Transcript Document

REGION 10 RHP
PUBLIC HEARING
December 12, 2012
WELCOME
Robert Earley, CEO, JPS Health Network
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1115 WAIVER OVERVIEW
David Salsberry, CFO, JPS Health Network
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• Please refer to webinar posted on Nov. 7, 2012
for an overview of the 1115 waiver and the
Region 10 RHP.
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TEXAS WAIVER
PARTICIPATION
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REGION 10 RHP
OVERVIEW
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Performing Providers - DSRIP
Mental Health
Hospitals
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•
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JPS Health Network
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Baylor All Saints
Cook Children’s
Children’s Medical
Center of Dallas
Ennis Regional
Glen Rose
HCA
• Medical Center of
Arlington
• North Hills Hospital
• Plaza Medical
•
Center Fort Worth
Methodist Mansfield
Texas Health Harris
• Arlington Memorial
• Azle
• Cleburne
• Fort Worth
• Huguley
• Hurst Euless
Bedford
• Southwest Fort
Worth
• Stephenville
Wise Regional
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•
•
•
Other
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•
Tarrant County Public
Health
University of North
Texas Health Sciences
Center
Physician Groups
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•
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Lakes Regional
Pecan Valley
Helen Farabee
MHMR Tarrant
County
JPS Health Network
Physician Group
Wise Clinical Care
Associates
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REGION 10 RHP DSRIP
PROJECTS
Allen Miller, CEO, COPE Health Solutions
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Total number
of projects and outcomes
Category 1 and 2 projects: 112
Category 1
Infrastructure development projects: 38
Category 2
Program Innovation and Redesign projects: 74
Category 3
Quality Improvement Outcomes: 207
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Community Health Needs
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Major Areas of Community Need
Capacity
-Increase capacity in primary and specialty care
Access
-Eliminate or reduce barriers to access
Delivery Transformation
-Change the manner in which health care is delivered
Population Health
-Improving health and wellness of the region through
cooperation among providers
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Community Need - Capacity
More provider capacity (CN.1)
More primary care and specialty care services (CN.2 and
CN.3)
More mental health services access (CN.4)
More dental care access (CN.6)
More geriatric, long-term care, and home health
resources (CN.9)
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Region 10 DSRIP Transformation
New Regional Project
Impacts by 2016
Pass 2 and 3 projects addressing Capacity needs
New Interventions in Pass 2 and 3
Develop crisis stabilization
services for mental health
patients
Improve and standardize
medical procedures
Establish consultative palliative
care program and pain
management
Establish depression/trauma
consulting center
Expand Substance Use
Disorder Program
Establish TB Clinic
Expand Family Medicine
residency program
Community based behavioral
health care for elders
Reduce average length of
inpatient stay for targeted
population
New Outcome Measurements in Pass 2 and 3
Average length of inpatient stay
Participating Providers
Preventable hospital-acquired
complications
Children’s Medical center of
Pain management
Dallas
Pain related ED utilization and
Glen Rose Medical Center
admission
Helen Farabee
TB treatment completion rate
JPS Hospital
Number of future physicians
JPS Physician Group
working in HPSA or MUA
Lake Regional
Pediatric asthma ED utilization
MHMRTC
rate
Pecan Valley
Tarrant County Public Health
UNTHSC
Wise Clinical Care Associates
Wise Regional
Reduce incidents of preventable
hospital-acquired complications
Increase number of documented
pain screening and intervention
Reduce pain related ED
utilization and admission
Increase TB treatment
completion rate
Increase number of future
physicians working in HPSA or
MUA for at least 5 years
Reduce pediatric asthma ED
utilization rate
Capacity Projects by County
Ellis
Erath
Hood
Johnson
Navarro
Parker
Somervell
Tarrant
Wise
Pass 1
4
0
0
2
2
0
2
37
4
Pass 2
1
0
0
0
1
0
1
10
2
Pass 3
0
0
0
0
0
0
0
3
0
Total
5
0
0
2
3
0
3
50
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County
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Total number of projects that address or partially
address Capacity needs: 69
More to do
_______________
• Dental care capacity
• Geriatric, and long-term
care capacity
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Community Need - Access
Reduce geographic barriers that impede access to care
(CN.7)
Improve healthcare access for residents facing financial
barriers (CN.8)
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Region 10 DSRIP Transformation
New Regional Project
Impacts by 2016
Pass 2 and 3 projects addressing Access needs
New Interventions in Pass 2 and 3
Expand service hours
Implement pediatric disease
management program
Establish school-based
health care
Establish TB clinic
Community based behavioral
health care for elders
Implement pain management
program
Reduce pediatric asthma ED
utilization rate
New Outcome Measurements in Pass 2 and 3
Pediatric asthma ED
Participating Providers
utilization rate
Pediatric asthma ED
Children’s Medical Center
utilization
of Dallas
Pediatric asthma
Helen Farabee
readmission rate
JPS Hospital
ED utilization and admission JPS Physicians Group
for pain
Pecan Valley
TB treatment completion rate Tarrant County Public
Health
UNTHSC
Reduce pediatric asthma ED
utilization
Reduce pediatric asthma
readmission rate
Reduce ED utilization and
admission for pain
Increase TB treatment
completion rate
Access Projects by County
Ellis
Erath
Hood
Johnson
Navarro
Parker
Somervell
Tarrant
Wise
Pass 1
2
0
0
2
1
2
0
19
3
Pass 2
0
0
0
0
0
0
1
5
1
Pass 3
0
0
0
0
0
0
0
1
0
Total
2
0
0
2
1
2
1
25
3
County
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Total number of projects that address or partially address
Access needs : 36
More to do
_______________
• Reduce Geographic
barriers
• Reduce Financial
barriers
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Community Need – Population Health
More access to healthy foods (CN.14)
More education, resources to promote a healthy lifestyle
(CN.15)
Reduce incidence rates of syphilis and chlamydia
(CN.16)
Improve management of Varicella (Chicken pox) (CN.17)
Improve management of Pertussis (Whooping cough)
(CN.18)
Improve Public Health Bio surveillance (CN.20)
Reduce tuberculosis (TB) prevalence (CN. 21)
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Region 10 DSRIP Transformation
New Regional Project
Impacts by 2016
Pass 2 and 3 projects addressing Population Health needs
New Interventions in Pass 2 and 3
Implement pediatric disease
management program
Implement school-based
health care
New Outcome Measurements in Pass 2 and 3
Reduce pediatric asthma ED
utilization and admission
Pediatric asthma ED
utilization and admission
Pediatric asthma
readmission
Reduce pediatric asthma
readmission
Participating Providers
Children’s Medical center
of Dallas
Glen Rose
JPS Hospital
Tarrant County Public
Health
UNTHSC
Population Health Projects by County
Ellis
Erath
Hood
Johnson
Navarro
Parker
Somervell
Tarrant
Wise
More to do
Pass 1
0
0
0
0
0
0
0
9
0
Pass 2
0
0
0
0
0
0
1
3
0
Pass 3
0
0
0
0
0
0
0
0
0
Total
0
0
0
0
0
0
1
12
0
County
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Total number of projects that address or partially address
Population Health needs: 13
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• More access to healthy
foods
• More education on
healthy lifestyles
• Lower rates of
communicable disease
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Community Need – Delivery Transformation
Integrate mental healthcare in primary care system
(CN.5)
Reduce emergency department (ED) services (CN.10)
More coordination of care between providers (CN.11)
More culturally competent care to address needs (CN.12)
More patient education programs (CN.13)
More early prenatal care (CN.19)
Improve health IT infrastructure (CN. 22)
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Region 10 DSRIP Transformation
New Regional Project
Impacts by 2016
Pass 2 and 3 projects addressing Delivery Transformation needs
New Interventions in Pass 2 and 3
Develop crisis stabilization
services for mental health
patients
Implement pediatric disease
management program
Improve and standardize
medical procedures
Establish consultative palliative
care program and pain
management
Establish depression/trauma
consulting center
Develop care model with
outcome-based payments
Expand Substance Use
Disorder Program
Establish TB Clinic
Community based behavioral
health care for elders
Implement maternal medical
homes and pregnancy
programs
Reduce preventable hospitalacquired complications
New Outcome Measurements in Pass 2 and 3
Preventable hospitalParticipating Providers
acquired complications
Pain management
Children’s Medical Center of
Pain related ED utilization
Dallas
and admission
Glen Rose
Cost of care delivery
HCA Hospitals
TB treatment completion rate Helen Farabee
JPS Hospital
Pediatric asthma ED
JPS Physicians Group
utilization rate
Lake Regional
MHMR Tarrant County
Pecan Valley Center
Tarrant County Public Health
UNTHSC
Wise Clinical Care
Associates
Wise Regional
Improve patient pain
management
Reduce pain related ED
utilization and admission
Improve quality of care
delivery while reducing
unnecessary cost
Improve TB treatment
completion rate
Reduce pediatric asthma ED
utilization rate
Delivery Transformation Projects by County
Ellis
Erath
Hood
Johnson
Navarro
Parker
Somervell
Tarrant
Wise
More to do
_______________
Pass 1
3
0
0
2
2
2
3
56
0
Pass 2
1
0
0
0
1
0
2
11
2
Pass 3
0
0
0
0
0
0
0
3
1
Total
4
0
0
2
3
2
5
70
3
County
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Total number of projects that address or partially address
Delivery Transformation needs: 89
• Integrate Mental Health
and Primary care
• Improve cultural
competency
• More patient education
• Earlier prenatal care
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Learning Collaboratives
1) Access to and Capacity for Behavioral Health
Care, including integration with primary care
2) Care Transitions and Patient Navigation
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POTENTIAL FINANCIAL
IMPACT ON REGION 10 RHP
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DSRIP Project Funding Highlights
• DSRIP funding is not block grant based but determined
on a federal matching fund mechanism
• Allocations of DSRIP funding are driven by Program
and Funding Protocol and not by the anchor facility
• DRSIP funding requires a qualifying local government
entity to commit and provide an Inter-Governmental
Transfer (IGT)
• Project valuation was determined in Region 10 based
upon a valuation model that included significant vetting
and participation by RHP participants
• Ultimate payment is dependent on performing provider
performance on DSRIP milestones and outcomes
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Delivery System Reform Incentive Payment
• Community needs assessment is conducted
to identify areas of opportunity to improve
health in each county within a region.
• The participating providers use the
assessment to inform the selection of DSRIP
projects.
• Payment from the DSRIP pool is contingent
on outcomes achieved within designated time
periods.
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Potential DSRIP Funds – Region 10
Gross DSRIP
Allocation *
Required
IGT **
Net Potential
DSRIP Funds
Waiver Year 1
(DY1)
$48.7M
($20.3)M
$28.4M
Waiver Year 2
(DY2)
$224.1M
($93.6)M
$130.5M
Waiver Year 3
(DY3)
$259.7M
($108.5)M
$151.2M
Waiver Year 4
(DY4)
$277.8M
($116.1)M
$161.7M
Waiver Year 5
(DY5)
$302.0M
($126.2)M
$175.8M
Total
$1.1B
($464.7)M
$647.6M
* Statewide totals approved in the 1115 Waiver
** Estimated @ current FMAP rate
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NEXT STEPS
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Region 10 RHP Development Timeline
Final Region 10 RHP Plan submission with Pass
1, 2 and 3 Projects
Week of Dec. 17, 2012
HHSC deadline for final RHP Plan submission
with all required documents
Dec. 31, 2012
HHSC 30-day formal review
Following date of full plan submission
CMS 45-day formal review
Following receipt of approved plans from HHSC
CMS approval or denial of RHP plans
May 1, 2013 or 15 days after receipt of revised plan
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FEEDBACK AND COMMENTS
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Contact information
• Email: [email protected]
• Website: http://www.jpshealthnet.org/rhp.aspx
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