2020 NRTRC TAO VIRTUAL CONFERENCE Northwest Regional Telehealth Resource Center and the Telehealth Alliance of Oregon Welcome You Bronze Sponsors: Exhibitors: Non-profit: Pacific Northwest University of Health Sciences University of Utah Health Clinical Neuroscience
VIRTUAL SESSION INSTRUCTIONS • Audio and video are muted for all participants • Use the Q&A feature to ask questions • Moderator will read questions to the speaker • Presentation slides are posted at https://nrtrc.org/sessions. Recordings will be posted after the conference.
Access To Care Via Telehealth: An Accountable Care Organization Examines Application of Telehealth Services in a High Poverty, Transient Population • Moderator: Rose Locklear • Presenter: – Michelle Hager, Managing Partner, Blue Cirrus Consulting
Telehealth Strategy: Bridging the Access to Care Gap through Partnership and Collaboration NRTRC Virtual Conference April 2020 1
My Care Family Main Service Area Communities in Massachusetts Lawrence • Methuen • Haverhill • Lowell • Andover • North Andover • NRTRC Virtual Conference April 2020 2
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Primary Care Hospital Partners Partner GLFHC Lawrence GLFHC Main Site GLFHC North Site High School Lawrence General Hospital GLFHC West Site Methuen Site GLFHC Greater Lawrence Technical School Lawrence Family Medicine Residency GLFHC South Site GLFHC Community based Center NRTRC Virtual Conference April 2020 4
About My Care Family u ACO Partners Greater Lawrence Family Health Center • Lawrence General Hospital • Neighborhood Health Plan > Allways Health Partners • u Care Team 130 Primary Care Physicians/16 practices • Nurse Care Manager(s) • Clinical Pharmacist • Social Worker(s) • Social Care Manager(s) • Community Health Worker(s) • Population Health Manager • u Patient Population: 33,880 +/- Medicaid patients • NRTRC Virtual Conference April 2020 5
MVACO Member Data ACO Membership in Membership Age Gender Service Area 0 to 12 Member mo 12% 3% 22 to 1 to 17 Male 64 yr yr 44% Female Non- 47% 42% 56% Member 18 to 88% 21 yr 8% Service Area Pop = 276,263 Risk Stratum Race High 5% Unknown Rising 19% 19% Non-Hispanic 11% Low Hispanic 76% 70% NRTRC Virtual Conference April 2020 6 Approximate percentages
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Patient Population Transportation - Lack of easy access to transportation options u Language - 70% Hispanic (multiple dialects, primarily Dominican Republic) u Culture - Traditionally seek primary care at hospital/ED u Homelessness - Transient population/ displaced by explosions u Illegal Housing - High cost of housing/shared domiciles u Fearful of Immigration enforcement Aversion to video due to status u Communication - Lack of access: cell phone, mail, computer, etc u NRTRC Virtual Conference April 2020 9
Current Telehealth Programs Meeting My Care Family’s Program Interaction Needs Medication therapy management to improve Current downstream cost and utilization, continuity of Telepharmacy Provider-to-Patient care and quality, and patient engagement and self-efficacy Advisory consults, educational sessions and Current Provider-to-Provider mentoring in Dermatology, Rheumatology, MAVEN Project Provider-to-Patient Endocrinology, Urology, Allergy and Gastroenterology NRTRC Virtual Conference April 2020 10
My Care Family ACO Goals Goal 1 Reduce total cost of care u Goal 2 Integrate providers and their services across the continuum of care for MVHP members u Goal 3 Integrate information systems across the continuum of care in the MVHP u Goal 4 Increase patients’ active involvement in their care, including goal-setting for their personal u health and by expanding use of qualified interpreter services among MVHP providers Goal 5 Develop a new system to manage the measurement, reporting and tracking of quality u measures across the continuum of care in order to set focused quality improvement targets based on gaps compared NRTRC Virtual Conference April 2020 11
The MyCareFamily/Telehealth Consulting Team My Care Family u u Andrea Sullivan – Chief Executive Officer u Patrick Grotton – Chief Information Officer u LaShaun Shaw – Director of Operations Telehealth Consulting Team u u Managing Partner u Operations Director u Sr. Telehealth Consultant/Team Lead u Sr. Telehealth Clinical Consultant/Quality Assurance u Sr. Management Technical Consultant u Business Analyst NRTRC Virtual Conference April 2020 12
Project Overview NRTRC Virtual Conference April 2020 13
Clinical Priorities My Care Family Stakeholder Feedback - k o o l r e e d s o i l l s C t x e n Provider-to-Provider 28% Physician to specialist access • Provider-to-Patient Provider-to-Provider 15% Chronic disease management • Provider-to-Patient 13% Access to primary care providers Provider-to-Patient • 13% Access to Care Patient-to-Provider • 13% Coordination of Care / Transitions of Care Provider-to-Provider • 8% Triage / follow-up (home, homeless shelter, other) Provider-to-Patient • 8% Decrease no show Patient-to-Provider • 5% Community Outreach Provider-to-Patient • NRTRC Virtual Conference April 2020 14
Clinical Priorities Access to Specialists When Needed - Detail 29% Behavioral Health • 16% • Dermatology 15% Endocrinology • 9% Neurology Pediatrics • • 7% • Rheumatology • Cardiology 4% Hematology • • Emergency Department 2% Nephrology • Infectious Disease • NRTRC Virtual Conference April 2020 15
What We Heard from MCF - Challenges Convincing physicians of value /… 16% Patient acceptance / education 14% Staffing 11% Lack of technology in community 11% Funding 6% Sustainability of program 6% Reimbursement 6% Lack of coordinated effort / strategy 6% IT Ability to deliver / integration 5% Undefined marketing / messaging… 5% Lack of skillset/Education/Experience 5% Competing corporate initiatives 3% Device Technology 3% Credentialing 2% 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% NRTRC Virtual Conference April 2020 16
Legislating Telehealth Telemedicine Parity Law Partial Parity Law Proposed Parity Bill No Parity Legislative Parity Laws require that insurers reimburse telehealth providers Activity exactly as they would for an in-person visit. As it stands, 29 states and the District of Columbia have parity Laws. NRTRC Virtual Conference April 2020 17
ACO () SWOT Analysis: Organization ACO Partner (orange) • TH not directly mapped to vision, mission & strategic plan • Executive Leadership support • TH Governance still forming • Organizational excitement about Telehealth • Lack of some physician specialty resources • TH roadmap and strategic plan being developed • No system wide EMR • Strong primary care footprint in region • Unclear definition of patient risk stratification • Clinical Learning environment – high resident usage • TH funding unclear* • High usage of mid-level care (practice at top-of-license) • Organizational growing pains • PCPs providing widespread services • GLFHC 2 nd largest clinic in state • Approval process for new programs unclear • ACO leaders TH vision still in development • Eager to pilot TH programs in clinics • Exec leaders @ clinics lack consensus • TH Governance forming Strengths Weaknesses • Community practices small in size • MCF works with 13 home health agencies • Meeting requirements of ACO • Expand culturally appropriate participation translation capacity Opportunities Threats • Keeping patients in network • Expand access to patients • Hard to contact patients • Telehealth outreach to community partners • No MassHealth Reimbursement for TH* • Expand access for homeless patients • Members numbers constantly changing • Expand access to specialists • Communication and consistency in provision of • Providers receptive to Telehealth care between multiple care providers and care • Expand Care Coordination among care teams teams • Improve patient compliance • Members afraid of video due to Immigration Services • Pilot TH program at Haverhill: largest site NRTRC Virtual Conference April 2020 18
Decision Model Blueprint CHNAs Corporate and Strategy Analysis Telehealth Programs Cost and Onsite Competition Surveys NRTRC Virtual Conference April 2020 19
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