HCH Advisory Committee

Transcription

1 HCH Advisory Committee January 5, 2016 *Please do not put phone on hold

2 Cally Vinz Chair Welcome Introductions Review of Agenda

3 Bonnie LaPlante HCH Director Announcements Updates

4 Diane Rydrych Health Policy Director Legislative Primer

5 HCF TF Recommendations (preliminary) Prospective payment for care coordination Reduce administrative burden/payment lag Modify tiering to ensure it is sufficient, and to incorporate nonmedical/social complexity as well as clinical Encourage/incent care coordination with a wider variety of community/social services organizations HIE recommendations to ease data sharing Voting in January; Report to Legislature

6 Statute vs Rule General Statute tells us what to do (implement a program, write a report, etc) Rule spells out how (program details) MDH has general rulemaking authority Don t always need it sometimes statute is sufficiently clear/detailed Sometimes explicit rulemaking authority is given or we are directed to adopt rules Used more often with complex, new programs HCH Rule developed using expedited process in 2009

7 HCH Statute vs Rule HCH Statute General principles for certification Requirement to recertify annually Require all clinicians in a HCH to participate State establishes learning collaborative Requirement to meet process/outcome/quality standards Advisory committee HCH Rule Detailed definitions (care coordination, care plan, family, etc) Detailed requirements, by domain, for initial certification and recertification Processes and application requirements Benchmarking process/timeline Variance processes and criteria Appeals and revocation Tiered payments based on pt complexity

8 HCH Statute vs Rule Example Certification Standards HCH Statute Ensure that HCH develop and maintain appropriate comprehensive care plans for their patients with complex or chronic conditions, including an assessment of health risks and chronic conditions; HCH Rule One or more members of care team meets with patient to set goals and identify resources to meet them Team and pt determine how/how often to meet, community resources to involve Care plan documents referrals and follow up, tests and results, admissions, post-discharge plans, etc

9 Administrative changes Some changes can be made administratively, without change in Rule or statute Process for assigning patients to tiers Level of PMPM payment for patients in different tiers Billing process for care coordination payments; prospective vs retrospective payment Topics/method of participation for learning collaborative Benchmark rates and selected measures

10 Statute vs Rule Timeline and Process HCH Statute: 2017 session General plan/proposals: summer 2016 Stakeholder/community discussions Approval by: MDH/DHS Governor s office Legislature HCH Rule month process First step: Public comment period on part/all of Rule Multiple public input windows Proposed and final Rule Multiple layers of review/approval by: Agency program/legal staff Governor s office Office of Administrative Hearings

11 Rulemaking Progress Chart Health Care Homes Program/State Innovation Model Grant

12 Next (first?) Steps Identify and educate stakeholders on - components of statute, Rule that MDH may be interested in updating Identify changes that could be made administratively Ensure robust opportunities for public participation Advisory committee, public comments, presentations/meetings, other Think through budgetary implications and timelines

13 Learning Collaborative Updates Charter Revised but still needs final approval Deliverable 1: Learning Days offer Beginners & Advanced Sessions by 4/27/16 Deliverable 2: Disseminate resources to foster clinics linking to community organizations that can aid in care coordination by 6/30/16 Deliverable 3: Design learning activities to improve workforce capabilities that support Health Equity by 12/31/16

14 Financial Sustainability Update Charter Approved with Modifications Deliverable 1: Conduct analysis on various payment models used in MN and nationwide by 3/30/16 Deliverable 2: Develop an integration on ramp for HCH to move towards an integrated value based model by 12/31/17 Deliverable 3: Partner with key stakeholders to maintain and improve capacity of HCHs to link data to performance and payment by 12/31/16

15 Communication & Evaluation Updates Charter Approved with Modifications Collaboration with MDH Communication Office Deliverable 1: Develop strategically focused marketing and communication plans for health care homes advancement engaging digital, print, social media and other strategies to build awareness and strengthen relationships with key stakeholders by 12/30/16. Deliverable 2: Evaluate measures that assess population health impact to advance health equity and the correlation to care coordination activities by 6/30/17. Deliverable 3: Review program evaluation measures and assess whether to add community impact, health capacity and/or practice transformation measures by 6/30/16.

16 Practice Transformation Updates Charter Revised but still needs final approval Deliverable #1: Define alignment. Describe how HCH supports and links with other services, models and initiatives (MACRA, BHH, IHP s/aco s, ACHs, etc) by 6/30/16 Deliverable #2: Refine HCH certification and recertification process Deliverable #3: Partner with MDH Office of Health Information Technology to provide technical assistance to clinics to identify processes that use patient name and primary care provider data fields that will be used for interoperability with other medical providers. Deliverable #4: Improve population health and care coordination technical assistance to clinics by 12/31/16.

17 Approve Timeline Next Steps Finalize Strategic Plan Review Work Plan Drafts Begin To Think About Potential Legislation and/or Rule Changes Learning Days April 26 & 27, 2016 Next Meeting 4/12/16

18 Health Care Homes Contact Information HCH mailbox: HCH Website: index.html HCH telephone number: