NYP Queens PPS PAC Meeting. March 19, 2018

Transcription

1 NYP Queens PPS PAC Meeting March 19, 2018

2 Agenda 1. Welcome 2. DSRIP Updates - Key Upcoming Dates - NYS DOH Announcements 3. PPS Updates - PMO Staffing - Medical Record Review - MY3 Performance - Process Improvement 4. Clinical Project Updates 5. Questions 2 NYP/Q PPS PAC Meeting

3 NYP Queens PPS PAC Meeting DSRIP Updates 3

4 DSRIP Updates Key Dates March 3/22: Executive Committee Meeting 3/27: EMR and Data Usage Standing Committee 3/28: NYPQ DSRIP Finance Committee Meeting 3/28: PPS VBP Training for PCPs VBP 102 NYS roadmap 3/31: DY3 Q4 Ends April 4/1: DY4 Begins 4/30: DY3, Q4 MAPP Reports Due 4/30: 2018 Cultural Competency Training Sessions (GNYHA) 4 NYP/Q PPS PAC Meeting

5 DSRIP Updates NYS DOH Announcements NYS Medicaid Director, Jason Helgerson s resignation will be effective on April 6 th Departure will have no impact on DSRIP, VBP or MRT Donna Frescatore has been selected as the new Medicaid Director Statewide consumer education campaign 2018: A DSRIP Special Terms and Conditions governing requirement Selected vendor - New York Academy of Medicine (NYAM) Medicaid Spending growth in spending is at or below the target rate NYAM will be responsible for designing a state-wide research strategy, conducting focus groups consisting of Medicaid and uninsured populations, testing healthcare messages, and reporting to the Department of Health with recommendations for launching a state-wide education campaign on DSRIP principles. VBP Measurement Year 2018 Quality Measure Sets: MAP FIDA PACE 5

6 NYP Queens PPS PAC Meeting PMO Updates 6

7 PPS Updates PMO Workforce PPS PMO has recruited and filled the following positons; New Team Members/Roles: 1 Nurse Practitioner - Palliative Care and Readmission initiatives 1 Care Coordinator Palliative and Ambulatory 2 Patient Navigators - Hospital/Ambulatory and Post-Acute Care PMO will adapt existing roles in order to support: Improved quality measures Population Health Management Process Improvement and Rapid Cycle initiatives 7

8 PPS Updates Medical Record Review DOH Medical Record Collection and data abstraction is set to complete March A final report of the PPS MY3 results against the annual improvement targets will be released. PPS Reported Measures: o o Screening for Clinical Depression and Follow Up Plan Controlling High Blood Pressure Current Dashboard view (2018) Measure: NY Screening for Clinical Depression and Follow Up Plan Benchmark Indicator Benchmark Rate Current Rate Additional Hits Needed NYPQ MY2 Result Overall Numerator above target NYPQ MY3 Annual Improv Target Overall Numerator above target NYPQ Perf Goal Overall Numerator needed Measure: HEDIS Controlling High Blood Pressure Benchmark Indicator Benchmark Rate Current Rate Additional Hits Needed NYPQ MY2 Result Overall above target NYPQ MY3 Annual Improv Target Overall above target NYPQ Perf Goal Overall needed 8

9 PPS Updates Scorecard/Dashboard Available Measurement Year 3 Month 11 of 12 (06/ /2017) Results 9

10 PPS Updates MY3 2.a.ii Measure Results 10

11 PPS Updates AV Scorecard DY3, Q2 (7/17-9/17) 11

12 PPS Updates DRAFT Quality Committee Updates As DSRIP (Delivery System Reform Incentive Payment Program) program moves from pay for reporting to pay for performance the PPS is adapting a new governing structure to align focus to quality performance improvement to maximize funding to the network. The network is accountable for improvements to over 70 quality metrics by the conclusion of DSRIP and for partnering with network providers to build financially sustainable models to adapt to VBP reform. The refinement of the governing committee is crucial to the successful improvements of quality for hospital based and ambulatory activity. The quality structure will be inclusive of network partners and will align with lead hospital quality improvement efforts. Even though this process improvement strategy is lead through a Medicaid incentive program the committees will focus actions to ensure improvements for all payers and avoid payer specific clinical operations. The PPS Project Management Office (PMO) and committee leads will work to prioritize quality metrics and design meetings to maximize return of efforts and ensure effective member engagement. 12

13 PPS Updates DRAFT - Governing Structure NYP/Q Board of Trustees NYP/Q Lead Hospital PAC Executive Committee Audit Compliance PMO Finance Clinical Integration & Quality Workforce / Cultural Competency Hospital Based (Hospital & Post Acute) HIV (Clinical Integration) Adult Ambulatory (Primary Care, Chronic Disease & Behavioral Health) Pediatric Ambulatory (Primary Care, Chronic Disease & Behavioral Health) 13

14 PPS Updates DRAFT - Process Improvement Measures Metrics included below are a representation of all metrics and do not reflect prioritization of process improvement efforts. The prioritization will occur quarterly and committee efforts will focus to single or similar metrics at a time PPV PPR PPV (BH) PQI 90 PDI90 PQI 7 PQI 8 PQI 15 PCOS Hospital Based Adult Ambulatory CAHPS Access to Care Care Coordination Antidepressant Med Management Monitoring for Diabetes & Schizophrenia Monitoring for Cardio & Schizophrenia Pediatric Ambulatory Access to Care Asthma Med Management ADHD Medication 14

15 NYP Queens PPS PAC Meeting Clinical Project Updates 15

16 2.a.ii (PCMH) PPS Updates Clinical Project Updates The PPS is in the process of completing the final milestone for the PCMH project. All committed providers have achieved PCMH 2014 Level 3 certification as of the end of The PPS is currently in the tail end of working with providers to connect with the RHIO and anticipates completion by March b.v (Care Transitions) NYP Queens hospital and partner SNFs collaborated to develop and implement a warm handoff policy for patient transferred between the hospital and SNF facilities. The new workflow has received positive feedback from partners and the hospital currently is at a 50% compliance rate and is continuing to work to increase this rate. 2.b.vii (INTERACT) SNF partners has successfully implemented the INTERACT tool at their facilities and are utilizing the tool to assist with reducing preventable readmissions through treat in place efforts and improved staff engagement through the train-the-trainer and INTERACT champion models. The SNFs are collecting readmission data for measuring the success of the INTERACT tool. 3.a.i (Primary / Behavioral Health) The PPS is working with partners to identify the opportunities for successful co-location. The DOH released rate codes for co-located sites to address billing concerns 2 PPS partners have been approved to use these codes, Child Center of NY and MHPWQ. The PPS has submitted 3 of the NYPQ ambulatory clinics for rate code approval. 16 NYP/Q PPS PAC Meeting

17 3.b.i (Cardiovascular) PPS Updates Clinical Project Updates The PPS is continuing to work on implementing a patient stratification system at the hospital to identify high-risk patients who have not been diagnosed with hypertension and need to have a follow-up appointment. Currently, the PPS anticipates successfully completing all project milestones by March d.ii (Pediatric Asthma) The Asthma Coalition Queens is continuing to educate providers on pediatric asthma triggers, treatment, and family/patient education in addition to working with the new quality committee to pilot a new initiative specific to asthma medication management with Total Care RX. 3.g.ii (Palliative Care in SNF) The PMO has hired a Palliative Care NP to work with SNF partners on palliative care. She will coordinate and complete trainings to educate participating partners on palliative care recourses, how to speak to families/patients on palliative care, tracking of quality data, and the impact of palliative care on preventable readmissions. 4.c.ii (HIV) Our network partners Brightpoint Health and Aids Center of Queens County (ACQC) have recently hired peers to support the peer-led intervention education initiative. The committee to support our HIV initiatives will remain as currently constructed however, the committee will serve as an advisory group and forum for new CBO led strategies and projects. 17 NYP/Q PPS PAC Meeting

18 Questions 18 NYP/Q PPS PAC Meeting