Collaborative Ventures Network 2017 Annual Meeting February 6, 2017 700 E. Jefferson St., Suite 100/400 Phoenix, AZ 85034 Main: 602.253.0090 Fax: 602.252.3620 Website coming soon! Collaborative Ventures Network Who We Are the Corporate Members Adelante Healthcare Canyonlands Healthcare Chiricahua Community Health Centers Circle the City Copper Queen Medical Associates El Rio Community Health Center Desert Senita Community Health Center Maricopa Integrated Health System Mariposa Community Health Center MHC Healthcare Mountain Park Health Center Native Health North Country Healthcare Sun Life Family Health Centers Sunset Community Health Center United Community Health Center Maria Auxiliadora Valle del Sol Wesley Community Health Center
Collaborative Ventures Network What We Do - Purpose and Mission Organization Collaborative Ventures Network was organized in 1997 as an Arizona not for profit integrated services network under guidelines consistent with the Affiliation Policies of the Bureau of Primary Health Care. Corporate Purpose To promote and facilitate the development and delivery of culturally acceptable, geographically available and economically accessible Community-Based quality health care. Mission To foster collaborative business activities which enhance Community Health Centers individual abilities to serve their communities to meet the needs of Arizona s uninsured, underinsured and underserved. CVN Strategic Goals Statewide community-based patient-centered primary care network Collaboration among and between essential community providers, public programs and health plans for affordable quality health care Data-based benchmarking and decision making Demonstrable value-based care through continuous improvement in quality of service, health outcomes, and reduction in the overall cost of health care Fiscally sustainable operations to meet continued growth in populations served
CVN Current Network Activities Healthy Communities Collaborative Network (HCCN) HRSA Health Center Controlled Network August 1, 2016 thru July 31, 2019 $2.25 million award ($750,000/year) 20 Participating Health Centers The purpose of this funding opportunity is to support meaningful use of ONC-certified electronic health records, adoption of technologyenabled quality improvement strategies, and engagement in health information exchange, to strengthen the quality of care and improve patient health outcomes achieved by Health Center Program award recipients and look-alikes.
HCCN Grant Core Objectives & Focus Areas A. Health IT Implementation & Meaningful Use 1. Increase to 100% the health centers with ONC-certified EHR adopted and implemented 2. Increase % of providers receiving incentive payments for Meaningful Use B. Data Quality & Reporting 1. Increase % of Health Centers that can electronically extract data for UDS 2. Increase % of Health Centers that produce health center and sitelevel Quality reports 3. Increase % of Health Centers that integrated data from different service types 7 HCCN Grant Core Objectives & Focus Areas C. Health Information Exchange (HIE) & Population Health Management 1. Increase % of Health Centers that improve care coordination through HIE 2. Increase % of Health Centers using HIE to support population health management D. Quality Improvement 1. Increase % of Health Centers that meet/exceed HP2020 goals for at least 5 UDS measures 2. Increase % of Health Centers that improved value, efficiency and/or effectiveness of services 3. Increase % of Health Center sites that have current PCMH recognition 8
CVN Current Network Activities Origination of CVN s IPA Strategy In the fall of 2013, CVN was asked by the AACHC Board of Directors for the to pursue the opportunity of leading the effort to create a single statewide network of community health centers for the purpose of collaborating on enhancing the value of patient-centered primary health care and the availability of options to contract with health plans in Arizona. The primary reasons are still true today: 1. The world around CHCs is dramatically changing, and in fundamental ways that force change within CHCs and how they fit within the health care delivery system 2. CHCs have unique value in the health care marketplace... We must get payers (Medicaid MOCs, Medicare Advantage, ACOs, Commercial, etc.) to understand/acknowledge this 3. By aggregating the number of health plan lives, CHCs mitigate risk and improve their position in the health care delivery system
Roadmap to Clinical Integration Use of Legal Entities Participation Criteria Performance Improvement Flow of Funds Clinician Leadership Information Technology Joint Contracting CINs should have a clear & identifiable legal entity that serves as the convener CINs must not be organized solely to generate more money for its participants but to improve the health of its patients CINs only allow participation from organizations that are committed to further the clinical purpose CINs must demonstrate they have specific tools to further clinical & cost programs, and these tools are used consistently across the membership Participants in a CIN are required to constantly work towards a higher level of quality and/or cost performance The financial success of a CIN is determined by the aggregate performance of the members CINs must demonstrate a significant investment of capital, financial & human resources, in the pursuit of improved clinical performance AACHC CVN Memorandum of Agreement CVN will not duplicate efforts and activities undertaken by AACHC in connection with any joint programs administered and operated by AACHC on behalf of its membership CVN shall notify AACHC of any new opportunities presented to CVN (or of which CVN becomes aware) for participation in such programs and AACHC shall have the right of first refusal to either pursue or reject such opportunities, on behalf of its membership AACHC will have the primary responsibility for directing legislative and regulatory advocacy activities, public relations, education activities and media relations to support each organization AACHC to provide certain staff and administrative support services to CVN, as well as office space, utilities, equipment and/or supplies as required by CVN staff and activities
CVN Engagement in Clinical Integration In the ensuing years, CVN s Board of Directors has: Adopted policies and procedures for operation as a Messenger Model IPA Amended CVN s Bylaws to provide for a Board-designated Quality/Clinical Management Committee Approved the hiring of a Chief Medical Officer and Medical Director for Quality/Clinical Integration Coordinated with Arizona Health-e Connection (AzHeC), manager of Arizona s Health Information Exchange (HIE) in defining CVN s qualified permitted use of patient and population health data Supported AACHC in defining a need for statewide health center Health Information Technology (HIT) Authorized the offering of a Participating Provider Agreement which includes the terms and conditions for participation in CVN s Clinically Integrated Provider Network Patients Served in 2015
Indica of Clinical Integration I. HIT and HIE II. The use of common information technology to ensure exchange of all relevant patient data Clinical Protocols The development and adoption of clinical protocols may delineate utilization and quality goals for various diagnoses III. Care Review Care review based on the implementation of protocols IV. Adherence to Protocols Mechanisms to ensure adherence to protocols including performance relative to utilization and quality goals, as documented in protocols Source: A Report by the Federal Trade Commission and the Department of Justice, July 2004
Questions? Group Networking Questions Eight Groups (+56 registrants 8 tables of 7) Four Questions: two groups assigned to each question Each group selects a scribe 15 minutes to discuss in group 10 minutes to present responses (i.e., both groups for each) Open discussion Parking Lot Items Wrap
Group Question Dealing with Change 1. How flexible are Arizona community health centers in dealing with the everchanging landscape? Consider and identify Strengths and/or Weaknesses relative to: Level of Governance knowledge and understanding Shared Vision of Leadership teams Organizational culture receptive to adopting/managing change Efficiency of operations (access, capacity, productivity, etc) Timely and accurate data (quality, clinical, operating and financial) Resources (clinical providers, support staff, HIT and financial capital) Engagement in advancing results from managed care contracting Development of community-based relationships Group Question Managed Care 1. How has participation in Managed Care Agreements affected Arizona community health centers ability to deliver value-based care and what changes/improvements should be in the offering? Consider and identify Challenges and/or Opportunities relative to: Patient panels (assignment and attribution) Care coordination (prior authorization, referrals, ADT) Integrated care (medical, oral, behavioral health) Disease case management Patient health information (access and decision-making) Quality improvement (measurement and incentives) Financial results (total cost of care and shared savings)
Group Question HIT & Data Management 1. As Arizona community health centers advance their use of in-house ONCcertified EHRs and, at the same time, move to health information exchange within and beyond their communities, what enhancements are needed to support clinical decision making and population health? Consider and identify Benefits and/or Shortcomings relative to: Access to data and ease of HIT use across the health care delivery system Consistency in data capture and measurement Data integration (medical, oral, behavioral health) Patient engagement Clinical quality measurement (tracking and reporting) Population health management Total cost of care Group Question Value 1. How can Arizona community health centers collaborate to positively affect the various elements of the Value Equation? Consider and identify opportunities that are Common to all Providers and/or Unique Arizona community health centers relative to: Outcomes Measurable indicators of population health which demonstrate effectiveness of a care model Cost of Care (CHC) Cost of care delivered (PPS Visit or FFS) and relative efficiency of this care Cost of Care (non-chc) Cost of care delivered outside the health center Risk Ability to address the impact of factors (population health, SDOH, etc.) that impact the cost of care Scale Ability to provide access to, and deliver, a consistent care model to a large and increasing population of patients
Thank You 700 E. Jefferson St., Suite 100/400 Phoenix, AZ 85034 Main: 602.253.0090 Fax: 602.252.3620 Website coming soon!