EHR Report Implementation Training September 26, 2016

Transcription

1 EHR Report Implementation Training September 26, 2016

2 The McSilver Institute for Poverty Policy and Research at New York University Silver School of Social Work is committed to creating new knowledge about the root causes of poverty, developing evidencebased interventions to address its consequences, and rapidly translating research findings into action.

3 The McSilver Institute employs collaborative research methods via partnerships with policymakers, service organizations, consumers and community stakeholders.

4 The McSilver Institute s research efforts are guided by a recognition of the interrelatedness of race and poverty.

5 NYSHF is a private, statewide foundation dedicated to improving the health of New Yorkers. We strive to be focused and purposeful in our work; establish and adhere to clear goals and strategies; and measure our progress. We are committed to making grants, but also to making a difference beyond our dollars: informing health care policy and practice, spreading effective programs to improve the health system, serving as a neutral convener of health leaders across the State, and providing technical assistance to our grantees and partners. Generously supported the EHR project

6 The Community Technical Assistance Center of New York (CTAC) and the Managed Care Technical Assistance Center of New York (MCTAC) are training, consultation, and educational resource centers serving all behavioral health agencies in New York State. We help agencies strengthen their clinical and business infrastructure through training opportunities focused on implementing evidence-based practices and addressing the challenges associated with the recent changes in regulations, financing and overall healthcare reforms.

7 As of July 2016, 478 or 95.98% of all adult and children s clinics (n=498) have taken advantage of at least one CTAC training offering As of August 2016, MCTAC has engaged 82.8% of OMH (456) and 74.9% OASAS agencies (314).

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9 Goal: To help behavioral health providers improve quality of care while lowering healthcare costs. 1) Creating a comprehensive assessment database for practitioners and organization decision makers to identify clinical outcome and process measures OTO 2) Developing a set of standardized reports to integrate within organizations electronic health records (EHRs) 3) Disseminating project tools through presentations and training opportunities

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11 Pilot project 7 NYS agencies who operate over 65 programs 4 large Electronic Health Record (EHR) vendors: Netsmart, Foothold, Accumedic, IMA Activities included: focus groups, web-based meetings, and face-to-face sessions PIN outcome: design a set of standardized reports available though agencies EHR system using existing agency data

12 Provider Driven Focus Groups, with vendor guidance Calls Starting with information already in the EHR (mostly billing data) Allows standardization Lets agencies use the information they already have rather than collecting new information Diagnostic Categories, Service Type, Payer Mix

13 What do we already track? What is required and necessary? What do we need to track and why? Requires thinking in advance how data may best inform what we need to know How should we track our progress? Implement standard performance-monitoring protocol What changes do we need to make? Be willing to adjust measurements intermittently feedback loop

14 We do not want to produce reports where people don t use the information contained within them, especially when people put effort and time into the production of such reports.

15 Vendors would like to know about the control that their clients (i.e. meeting participants) will have over selection criteria for the report... concerned that over time, the abilities to create customizable reports will eliminate the standardization of these reports. Accordingly, want to know if there will be a standard selection criteria across the board that is locked down.

16 Payer Mix, Service Delivery, Diagnostic Each report will be available at the agency, program type, and individual program level Each report can be drilled down by diagnostic category and service type Standardized set of definitions Will be free of charge and available in perpetuity to ALL current and future NYS clients

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18 Get a sense of who they re serving The types of services they are delivering The types of services individuals with specific diagnoses are receiving Breakdown of clients by Insurance Type Key features: standardization of definitions and terms across organizations and vendors

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20 Self-pay: Individuals with no insurance or with insurance, but out of network Medicare fee-for-service: Individuals with only Medicare Medicare and Medicaid: Individuals with Medicare and Medicaid Medicaid fee-for-service: Individuals with only Medicaid Commercial Insurance: Individuals with non-managed insurance/ppo Commercial Managed Care: Individuals with commercial insurance that is managed Medicaid Managed Care: Individuals with Managed Medicaid + FIDA Medicare Managed Care: Individuals with Managed Medicare Total managed care and insurance: Includes commercial insurance, Managed Medicaid, Managed Medicare, and Commercial Managed Care Third Party Payer: Grants and other payers

21 Follows the structure of the DSM V, please consult for more thorough definitions. The service-type options correspond with the program type

22 2 3 pm

23 Netsmart Room X Presented by: TBD Foothold Room Y Presented by: TBD Accumedic Room Z Presented by: TBD IMA Room XYZ Presented by: TBD

24 Who, What, When, Where, How

25 Executive/senior team, quality compliance team, program directors, finance team and staff should see and understand reports. Ideally, reports should be produced and reviewed monthly

26 To succeed in new health care environment, all levels of staff must use the best available data to make informed-decisions Clinical staff will collect, monitor, and review clinical data to make treatment decisions» For example, seeing which diagnosis corresponds to what type of treatment in order to determine if the appropriate service is being provided Program directors will use payer mix data, clinical, claims and payment data for each service and program to understand profitability Leadership will use data to make decisions about staffing, and contracting and negotiating leverage

27 VBP and the importance of outcomes

28 Building upon these reports, providers will be better positioned to succeed in the Value Based Payment environment. VBP contracts require providers to have the tools to monitor performance in real time and course correct based on that data so that their outcomes can meet the expectations of the contracts

29 Business Intelligence It will be important to incorporate data from a number of sources to begin understand what are the services and their costs that contribute to positive outcomes. The data will include: Client demographic data that includes behavioral and physical health conditions Service data at the client, program, and episode of care level Financial data cost per service, cost per episode of care, base revenue, and performance revenue Outcome data for clinical outcomes, social outcomes, and system utilization outcomes

30 Outcomes Database: Where Are the Reports? Within your EHR. OMH Online Access to Statistical Data: Client or Program Specific Data you may have access to: -Psychiatric Clinical Knowledge Enhancement System (PSYCKES) -Children & Adult Information Reporting System (CAIRS) -Integrated Program Monitoring and Evaluation System (IPMES) Quality Strategy for the NYS Medicaid Managed Care Program: df 2016 Quality Assurance Reporting Requirements: qarr_specifications_manual.pdf Plan Specific Reports of NYS Medicaid Managed Care Plans: For more resources and training information go to ctacny.org

31 Was this helpful? Do you plan to use/implement these reports? What obstacles/barriers do you forsee? Are there additional reports that would be useful?

32 An Assessment Resource for Providers

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36 Providers can search and identify assessment tools to be used within their agency Assessment tools range from daily living skills, to behavioral health, social, and employment Many of the assessment tools within the database allow providers to measure and track progress