Stakeholder Advisory Committee DHCS CCS Demonstration Update - - PowerPoint PPT Presentation

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Stakeholder Advisory Committee DHCS CCS Demonstration Update - - PowerPoint PPT Presentation

Stakeholder Advisory Committee DHCS CCS Demonstration Update April 23, 2012 CCS Demonstration Purpose Test innovative health care delivery models for transforming health care services for children with CCS conditions Objective Identify the


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SLIDE 1

Stakeholder Advisory Committee DHCS

CCS Demonstration Update April 23, 2012

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SLIDE 2

CCS Demonstration

Purpose

Test innovative health care delivery models for transforming health care services for children with CCS conditions

Objective

Identify the model or models that will result in a well-integrated, coordinated and value- based health care delivery system

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Demonstration Models

Existing Medi-Cal Managed Care Plans Enhanced Primary Care Case Management Specialty Health Care Plan Provider Based Accountable Care Organization

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Core Program Requirements

  • Family Centered Care
  • Comprehensive Care (no carve out)
  • Scope of Services
  • Enrollment
  • Consumer Protections
  • Evaluation Participation
  • Maintaining regionalized provider network
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SLIDE 5

Challenges to Start Up

  • Acceptance of Reimbursement

Rates

  • Ability to Meet All Readiness

Requirements

  • CMS Approval of Contracts
  • Data Sharing
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SLIDE 6

Project Evaluation

  • Improvement in care coordination
  • Improvement in quality of care
  • Reduction in rate of growth in spending
  • Improvement in the value or cost effectiveness of care
  • Improvement in patient and family satisfaction
  • Improvement in provider satisfaction
  • Change in the distribution of mix of services (reduction in

ER and inpatient services and increased use of community based services)

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SLIDE 7

Project Evaluation

UCLA Center for Health Policy Research CCS Evaluation Advisory Committee Evaluation Collaboration with each model

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SLIDE 8

Questions?