31, 2019

19

Jan 2020

Legend Data Sources

Measures are calculated using ProviderOne claims and enrollment data and

• ther administrative and

public health data sources. Measure performance and targets are provided by the Washington Health Care Authority via the Healthier Washington Measures Report. Lower rate indicates better performance Current SWACH performance is worse than 2019 target



What are Pay-for-Performance (P4P) measures?

• ACH Pay-for-Performance (P4P) measures are a set of quality

measures, for which ACHs must demonstrate improvement

• HCA calculates ACH performance for P4P measures
• P4P results are calculated for the entire region, based on

Medicaid enrollee residence – they are not limited to Medicaid enrollees treated by partnering providers or participating in ACH projects

• P4P performance is measured annually, though current

performance data are shared quarterly

How are P4P measures tied to ACH funding?

• ACHs will earn a portion of their funding based on their performance on a set
• f P4P measures
• The portion of ACH funding tied to P4P measures increases throughout

Medicaid Transformation

2017 2018 2019 2020 2021 Percent of ACH project incentives tied to P4P 0% 0% 25% 50% 75%

How are P4P measures tied to ACH funding?

• Performance is measured based on progress toward Improvement Targets
• Improvement Targets are performance goals for each metric and associated sub-metrics,

and will change for each performance period or target year (TY)

• HCA determines Improvement Targets for each ACH
• To earn 100% of incentive funds, ACHs must meet or exceed their Improvement

Targets for P4P measures

• ACHs can earn partial credit - and a smaller portion of incentive funds - for making progress

towards an Improvement Target, even if they do not meet it

• The amount of progress an ACH makes toward P4P targets determines their Achievement

Value (AV)

AV = 0 AV = .25 AV = .5 AV = .75 AV = 1.0

0% 25% 50% 75% 100%

P4P timeline by target year (TY)

TY 2019 TY 2020 TY 2021 Baseline Year 2017 2018 2019 Targets published Q4 2018 Q4 2019 Q4 2020 Performance measurement period 2019 2020 2021 Performance data published Q4 2020 Q4 2021 Q4 2022 Funds determined and dispersed Q1 2021 Q1 2022 Q1 2023

More info about P4P measures

For more information about Medicaid Transformation Pay-for-Performance Measures:

• The DSRIP Measurement Guide describes how performance is measured for Accountable

Communities of Health: https://www.hca.wa.gov/assets/program/mtp-measurement- guide.pdf

• The Healthier Washington Measures Dashboard displays performance, trends, demographic

and regional breakouts, and progress toward targets for ACH P4P measures: https://fortress.wa.gov/hca/tableau/t/51/views/HealthierWashingtonDashboard/FrontPage

• Technical specifications for P4P measures are listed here: https://www.hca.wa.gov/about-

hca/healthier-washington/medicaid-transformation-metrics

• SWACH P4P data reports:

https://public.tableau.com/profile/providence.core#!/vizhome/SWACH/DataReports

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WHOLE PERSON CARE & HEALTH EQUITY

Clinical & community transformation

COMMUNITY HEALTHCONNECT

Continuum of community & clinical care coordination

COMMUNITY-BASED WORKFORCE SUPPORT & CAPACITY

Community leadership for health transformation

REGIONAL COLLABORATION & SHARED LEARNING

Learning, Action, Equity, and Sustainability

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SWACH P4P measures by focus area

SWACH P4P Measures Focus Area 1 Focus Area 2 Focus Area 3 Focus Area 4

Acute Hospital Utilization

X X

All-cause Emergency Department Utilization

X X

Antidepressant Medication Management

X

Child and Adolescent Access to Primary Care

X X

Comprehensive Diabetes Care: Eye Exam

X

Comprehensive Diabetes Care: HbA1c Testing

X

Comprehensive Diabetes Care: Kidney Screening

X

Follow-up after Discharge from ED for Alcohol / Other Drug Dependence

X

Follow-up after Discharge from ED for Mental Health

X

Follow-up after Hospitalization for Mental Health

X

Medication Management for People with Asthma

X

Mental Health Treatment Penetration

X X

Patients on High Dose Chronic Opioid Therapy

X

Patients with Concurrent Opioid / Sedative Prescriptions

X

Percent Homeless

X X X

Plan All-cause Readmission

X X

Statin Therapy for Patients with Cardiovascular Disease

X

Substance Use Disorder Treatment Penetration

X X

Substance Use Disorder Treatment Penetration (Opioids)

X X

Next Steps

• Upcoming meeting and events
• Email/call Brette with recommendations for

May meeting agenda

• Evaluation & Closing

Thank you!