Transcript Power Point Presentation - New York Care Coordination Program

Introduction to Beacon Health Strategies
Western Region RBHO County Director’s Meeting
November 21, 2011
Beacon serves 6 million lives in 13 states on behalf of over
50 health pans and State Partners
MEDICAID
MEDICARE
MULTI-SECTOR
November 2011 | 2
BEACON HEALTH STRATEGIES | 200 State Street Suite 302, Boston, MA 02109 | t. 617.747.1230 | beaconhealthstrategies.com
Beacon is NY’s largest public population MBHO
BEACON’S NEW YORK FOOTPRINT
642K
Medicare SNP
SMI/Duals
KEY NEW YORK BUSINESS HIGHLIGHTS
Working in the Hudson Valley since 1997
7 Health Plan Partners
7,000 Contracted Providers in New York State
2009 Case Management and Quality Improvement partnership
with NYCCP/ CCSI and 7 County systems:
•
Chautauqua, Erie, Genesee, Monroe, Onondaga,
Westchester, and Wyoming
Medicaid
>30 New York Clinicians Based Locally in NY:
•
UR, CM and Physician Advisors
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BEACON HEALTH STRATEGIES | 200 State Street Suite 302, Boston, MA 02109 | t. 617.747.1230 | beaconhealthstrategies.com
Quality Matters
Beacon Consistently Outperforms the State HEDIS/QARR Scores
30 DAY FOLLOW-UP RATE AFTER IP ADMISSION
SOURCE: NY DOH
7 DAY FOLLOW-UP RATE AFTER IP ADMISSION
SOURCE: NY DOH
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BEACON HEALTH STRATEGIES | 200 State Street Suite 302, Boston, MA 02109 | t. 617.747.1230 | beaconhealthstrategies.com
Engaging community service providers improves care and
social well-being
% OF HIGHEST COST SPMI MEMBERS RECEIVING COUNTY SPMI CARE MANAGEMENT PROGRAM
SERVICES
59% decrease in ER utilization
62% decrease in IPMH ALOS
34% decrease in self harm incidents
32% decrease in physical harm to others
50% decrease in suicide attempts
44% increase in gainful employment
Enrollees
654
704
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BEACON HEALTH STRATEGIES | 200 State Street Suite 302, Boston, MA 02109 | t. 617.747.1230 | beaconhealthstrategies.com
Beacon engages high risk members using a team-based
approach
OVERVIEW OF THE WESTCHESTER CARES ACTION PROJECT (CIDP)
MEMBER:
High risk, multiple chronic
diseases, 39% homeless, FFS
COMMUNITY-BASED
ORGANIZATIONS NETWORK:
>29 organizations signed
confidentiality agreements
and provide referrals
OUTREACH PERSONNEL:
outreach to club houses,
shelters, churches, libraries,
parks, etc.
CLINICIAN:
actively engage clients with
initial intake, weekly
telephonic coaching,
quarterly face to face
appointments, re-assessment
every 6 months.
SOCIAL
SUPPORTS
PEER NAVIGATOR:
makes connection to social
and medical services, adds
credibility, serves as a role
model of recovery
MEDICAL
APPOINTMENTS
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BEACON HEALTH STRATEGIES | 200 State Street Suite 302, Boston, MA 02109 | t. 617.747.1230 | beaconhealthstrategies.com
HOUSING
RBHO Partnership with CCSI and County Systems will inform
Participation in Phase II of the NY’s Medicaid Redesign
•
Beacon brings managed care preparedness, IT infrastructure and
clinical and analytic leadership to its RBHO work
•
Health Home review and consideration underway
•
Expanding staff in the Western Region to support provider, County, peer
and health plan engagement
•
Fully operational Jan 1, 2012
Contact Information:
Jim Spink, Chief Client Officer, BHS
[email protected]
Mark Deasy, Dir. Account Ops. BHS
[email protected]
Chris Mangione, Clinical Mgr, BHS
[email protected]
Adele Gorges, Ex Director, NYCCP
[email protected]
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BEACON HEALTH STRATEGIES | 200 State Street Suite 302, Boston, MA 02109 | t. 617.747.1230 | beaconhealthstrategies.com