Center of Excellence for Health Systems Improvement for a Tobacco-Free New York: Statewide Stakeholder Workgroup Meeting Minutes

Transcription

1 Center of Excellence for Systems Improvement for a Tobacco-Free New York: Statewide Stakeholder Workgroup Meeting Minutes May 15, :30am 2:00pm Hilton Albany, Anteroom, Albany, NY Attendees - Kathy Alexis, Director of Clinical Quality Improvement Program, Community Center Association of New York State - Haven Battles, Assistant Director, Bureau of Chronic Disease Evaluation and Research, New York State Department of - Peggy Bonneau, Director of Initiatives, Office of the Medical Director, New York State Office of Alcoholism and Substance Abuse Services - Shadi Chamany, Director of Clinical and Scientific Affairs, Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of and Mental Hygiene - Susan Kansagra (call-in), Assistant Vice President, Population, Medical, and Professional Affairs, New York City and Hospitals Corporation - Elizabeth Misa, Deputy Medicaid Director, Office of Insurance Programs, New York State Department of - Mark Moss, Public Dentist, Bureau of Dental, New York State Department of - Wade Norwood, Chief Program Officer, Finger Lakes Systems Agency - Alda Osinaga, Medical Director, Division of Program Development and Management, Office of Insurance Programs, New York State Department of - Michael Seilback, Vice President, Public Policy and Communications, American Lung Association of the Northeast - Michael Seserman, Director, Strategic Alliances, American Cancer Society - Donna Shelley (call-in), Associate Professor of Population, Co-Chair Section on Tobacco, Alcohol and Drug Use, Department of Population, New York University School of Medicine - Jill Williams (call-in), Associate Professor of Psychiatry and Director, Division of Addictions Psychiatry, UMDNJ-Robert Wood Johnson Medical School Bureau of Tobacco Control - Harlan Juster, Director, Bureau of Tobacco Control, New York State Department of - Julie Wright, Program Manager, Systems, Bureau of Tobacco Control, New York State Department of

2 2 CAI - Michelle Gerka, Vice President, Family and Community Education, CAI - Elizabeth Jones, Director, Systems Improvement, CAI - Francesca Sherman, Deputy Director, Systems Improvement, CAI - Kameron Wells, Consultant, CAI Members Not Present - Anthony Fiori, Managing Director, Manatt Solutions / Coalition of New York State Public Plans - Gregory Miller, Medical Director, Adult Services, New York State Office of Mental - Cynthia Sutliff, Director of Policy, New York e Collaborative Meeting Minutes Purpose: To review priorities identified during the previous Statewide Stakeholder Workgroup meeting, provide additional background information on identified priorities, and further refine policy issues to be addressed by the Statewide Stakeholder Workgroup in order to promote a policy environment that facilitates the work of the 10 Systems Regional Contractors. Members of the Statewide Stakeholder Workgroup engaged in rich discussions surrounding the role of Population Improvement Programs (PHIP) in New York State s changing health care landscape, the value and feasibility of adding a measure related to tobacco screening and treatment to the New York State Quality Assurance Reporting Requirements (QARR), and the forthcoming policy change that will un-limit Medicaid Managed Care plan coverage of tobacco cessation medication. I. Population Improvement Programs (PHIPs) Presentation by Wade Norwood, Chief Program Officer, Finger Lakes System Agency (FLHSA) - In order to meet the needs of the most vulnerable populations in the changing health care environment, regional collaboration is essential to create synergies, avoid duplication of efforts, and advance the goals of both the New York State Innovation Plan (SHIP) and the Systems Improvement for a Tobacco-Free New York program o The State Innovative Models Testing Grant Application (SIM) finances the SHIP and is promoting advanced primary care initiatives across New York State

3 o Advanced primary care initiatives draw on the principles of the Patient Centered Medical Home, and seek to adequately address the needs of vulnerable populations by promoting integrated behavioral and population health approaches, workforce development, value-based reimbursement, and common metrics o The New York State Department of (NYS DOH) has taken both top-down and bottom-up approaches to improving health outcomes and reducing health disparities o Workgroup members discussed the importance of working on the regional level to identify needs and resources within counties and communities - This health planning (as opposed to health care planning ) supports the identification of upstream risk factors that are barriers to individuals achieving optimal health - Relationships and connections that have been formed through with Performing Provider Systems performing Delivery System Reform Incentive Payment (DSRIP) projects can be leveraged to support health planning efforts (in cases where such work is beyond the focus of DSRIP projects) - PHIPs are convening regional stakeholders to examine disparities and needs, and identify and share best practices to promote population health o Workgroup members agreed that the COE for HSI Webinar on the PHIPs is an opportunity for Systems Regional Contractors to learn about why engaging PHIP Contractors will support achievement of work plan deliverables - PHIP Contractors bring health stakeholders together in a structured, analytical data-driven process - This process in an opportunity to bring focus to the ways in which prevention and a tobacco-free New York is essential to population health improvement - As part of this process, Systems Regional Contractors can engage new stakeholders and enhance existing relationships o It also will be valuable for the COE for HSI to introduce PHIP Contractors to the Systems Improvement for a Tobacco-Free New York program, ensuring that PHIP Contractors have a concrete understanding of the program and why partnership with Systems Regional Contractors is mutually beneficial - The focus of PHIP Contractors is not on program implementation activities, but on the core activities of: (1) convening, (2) using data to drive discussion, and (3) arriving at an agreement on priorities as a region - The PHIP Contractors are looking for do-ers to work on identified priorities in their respective regions; Systems Regional 3

4 4 Contractors can support efforts by carrying-out practice transformation within priority health care settings o Workgroup members recommended that PHIP and Systems Regional Contractors collaborate to compile a landscape inventory, identifying people, programs, and partnerships - Much of this information can be gleaned from Systems Regional Contactors Year-End Reports o With collaboration, PHIP Contractors regional planning priorities will reflect the importance of addressing tobacco dependence treatment and ensure that addressing tobacco dependence is part of the County Improvement Programs (CHIP) II. III. Creating Quality Assurance Reporting Requirements (QARR) Measure(s) on Tobacco Use Presentation by Elizabeth Jones, Director, COE for HSI - The introduction of QARR measures on tobacco use would prompt Medicaid Managed Care plans and health care providers alike to pay more attention to the provision of evidence-based tobacco dependence screening and treatment o QARR data are used by insurance purchasers and consumers, as well as regulatory and accreditation agencies, to gauge health insurance plan quality o Workgroup members decided the addition of a QARR measure is a worthwhile venture to take on; however, it will require additional research to determine (1) the exact process for proposing a new measure, and (2) if a process measure, an outcome measure, or both should be recommended o Workgroup members discussed the importance of presenting tobacco use as a chronic disease in order to justify the addition of a process and/or outcome measure related to tobacco use screening and treatment - The Workgroup decided that reviewing existing National Quality Forum (NQF), care Effectiveness Data and Information Set (HEDIS), and Joint Commission measures will be very helpful in informing the definition of the proposed additional QARR measure(s) Unlimiting Medicaid Managed Care (MMC) Plan Coverage of Tobacco Dependence Treatment Medication - MMC plans currently are not required to cover all seven FDA-approved tobacco dependence treatment medications, and benefits are limited in terms of medication brand, number of quit attempts, and counseling coverage o One Workgroup member stated that between 2009 and 2013, Medicaid claims data showed an increase from 3.8% to 16.2% for tobacco

5 5 dependence counseling utilization, while pharmacological utilization decreased from 13.7% to 13.4%; this data demonstrates the need for an increased focus on raising the utilization of tobacco dependence treatment medication among MMC plan enrollees o Workgroup members discussed the need for a mechanism to require that all MMC plans cover all of the FDA-approved tobacco cessation medications in accordance with the December 2014 guidance from Department of Finance - Though guidance was written for new plans, Workgroup members agreed that the guidance may be applicable to existing MMC plans as well; further research is needed, which Michael Seserman will present on at the next meeting o Workgroup members discussed the current opportunity with the Office of Quality and Patient Safety s 2015 Performance Improvement Program (PIP), which has the objectives to (1) identify MMC plan enrollees who use tobacco and design appropriate interventions to address tobacco cessation, (2) decrease the prevalence of tobacco use among MMC enrollees within plans by 2017, and (3) increase the utilization of tobacco cessation benefits among MMC enrollees in plans by The Bureau of Tobacco Control (BTC) has reviewed proposals and will be notified in the event of future opportunities to get involved Next Steps 1. COE for HSI: Circulate meeting minutes 2. COE for HSI: Schedule subsequent Statewide Stakeholder Workgroup Meetings 3. COE for HSI: Hold first Mental Sub-Committee meeting on July 9, COE for HSI/FLHSA: Hold PHIP Webinar for the Systems Contractors on June 18, COE for HSI: Reach out to Pat Roohan, Office of Quality and Patient Safety, about the Department of Finance December 2014 guidance, including whether this guidance applies to existing MMC plans 6. COE for HSI: Compile a list of existing NQF, HEDIS, and Joint Commission tobacco use measures 7. Wade Norwood: Circulate white paper on how the Statewide Stakeholder Workgroup relates to the work of PHIP Contractors, and how these two contracts can work together to advance project goals 8. COE for HSI: Arrange Systems for a Tobacco-Free New York presentation for PHIP Contractors in fall 2015