TOOLS AND RESOURCES Allison Silvers, MBA Vice President, Payment - - PowerPoint PPT Presentation

REVIEW OF ACCELERATOR TOOLS AND RESOURCES

Allison Silvers, MBA Vice President, Payment & Policy Center to Advance Palliative Care

Accelerator Class 2018-9 Webinar March 8, 2019

Link to Webinar Recording

Webinar Recording: How to Use Accelerator Tools Click on the link above to access the recording of the webinar for these slides.

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Accelerator Action Items

1.

Answer Poll Question in Webinar: Please identify a specific topic or challenge as you seek out financial partners that you would like addressed during the program check-in session (on 3/22). Responses will be collated and shared with the facilitator to inform the session.

2.

Complete this survey (progress report) by March 13th

– Deadline extended from 3/7 to 3/13 – Expected completion time: 3 minutes

3.

Register for the Accelerator-exclusive Program Check-in

• n March 22nd

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Thank k you to those e who have e comple leted ted these e action tion items ms!

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26 tools and resources for organi- zations in the 2018 CAPC Payment Accelerator class

Organization of resources

➔Program Adaption: Tools to help you “play

with” staffing and patient visit changes

➔Business Partnerships: Tools for showing

your value, making your pitch, and building partnerships

➔Financing: Tools to help understand how

payment works and how to develop a price

➔Target Measures: Suggest quality measures

for pitches and contracts; cost benchmarks

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Organization of resources (cont’d)

➔Managing Populations: Tools to find

appropriate patients and risk-stratify them, using both data and clinical relationships

➔Contracting and Legal: Tools for your lawyers

to use! Plus guidance on regulatory/licensure issues and on hiring lawyers and actuaries

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A CLOSER LOOK AT A FEW . . .

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➔ Suggestions on what to present when you meet with a

potential financial partner

➔ Prompts the basics:

– What is palliative care, and what are its benefits – Existing slides of published literature – Patient story – Introduction of organization, and of program

➔ Prompts articulation of your program’s unique

advantages

– What data to gather

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➔ Who pays you now? Who refers to you now? ➔ How do you compare to competitors and potential

competitors?

➔ What local organizations are “hurting” now

– Hospitals with Medicare re-admission penalties (look through www.medicare.gov/hospitalcompare/readmission- reduction-program.html) – Hospitals with fewer than 3 Stars (look through www.medicare.gov/hospitalcompare/search.html)

➔ Who’s pursuing value in your area?

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CMMI: Where Innovation is Happening

➔https://innovation.cms.gov

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➔ Understanding how your

program design impacts your costs

➔ Modifying your program

design and determining the impact on costs

➔ Turning costs into prices

for negotiation

➔ Yes, this tool is complicated ➔ Yes, it has spreadsheets ➔ Resources to help:

– Instruction Guide – Example Workbook – Webinar Recording of “Deep Dive into Understanding Costs”

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➔Document that lays out “who does what” in

a pilot partnership

– Can be the only document for a long-term relationship as well

➔Prompts for each section ➔Gives your lawyer a starting point

– Don’t try this at home!

➔Raises the cautions of potential

compliance issues

– Delivering home-based care – Anti-Kick-Back Statute – Stark Law

➔Gives your lawyer a starting point

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➔ Enrolling patients without relying solely on

referrals!

– How to find appropriate patients – How to introduce your services to patients and families – How to coordinate and build relationships with treating clinicians

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➔Advice on:

– Choosing a video platform – Preparing patients for video visits (sample scripts) – Do’s and Don’t’s – Billing considerations

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➔Emerging model of small monthly payment

for home-based care – how to make it work?

➔Existing ratios for MDs, NPs, RNs, SW, and

• thers

➔Considerations for developing a cost-

conscious staffing model

➔ We work with a very

high-cost population and we can’t make them low- cost

➔ These benchmarks show

how high a total cost of care really is for seriously ill patients

➔ This data is not easy to

get!

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Payment Primer and Glossary

➔Starts with the basics of how payment for

health care works in the US

– How health plans work – What incentives are at play

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But wait, there’s more . . .

• First Program Check-in on March 22nd (in 2 weeks)
• Learn from your peers and discuss what is working, what is/has been

challenging, how colleagues have overcome similar challenges

• Stay connected, leave with new ideas

Program Check-in (Quarterly Convening)

• Managing Populations on May 21st
• How to use data to find the right patients, successfully bring them on

program, and work with treating providers by developing clinician relationships

Accelerator-Exclusive Webinar

• Introductory email will be sent no later than March 12th
• Stay up to date! Reminders for upcoming Accelerator-exclusive events
• Opportunity for peer support and discussion

Accelerator listserv

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CAPC MEMBERS: Don’t forget to take advantage of membership offerings and benefits as well! (Webinars, VOH, Toolkits)

Accessing the Accelerator Tools

➔ DropBox and BaseCamp

– Email Seema.Setia@mssm.edu to have your email address added to the Dropbox folder and Basecamp site – This enables access to any new materials and updates

➔ Email ZipFile (last resort)

– Email Seema and request file – Caveats:

• No access to any new materials or updates
• Large file may not make it past your organization’s firewall

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Questions?

Please type your question into the questions pane

• n your WebEx control panel.