SESSION 2 CONSIDERATIONS FOR HEALTH CENTERS AND HOSPITALS IN DEVELOPING SUCCESSFUL PARTNERSHIPS Speakers: Arthur Jones, M.D., Principal, has over 25 years of experience as a founding physician and CEO at a large Community Health Center in Chicago. Dr. Jones helped establish it as a model managed care organization that has served its Medicaid, Medicare and commercial population under a near global capitation payment system since the early 1990 s. At HMA, Dr. Jones focuses on advancing safety net integrated delivery systems and helping federally qualified health centers redesign their practices to manage the full continuum of care and reap some of the downstream financial benefits from operating as a well-functioning, patient-centered medical home. Art Jones, MD Principal Health Management Associates Dr. Jones was one of the founders and currently serves part time as the Chief Medical Officer of Medical Home Network, an accountable care organization focused on improving the health status of 140,000 Chicago area Medicaid clients by integrating the efforts of six hospital systems and six FQHCs. This work led to those entities creating and contracting as an ACO to serve the Medicaid population. Dr. Jones earned his MD from the University of Illinois. Dr. Jones completed his internal medicine residency, chief residency and cardiology fellowship and now holds a position as Clinical Associate at the University of Chicago. He lived in the impoverished community that he served for 34 years. Sarah Mutinsky, JD, MPH Founding Senior Advisor Eyman Associates Sarah Mutinsky focuses her practice on providing regulatory, legislative, advocacy, and compliance assistance to national associations, public and non-profit hospitals, and other health care providers and suppliers in issues related to health law, financing, and policy. She joined Eyman Associates in November 2011, after several years as an Associate in the Health Care Group at Ropes & Gray, LLP. She serves as Deputy General Counsel to the America's Essential Hospitals. Sarah earned her Master in Public Health in Health Policy from the George Washington University. Prior to practicing law, Sarah worked as a consultant specializing in market research and sales force analysis for pharmaceutical and biotechnology clients. She has experience across many of the areas describe under Our Practice Focus, with particular expertise in health reform, Medicaid, the 340B drug discount program, health information technology incentive payments, and administrative appeals
SESSION 2 Jacki Leifer, JD Partner, Health Law Practice Leader Feldsman, Tucker, Leifer, Fidell, LLP Jacki counsels national associations, state affiliates, health care organizations, and managed care entities and networks that have been formed by health care providers and their strategic partners. Jacki handles a variety of corporate issues, including development of articles of incorporation, bylaws, applications for tax exempt status, personnel and financial policies; negotiation and enforcement of contracts with employees, vendors, insurers and federal government agencies; corporate restructuring, consolidations and affiliations; corporate compliance programs; and risk management. In addition, she counsels health care clients on issues related to: Medicaid and Medicare managed care programs and reimbursement, federal grants, anti-kickback laws, Stark self-referral laws, antitrust and federal tax exemption. Jacki regularly teaches courses for the boards and staff of hundreds of nonprofit organizations, including statebased affiliates and national associations. She has made presentations to the following organizations, among others: the Independent Sector, the National Risk Management Institute, the National Center for Nonprofit Boards, the Support Center, the National Association of Community Health Centers, the National Health Council, and the National Assistance Management Association. Prior to joining the law firm in 1980, Jacki served as an attorney advisor in the Office of General Counsel of the United States Department of Health and Human Services, where she served as principal counsel to the Bureau of Community Health Services (now the Bureau of Primary Health Care). Nancy Garrett, PhD Chief Analytics Officer Hennepin County Medical Center Nancy Garrett joined HCMC in 2012 and was named Chief Analytics Officer in 2013. In this role, Nancy is aligning Analytics and Information Technology to develop informationdriven solutions to managing the health of our population. Nancy has a Ph.D. in Population Statistics from the University of Illinois, and an extensive payer background, including building a centralized analytics function at Blue Cross Blue Shield of Minnesota. She also served on the Board of Minnesota Community Measurement where she was instrumental in implementing its first cost measure, and currently is serving on expert panels for Cost and Resource Use measures and Socioeconomic Status and Risk Adjustment at the National Quality Forum.
SESSION 2 Summary: This session included four presentations that focused on important elements of successful partnerships, legal considerations around hospital-fqhc partnerships, and approaches for data sharing. Dr. Art Jones of Health Management Associates began the discussion by describing an innovative model for optimizing the health care infrastructure in Chicago s South Side. He stressed that a successful hospital- FQHC partnership depends on six key elements: 1) stakeholder engagement; 2) data sharing and analytics; 3) innovative models of care; 4) aligned incentives; 5) leadership development; and 6) shared purpose, governance and decision making. Participants asked Dr. Jones questions around staffing models and data sharing and Dr. Jones offered insight into how they addressed these issues in Chicago. For example, the partnership in Chicago was faced with the fact that different FQHCs use different electronic health record systems and Dr. Jones highlighted the benefits of using an online portal, called MHNconnect, which allows for real-time alerts and information exchange among all participating providers. Next, Ms. Jacqueline Leifer of Feldsman, Tucker, Leifer, Fidell LLP and Ms. Sarah Mutinsky of Eyman Associates each described important legal considerations when creating partnerships, from the perspectives of both FQHCs and hospitals. Ms. Leifer described various collaborative opportunities, including referral arrangements, co-location arrangements, and the transfer of hospital outpatient practice sites to FQHC s operational authorities, and provided an overview of the unique legal matters for each of these opportunities. Ms. Mutinsky described other legal issues around cost-sharing assistance for individuals newly enrolled in the health insurance exchanges. This presentation had particular significance for attendees from the Richmond Safety Net Partnership, who are in the process of developing a cost-sharing assistance program and are working through some legal and regulatory considerations. Finally, Dr. Nancy Garrett of Hennepin County Medical Center provided an overview of the Hennepin Health ACO model. She described the processes of developing a governance and committee structure, developing the care model, staffing the care model, and investing in data and analytics. She also emphasized the importance of their data warehouse, which includes medical claims data, social services data, and patient electronic health records.