Date and Time 8/29/2017, 9:00 10:00AM Meeting Title NYP PPS Finance Committee. Conference Line. Invitees

Transcription

1 DSRIP Meeting Agenda Date and Time 8/29/2017, 9:00 10:00AM Meeting Title NYP PPS Finance Committee Location Go to Meeting Milstein Hospital Building, 177 Fort Washington Avenue, Heart Center Room 3 oin/ Facilitators Conference Line David Grayson & Jeremy Arnold United States +1 (872) Access Code: Co-Chair: David Grayson (Calvary) Michael Ashby (1199 SIEU) Rob Basile (Metropolitan Center for Mental Health) Carol Cassell (ArchCare) Dan Del Bene (SPOP) Jay Gormley (MJHS) Isaac Kastenbaum (NYP) Invitees NYP Co-Chair: Jeremy Arnold Judy Hederman (The Alliance for Positive Change) Hanny Hillal for Elan Katz (QuickRx) Carolyn Wiggins (Fort George Community Enrichment Center) Steve Zhou (Village Care) Andrew Missel (NYP) Meeting Objectives Facilitator Time Start End Welcome, Roll Call & Updates David Grayson & Jeremy Arnold 5 min 9:00 9:10 Presentation by Adult Medicine Population Line Dr. Elaine Fleck, Felicia Blaise, 35 min 9:10 9:45 Julie Chipman, Josh Choe Check-In on Participation Incentive Program & Overview of Projected Payments Andrew Missel 10 min 9:45 9:55 Notes for Review of July PPS Budget Report Andrew Missel 5 min 9:55 10:00 Next Steps a. Crosswalk of Annual Budget/Expense to Projected P4P Performance Andrew Missel 0 min Action Items Description Owner Start Date Due Date Status Model scenarios w/ GNYHA tool: 1) if P4P perf improves; 2) if P4P perf stays flat Pop Line budget modeling: 1) Which project budgets incr/decr from DY2 to 3?; 2) What if admin costs were spread evenly across DY3 Pop Line budgets? Isaac Kastenbaum Isaac Kastenbaum 6/9 9/15 In-Progress 6/9 9/15 In-Progress Page 1 of 1

2 Adult Population Line PPS Finance Committee Meeting August 29,

3 Population Line Team Members Adult Population Line Elaine M. Fleck, MD, MPH Associate Chief Medical Officer, NYP Ambulatory Care Network Felicia Blaise, MPH, MA Manager, Integrated Delivery System Development Julie Chipman, LCSW, MPA Manager, Integrated Delivery System Development Joshua Choe, MPA Panel Management Coordinator Andrew Missel, MPH Manager, Strategy & Project Management 2

4 Agenda 1. Population Line Strategy & Scope 2. P4P Metrics Overview 3. P4P Metrics Data of Interest 4. Quality Improvement Successes & Challenges 5. Population Line Collaborator Engagement 6. Population Line Finances 7. Population Line NYS Project Requirements 8. Next Steps 3

5 Population Line Strategy & Scope: Adult Population Line Population Line Strategy (4/1/ /31/2017) Establish a replicable quality improvement framework. See charter for specific goals.* Scope of the Population Line Internal Medicine Interdisciplinary Rounds (IDT) Palliative Care Tobacco Access to Primary/Ambulatory Care Behavioral Health 4

6 NYP PPS Approach to Supporting the Shift to P4P The approach has shifted to utilize infrastructure for optimal performance Sustain the Effort Implementation Ongoing performance tracking VBP Strategy & Data Quality improvement Care coordination PPS-supported staff Improved Integration Integrate Population Lines Identify Internal and External Data Gaps NYP internal + committee integration NYP integration with community partners DRAFT 5

7 2017 Quality Improvement Goal for Adult Medicine Improve performance on select metrics by 10% Select Metrics Access to Preventive or Ambulatory Care Visit in Last Year Cervical Cancer Screening Chlamydia Screening Adherence to Antipsychotic Medications for People with Schizophrenia Antidepressant Medication Management Cardiovascular Monitoring for People with CVD and Schizophrenia Diabetes Management for People with Schizophrenia or Bipolar Disease Follow-Up Care for Patients on ADHD Medications 6

8 Performance Metric Focus Access to Care Metric Unit of Measurement MY3 Goal Current Performance On-Track to Meet MY3 Target? Status of Intervention Adults w/ Preventive or Ambulatory Care Visit in Last Year - 20 to 44 years Adults w/ Preventive or Ambulatory Care Visit in Last Year - 45 to 64 years Adults w/ Preventive or Ambulatory Care Visit in Last Year - 65 and older Percentage 84.6% 83.4% No Intervention Percentage 92.8% 92.1% No Intervention Percentage 92.1% 92.1% Yes Intervention Key Take-Away(s): 1. Higher percentage of older adults (45+ yo) receive annual PCP visits vs. younger adults (20-44 yo). 2. If Measurement Year 3 ended at this point, PPS would not meet targets for 2 of 3 metrics. Data are current as of: 12/31/2016. Source: NYS (MAPP), accessed 08/09/

9 Prct. Adults yo w/ PCP Appointment in Past 12 mo In CY2016, Performance on Adult Access to PCP (20-44 yo) Backslid from CY2015 Performance & Remains Below Target Measurement Year 2 Measurement Year 3 Key MY3 Target CY2016 Trend CY2015 Trend Month, Year Data are current as of: 12/31/2016. Source: NYS (MAPP), accessed 08/09/

10 Performance Metric Focus Medical Management Metric Unit of Measurement MY3 Goal Current Performance On-Track to Meet MY3 Target? Status of Intervention Cervical Cancer Screening Percentage 70.3% 68.3% No Intervention Chlamydia Screening (16-24 Years) Cardiovascular Monitoring (LDL-C Test) for People with Cardiovascular Disease and Schizophrenia Diabetes Monitoring (Both LDL-C Test & HbA1c Test) for People with Diabetes and Schizophrenia Percentage 75.1% 75.3% Yes Intervention Percentage 61.7% 50.0% No Planning Percentage 60.4% 64.9% Yes Planning Key Take-Away(s): 1. Chlamydia screening rates improved since PPS shift to focus on performance metrics (March 2016). 2. Low performance on cervical cancer is possibly due to documentation/billing issues. 3. Largest gap: Disease management for people with CVD and Schizophrenia. 4. Program for behavioral health intervention still in development phase (Planning). Data are current as of: 12/31/2016. Source: NYS (MAPP), accessed 08/09/

11 Provider Education / Specific Information Through Goal Screen and monitor patients with co-diagnosed diabetes and/or schizophrenia and/or bipolar disorder by 6/31/2017 (AHRQ metric). Change 1. Place a pending order NOW for hemoglobin A1C +/- lipid profile for the following patient(s); 2. Ask patients to check labs when you are next scheduled to see them. PCP Lerner, Benjamin Andrew Malhotra, Sujata Nussdorf, Amanda Oriel MRN PT LAST NAME PT FIRST NAME DATE LAST A1C DATE LAST PCP VISIT xxxxxxxx B L 7/8/2016 DATE NEXT PCP VISIT xxxxxxxx C J 3/23/2016 2/17/2017 4/19/2017 xxxxxxxx D E 4/11/ /20/

12 Hardwiring Quality Flags into Provider IT Tools inyp Dashboard Used to display general preventative care tests in one place. Does your organization have quality flags from these same metrics? Cervical Cancer Notification Chalmydia Notification 11

13 Population Line Status Update Adult Population Line Successes Development of access proposal for NYP access center CHW integration for High Risk Patients Hiring Health Priority Specialist for population health efforts Integration of outside health home organization into patient care setting Agreement for end to end quality improvement process. Challenges West campus NYP focused Expansion of CBO s Maximizing the roles of the physician champions 12

14 Population Line Collaborator Engagement Adult Population Line Current Engagement Efforts Charles B. Wang Discovery of phase of meeting with them in the Lower Manhattan Campus to engage the community in tobacco cessation services. Partnering with CBO s for Education: Tobacco Integrating CBO s into Interdisciplinary Efforts Future Engagement Efforts Community Health Network FQHC. 13

15 Population Line Budget Review (DSRIP Year-To-Date) New York and Presbyterian Hospital PPS DSRIP Year 2 YTD Budget vs. Expenses As of June 1, 2016 Budgeted YTD Expense Variance NYP Salary + Fringe $ 150,000 $ 12,000 $ 138,000 OTPS $ 45,000 $ 3,600 $ 41,400 NYP Total $ Committee 195,000 $ 15,600 $ 179,400 Budgets on-hold until approved by PPS Finance Collaborator Expense $ 85,000 $ 1,000 $ 84,000 Collaborator Total $ 85,000 $ 1,000 $ 84,000 Total $ 280,000 $ 16,600 $ 263,400 14

16 Adult Population Line Next Steps Education For Clinicians Palliative Care Goals of Care Advance Care Planning Having Difficult Conversations Tobacco Cessation Leverage IT Tools such as Alerts; Automatic Reminders Maximize IDT Rising Risk Quality Improvement Retreat Integrating metrics Mass Mailing for Tobacco Cessation Education Reminders 15