Practice Transformation Academy Orientation Webinar. Monday, October 9, 2017

Transcription

1 Practice Transformation Academy Orientation Webinar Monday, October 9, 2017

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3 GoToWebinar Logistics Introductions We will unmute you when it is your turn to speak If you do not have audio set up, please be prepared to type your response in the chatbox Have a question? Please enter it in the chatbox

4 Agenda Value-based payments overview Practice Transformation Academy program structure Getting to know each other National Council faculty Participating organizations and leads Program components Stretch projects Practice transformation lead and VBP steering committee Assessment tool Kick-off meeting Next steps

5 The Hub: A Four-year, State Innovation Model (SIM) Testing Grant Three separate contracts, funded by DOH Qualis Health provides Practice Coaches and Regional Connectors programs Web Resource Portal offered through partnership with UW Department of Family Medicine Primary Care Innovation Lab 5

6 Hub Goals Help Providers to: Integrate physical and behavioral health Move from volumebased to value-based care Improve population health through clinical and community linkages To achieve the Triple Aim 6

7 What Connections Do You Need for Successful Practice Transformation? 7

8 What Brings Us Here Today?

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10 Value Is:

11 Aligning value-based payments across payers, providers, & programs Emily Transue, MD, MHA, Associate Medical Director J.D. Fischer, Senior Health Policy Analyst Samantha Zimmerman, Senior Health Policy Analyst October 9, 2017

12 HCA Purchasing Goals By 2021, 90% of state purchased care and 50% of commercial care will be in value-based arrangements 2021: 90% VBP 2019: 80% VBP Medicaid PEBB % VBP 12

13 Alignment with federal VBP goals APM Framework % state-financed 50% commercial 13

14 Defining Value-Based Payments HCP-LAN Alternative Payment Model Framework 14

15 Alignment with CMS Alternative Payment Models Framework 15

16 Alignment driving common elements Federally-led transformation (LAN Framework, VBP goals, & MACRA) HCA s Quality Improvement Model (rewards improvement & attainment) Data Care transformation based on evidence (Bree Collaborative) WA Statewide Common Measure Set (57 measures) 16

17 Example of VBP in Washington: Medicaid MCOs HCA withholds 1% of the MCO premium: they can earn this back based on quality performance and on implementing VBP arrangements with providers Seven quality measures from Statewide Common Measure Set, including 2 HEDIS measures of antidepressant management (acute and chronic) 4 behavioral health quality measures also included in FIMC regions: Substance use disorder treatment penetration Mental Health treatment penetration Substance Use Disorder treatment initiation and engagement All Cause Hospital Readmission rate 17

18 VBP in Washington: Medicaid MCO Provider contracts MCOs are integrating VBP into provider contracts in a variety of ways: Incentives for practice changes (collaborative care/behavioral health integration incentive in CHPW) Upside incentives for quality (pay for performance) Shared savings tied to quality performance Upside/downside risk tied to quality performance Capitation with quality requirements 18

19 VBP Considerations for Providers Potential benefits tend to increase as risk increases Which arrangement is best for a given provider depends on their strengths and capabilities, and may change over time Certain capabilities (data tracking, registries, outreach) are important to most VBP; gradually building these will help prepare practices for success 19

20 More Information: Questions? Emily Transue, MD, MHA, Associate Medical Director J.D. Fischer, Senior Health Policy Analyst Samantha Zimmerman, Senior Health Policy Analyst 20

21 Competencies for Value-based Payment Contracts Patient and Family- Centered Care Design Continuous, Data- Driven Quality Improvement Sustainable Business Operations 1.1 Patient & family engagement 1.2 Team-based relationships 1.3 Population management 1.4 Practice as a community partner 1.5 Coordinated care delivery 1.6 Organized, evidence-based care 1.7 Enhanced access 2.1 Engaged and committed leadership 2.2 QI strategy supporting a culture of quality and safety 2.3 Transparent measurement and monitoring 2.4 Optimal use of HIT 3.1 Strategic use of practice revenue 3.2 Staff vitality and joy in work 3.3 Capability to analyze and document value 3.4 Efficiency of operation

22 Program Goals 1. Build readiness for value-based payment arrangements 2. Cultivate strategic internal champions for value-based payment arrangements 3. Contribute to meeting the Healthier Washington VBP target of 90% by 2021

23 Program Structure Duration: October 1, 2017 January 31, 2018 Activities One in-person workshop Four informational webinars Two group coaching call Stretch project planning Tools and Resources Practice Transformation Support Hub Hub Resource Portal Value based planning guide Organizational assessment tool

24 Program Outcomes By the end of the Academy, participants will: Gain understanding of value-based principles and models in behavioral health consistent with the HCA Value-Based Road Map and Moving Apple Health to Value Cultivate buy-in among internal agency stakeholders Establish a VBP steering committee and identify a practice transformation lead Identify a value-based payment initiative aligned with one or more project metrics found in the Medicaid Transformation Project Toolkit; and Define and collect baseline data for a key value metric

25 Faculty Areas of Expertise Value-based payment arrangements and system drivers Developing evaluation and quality improvement strategies to strengthen large systems Integrated health approaches Program management Clinical design Medicaid financing Data-informed decision making Community behavioral health population and practice environment

26 Core Faculty Kate Davidson, LCSW Assistant Vice President, Policy and Practice Improvement, National Council for Behavioral Health Samantha Holcombe, MPH Director, Policy and Practice Improvement, National Council for Behavioral Health Nina S. Marshall, MSW Senior Director, Policy and Practice Improvement, National Council for Behavioral Health Faculty Coaches: Pam Pietruszewski, MA Integrated Health Consultant, National Council for Behavioral Health Elizabeth Arend, MPH Quality Improvement Advisor, National Council for Behavioral Health

27 Hub Practice Coaches and Regional Connectors Carolyn Brill, CPHIMS, CHP North Sound Gwen Cox, RN North Central Maria Klemesrud, MEd, LMHC Olympic and SW WA Regional Health Alliance Wei-Lin Huang, MSW, LICSW Pierce Sharon Poch, MSW King David Stipe, RRT Cascade Pacific Alliance Dawn Sayers Better Health Together Sam Werdel Greater Columbia 27

28 Participating Organizations 20 agencies across Washington Agencies representing all 9 ACH regions Licensure: 18 Dually-Licensed Agencies 1 SUD-Only Agency 1 Mental Health-Only Agency

29 Participating Organizations & Practice Transformation Leads Introductions Round 1 Catholic Charities, Chris De Villeneuve Catholic Community Services, Mary Stone- Smith & Stephanie Thelen Children s Home Society of Washington, Mandy Huggard Columbia River Mental Health Services, Craig Pridemore Compass Health, Stacey Alles

30 Participating Organizations & Practice Transformation Leads Introductions Round 1 DESC, Tyreesha Fambrough Frontier Behavioral Health, Jan Dobbs & Kelli Miller Grant Integrated Services, Darla Boothman Greater Lakes Mental Healthcare, Lorraina Clayton Evergreen Recovery Centers, Natalie Fryar

31 Phases of Transformation Set Aims Use Data to Drive Care Achieve Progress on Aims Benchmark Status Thrive as a Business Through Value-Based Payment Systems

32 Purpose What is a Stretch Project? Operationalize readiness for value-based payment Stretch beyond your current knowledge and skills Challenge your organization to grow Development Tailored to your organization Well-defined goal Can produce tangible outcomes Implementation Short-term (think PDSA) Kick-off meeting and coaching call will help define and refine the stretch project Strategic support from faculty coach

33 Practice Transformation Lead Involved in the day-to-day functions of service delivery Strong relationships with C-suite staff Responsible for communicating mechanisms for change Charged with driving change in their organization

34 Steering Committee Works closely with practice transformation lead A strong team is essential to the transformation process Comprised of clinical and administrative leadership Decision-makers within the organization Sets the vision for transformation strategy Invited to attend and participate in coaching calls and webinars

35 Participating Organizations & Practice Transformation Leads Participant Introductions Round 2 Evergreen Treatment Services, Bill Benham Kitsap Mental Health Services, Stacey Devenney Lourdes Health Network, Frank Becker Multicare Behavioral Health, Jeffrey Plancich Peninsula Behavioral Health, Dawn Brown

36 Participating Organizations & Practice Transformation Leads Participant Introductions Round 2 Sea Mar Community Health Centers, Claudia D'Allegri Sound Mental Health, Katrina Egner Valley Cities Counseling & Consultation, Lisa Halvorsen Willapa Behavioral Health, Elizabeth Limbocker Yakima Valley Farm Workers Behavioral Health Services, Mary O'Brien

37 Assessment Tool New Tool: Value Transformation Assessment Blend of two existing assessment tools Practice Assessment Tool (PAT) MeHAF Used to assess preparedness for VBP arrangements Evaluates progression through five phases of transformation Results: Can inform your Stretch Project focus and design Will be reviewed with your organization s faculty coach during the first coaching call Practice coaches are available to facilitate the assessment process

38 Kick-off Workshop Oct. 20 th Deeper dive: VBPs and Washington State context Population health management and risk stratification Readiness assessment and root cause analysis Intervention design and logic framework Establishing a VBP steering committee Important: please bring a laptop computer

39 Expectations Participants Provide adequate time, energy and enthusiasm to participate in the program Consistently attend all applicable program activities Have practice transformation lead and the CEO (or an executive leadership sponsor) attend kick-off workshop Develop a stretch project Actively participate in sharing and dissemination of lessons learned, successes and challenges to other program participants and to respective practice transformation steering committees

40 Expectations Faculty Commitment to guiding your organization on the path to readiness for VBP arrangements Commitment to providing tailored support adapted to the needs of your organizations Provide effective tools to developing concrete and actionable stretch projects

41 Next Steps: Monday, October 16 Submit to Joan Miller, 1. Completed Value Transformation Assessment (VTA) VTA milestones to potentially focus stretch project Friday, October 20 Kick-off workshop in Seattle, WA Hilton Seattle Airport & Conference Center

42 The Practice Transformation Support Hub Resource Portal 42

43 Other Important Dates Webinar Date Time Webinar #2 Webinar #3 Webinar #4 Wednesday, November 15, 2017 Friday, December 15, 2017 Wednesday, January 17, :30-12:30pm 11:30-12:30pm 11:30-12:30pm

44 Questions? Joan Miller

45 Thank you! The project described was supported by Funding Opportunity Number CMS-1G from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.