REGION 10 RHP PUBLIC HEARING. December 12, 2012

Transcription

1 REGION 10 RHP PUBLIC HEARING December 12, 2012

2 WELCOME Robert Earley, CEO, JPS Health Network 12/12/2012 2

3 1115 WAIVER OVERVIEW David Salsberry, CFO, JPS Health Network 12/12/2012 3

4 Please refer to webinar posted on Nov. 7, 2012 for an overview of the 1115 waiver and the Region 10 RHP. 12/12/2012 4

5 TEXAS WAIVER PARTICIPATION 12/12/2012 5

6 12/12/2012 6

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12 REGION 10 RHP OVERVIEW 12/12/

13 Performing Providers - DSRIP Hospitals JPS Health Network Baylor All Saints Cook Children s Children s Medical Center of Dallas Ennis Regional Glen Rose HCA Medical Center of Arlington North Hills Hospital Plaza Medical Center Fort Worth Methodist Mansfield Texas Health Harris Arlington Memorial Azle Cleburne Fort Worth Huguley Hurst Euless Bedford Southwest Fort Worth Stephenville Wise Regional Mental Health Lakes Regional Pecan Valley Helen Farabee MHMR Tarrant County Other Tarrant County Public Health University of North Texas Health Sciences Center Physician Groups JPS Health Network Physician Group Wise Clinical Care Associates 12/12/

14 REGION 10 RHP DSRIP PROJECTS Allen Miller, CEO, COPE Health Solutions 12/12/

15 Total number of projects and outcomes Category 1 and 2 projects: 112 Category 1 Infrastructure development projects: 38 Category 2 Program Innovation and Redesign projects: 74 Category 3 Quality Improvement Outcomes: /12/

16 Community Health Needs 12/12/

17 Major Areas of Community Need Capacity -Increase capacity in primary and specialty care Access -Eliminate or reduce barriers to access Delivery Transformation -Change the manner in which health care is delivered Population Health -Improving health and wellness of the region through cooperation among providers 12/12/

18 Community Need - Capacity More provider capacity (CN.1) More primary care and specialty care services (CN.2 and CN.3) More mental health services access (CN.4) More dental care access (CN.6) More geriatric, long-term care, and home health resources (CN.9) 12/12/

19 Region 10 DSRIP Transformation Pass 2 and 3 projects addressing Capacity needs New Interventions in Pass 2 and 3 Develop crisis stabilization services for mental health patients Improve and standardize medical procedures Establish consultative palliative care program and pain management Establish depression/trauma consulting center Expand Substance Use Disorder Program Establish TB Clinic Expand Family Medicine residency program Community based behavioral health care for elders New Outcome Measurements in Pass 2 and 3 Average length of inpatient stay Preventable hospital-acquired complications Pain management Pain related ED utilization and admission TB treatment completion rate Number of future physicians working in HPSA or MUA Pediatric asthma ED utilization rate Participating Providers Children s Medical center of Dallas Glen Rose Medical Center Helen Farabee JPS Hospital JPS Physician Group Lake Regional MHMRTC Pecan Valley Tarrant County Public Health UNTHSC Wise Clinical Care Associates Wise Regional New Regional Project Impacts by 2016 Reduce average length of inpatient stay for targeted population Reduce incidents of preventable hospital-acquired complications Increase number of documented pain screening and intervention Reduce pain related ED utilization and admission Increase TB treatment completion rate Increase number of future physicians working in HPSA or MUA for at least 5 years Reduce pediatric asthma ED utilization rate Capacity Projects by County County Wise Tarrant Somervell Parker Navarro Johnson Hood Erath Ellis Pass Pass Pass More to do Dental care capacity Geriatric, and long-term care capacity Total /12/2012 Total number of projects that address or partially address Capacity needs: 69 19

20 Community Need - Access Reduce geographic barriers that impede access to care (CN.7) Improve healthcare access for residents facing financial barriers (CN.8) 12/12/

21 Region 10 DSRIP Transformation Pass 2 and 3 projects addressing Access needs New Interventions in Pass 2 and 3 Expand service hours Implement pediatric disease management program Establish school-based health care Establish TB clinic Community based behavioral health care for elders Implement pain management program New Outcome Measurements in Pass 2 and 3 Pediatric asthma ED utilization rate Pediatric asthma ED utilization Pediatric asthma readmission rate ED utilization and admission for pain TB treatment completion rate Participating Providers Children s Medical Center of Dallas Helen Farabee JPS Hospital JPS Physicians Group Pecan Valley Tarrant County Public Health UNTHSC New Regional Project Impacts by 2016 Reduce pediatric asthma ED utilization rate Reduce pediatric asthma ED utilization Reduce pediatric asthma readmission rate Reduce ED utilization and admission for pain Increase TB treatment completion rate Access Projects by County County Wise Tarrant Somervell Parker Navarro Johnson Hood Erath Ellis Pass Pass Pass More to do Reduce Geographic barriers Reduce Financial barriers Total /12/2012 Total number of projects that address or partially address Access needs : 36 21

22 Community Need Population Health More access to healthy foods (CN.14) More education, resources to promote a healthy lifestyle (CN.15) Reduce incidence rates of syphilis and chlamydia (CN.16) Improve management of Varicella (Chicken pox) (CN.17) Improve management of Pertussis (Whooping cough) (CN.18) Improve Public Health Bio surveillance (CN.20) Reduce tuberculosis (TB) prevalence (CN. 21) 12/12/

23 Region 10 DSRIP Transformation Pass 2 and 3 projects addressing Population Health needs New Interventions in Pass 2 and 3 Implement pediatric disease management program Implement school-based health care New Outcome Measurements in Pass 2 and 3 Pediatric asthma ED utilization and admission Pediatric asthma readmission Participating Providers Children s Medical center of Dallas Glen Rose JPS Hospital Tarrant County Public Health UNTHSC New Regional Project Impacts by 2016 Reduce pediatric asthma ED utilization and admission Reduce pediatric asthma readmission County Ellis 12/12/2012 Erath Population Health Projects by County Hood Johnson Pass Pass Pass Total Navarro Total number of projects that address or partially address Population Health needs: 13 Parker Somervell Tarrant Wise More to do More access to healthy foods More education on healthy lifestyles Lower rates of communicable disease 23

24 Community Need Delivery Transformation Integrate mental healthcare in primary care system (CN.5) Reduce emergency department (ED) services (CN.10) More coordination of care between providers (CN.11) More culturally competent care to address needs (CN.12) More patient education programs (CN.13) More early prenatal care (CN.19) Improve health IT infrastructure (CN. 22) 12/12/

25 County Region 10 DSRIP Transformation Pass 2 and 3 projects addressing Delivery Transformation needs New Interventions in Pass 2 and 3 Develop crisis stabilization services for mental health patients Implement pediatric disease management program Improve and standardize medical procedures Establish consultative palliative care program and pain management Establish depression/trauma consulting center Develop care model with outcome-based payments Expand Substance Use Disorder Program Establish TB Clinic Community based behavioral health care for elders Implement maternal medical homes and pregnancy programs Ellis 12/12/2012 New Outcome Measurements in Pass 2 and 3 Preventable hospitalacquired complications Pain management Pain related ED utilization and admission Cost of care delivery TB treatment completion rate Pediatric asthma ED utilization rate Participating Providers Delivery Transformation Projects by County Erath Hood Johnson Children s Medical Center of Dallas Glen Rose HCA Hospitals Helen Farabee JPS Hospital JPS Physicians Group Lake Regional MHMR Tarrant County Pecan Valley Center Tarrant County Public Health UNTHSC Wise Clinical Care Associates Wise Regional Pass Pass Pass Total Navarro Total number of projects that address or partially address Delivery Transformation needs: 89 Parker Somervell Tarrant Wise New Regional Project Impacts by 2016 Reduce preventable hospitalacquired complications Improve patient pain management Reduce pain related ED utilization and admission Improve quality of care delivery while reducing unnecessary cost Improve TB treatment completion rate Reduce pediatric asthma ED utilization rate More to do Integrate Mental Health and Primary care Improve cultural competency More patient education Earlier prenatal care 25

26 Learning Collaboratives 1) Access to and Capacity for Behavioral Health Care, including integration with primary care 2) Care Transitions and Patient Navigation 12/12/

27 POTENTIAL FINANCIAL IMPACT ON REGION 10 RHP 12/12/

28 DSRIP Project Funding Highlights DSRIP funding is not block grant based but determined on a federal matching fund mechanism Allocations of DSRIP funding are driven by Program and Funding Protocol and not by the anchor facility DRSIP funding requires a qualifying local government entity to commit and provide an Inter-Governmental Transfer (IGT) Project valuation was determined in Region 10 based upon a valuation model that included significant vetting and participation by RHP participants Ultimate payment is dependent on performing provider performance on DSRIP milestones and outcomes 12/12/

29 Delivery System Reform Incentive Payment Community needs assessment is conducted to identify areas of opportunity to improve health in each county within a region. The participating providers use the assessment to inform the selection of DSRIP projects. Payment from the DSRIP pool is contingent on outcomes achieved within designated time periods. 12/12/

30 Potential DSRIP Funds Region 10 Gross DSRIP Allocation * Required IGT ** Net Potential DSRIP Funds Waiver Year 1 (DY1) Waiver Year 2 (DY2) Waiver Year 3 (DY3) Waiver Year 4 (DY4) Waiver Year 5 (DY5) $48.7M ($20.3)M $28.4M $224.1M ($93.6)M $130.5M $259.7M ($108.5)M $151.2M $277.8M ($116.1)M $161.7M $302.0M ($126.2)M $175.8M Total $1.1B ($464.7)M $647.6M * Statewide totals approved in the 1115 Waiver ** current FMAP rate 12/12/

31 NEXT STEPS 12/12/

32 Region 10 RHP Development Timeline Final Region 10 RHP Plan submission with Pass 1, 2 and 3 Projects Week of Dec. 17, 2012 HHSC deadline for final RHP Plan submission with all required documents Dec. 31, 2012 HHSC 30-day formal review Following date of full plan submission CMS 45-day formal review Following receipt of approved plans from HHSC CMS approval or denial of RHP plans May 1, 2013 or 15 days after receipt of revised plan 12/12/

33 FEEDBACK AND COMMENTS 12/12/

34 Contact information Website: 12/12/