Transcript Main Presentation - awmedicalpps.com

AGENDA
I.
Our DSRIP: ACP / AW Medical
What it means for community providers like us?
II. The Physician and DSRIP:
Pay for performance
III. Patient engagement:
Simple steps to higher payment
OUR DSRIP:
ACP / AW MEDICAL
LEAD: AW
MEDICAL
NYCPP
MEDISYS SYSTEM
North Shore - LIJ
NEW YORK COMMUNITY
PREFERRED PROVIDER
COMMUNITY
PREFFERED
NETWORK
RENAISSANCE
COLLABORATIVE
Community Provider Network (CPN)
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Asian American ACO
Chinese American IPA
Chinese Community ACO
Eastern Chinese American Physicians IPA
Korean American Physicians IPA
CBW Community Health Center
Renaissance Collaborative (RC)
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Balance Medical ACO
Balance Medical IPA
Breukelen Community Network IPA
Corinthian Medical IPA
Excelsior Medical IPA
Queens County IPA
NYCPP Leadership Team
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Dr. George Liu, Co-Chairman
Dr. Ramon Tallaj, Co-Chairman
Dr. Henry Chen, Treasurer
Dr. Emilio Villegas - Secretary
Dr. Bing Lu, Board of Manager
Dr. Hanbin Zheng, Board of Manager
Dr. Jonathan Chang, Board of Manager
Dr. Michael Li, Board of Manager
Dr. Sunhoo Foo, Board of Manager
Dr. Vincent Wang, Board of Manager
Dr. Hal Sadowy, Co-Chief Operating Officer
Ms. Peggy Sheng, Co-Chief Operating Officer
WHAT IT MEANS FOR COMMUNITY
PROVIDERS LIKE US?
We have brought over 2,000
physicians together as ONE
我們是一家人
Somos uno
AW Medical PPS is not just made up of Physicians
Hospitals
Physicians
Behavior
Health and
other
important
providers
Non-physician partners
Bronx
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ACMH, Inc.
Affinity Health Plan
Alpine Home
Health Care
Amazing Home
Care
Amber Court At
Home
Amber Court Of
Pelham Gardens
Arms Acres, Inc
Best Choice Home
Health Care, Inc.
Beth Abraham
Health Services
Boris Dubrovsky,
Phd
Bronx Center For
Rehabilitation &
Health Care
Bronx Lebanon
Hospital Center
Bronx Park Rehab
& Nursing Center
Bronx Supported
Housing
Bronx-Lebanon
Hospital Center
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Center for Urban •
Community
Services
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Centerlight
Healthcare Inc.
Centerlight Healthc •
are Diagnostic & Tr
eatment Center
CL Healthcare Inc •
Community Access
Inc
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Daughters Of
Jacob Nursing
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Home Company
Inc.
Doshi Diagnostic •
Imaging Services,
P.C.
Eli Leiter, Phd
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Friends And Family
Hebrew Home At
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Riverdale
Jewish Association
For Services For •
The Aged (Jasa)
Jewish Board Of
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Family And
Children'S Services •
Kings Harbor
Multicare Ctr.
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Kingsbridge
Hieghts Rehab And •
Care Center
Mvp Housing
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Development Fund
Company Inc.
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Narco Freedom,
Inc
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New York Dialysis
Services, Inc.
New York
Psychotherapy And •
Counseling Center
Palisade Nursing
Home Company, •
Inc.
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Park Housing
Development Fund •
Company Inc.
Phoenix Houses Of •
New York, Inc.
Postgraduate
Center For Mental •
Health
Project Renewal
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Rain (Regional Aid
For Interim Needs)
Riverdale Mental •
Health Association
Rosselle Estrella, •
Pt
Scheuer Gardens •
Limited Partnership •
Scheuer Plaza
Limited Partnership •
Schnurmacher
Center For
Rehabilitation And
Nursing
Seniorcare
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Emergency Medical
Services
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Seniorride
Sheryll Garcia, Pt •
St Barnabas
Hospital Health
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System
St Joseph's
Hospital
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Steinway Child And
Family Services,
Inc
Success
Counseling
Services, Inc
Sus-Mental Health
Programs, Inc.
Terrace Health
Care Center, Inc
The Bridge
The Pac Program
Of The Bronx, Inc
University
Consultation &
Treatment Center
For Mental
Hygiene, Inc.
University Nursing
Home
VIP Community
Services
Westchester Family
Health Center
Weston United
Community
Renewal, Inc.
Williamsbridge Man
or Nursing Home
Brooklyn
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MJHS License Home Care
Service Agency
AlphaCare
Amber Court at Home
Amber Court of Brooklyn
Americare Certified
Specialty Services, Inc.
Anna Sidorkina, LAC
Best Choice Home Health
Care, Inc.
BETH ISRAEL MEDICAL
CTR
BGR Services, Inc.
Boro Park Center for
Rehabilitation & Health Care
Breukelen Community
Network IPA
Bridge Back to Life Center,
Inc.
Bridger
BRIDGING ACCESS TO
CARE
Brooklyn Center for
Rehabilitation and
Residential Health Care
Brooklyn Community
Services
Bushwick Brooklyn ACT
Bushwick Center for
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Rehabilitation and Health
Care
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CAIPA Social Day Care
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Center
Catholic Charities
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Center for Nursing and
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Rehabilitation
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Center for Urban Community
Services
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CenterLight Certified Home
Health Agency
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Central Brooklyn ACT
CL Healthcare Inc
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Cobble Hill Health Center,
Inc.
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Community Access Inc./
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Warren Street
Community Radiology of NY •
Doshi Diagnostic Imaging
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Services, P.C.
East Brooklyn ACT Team
Elderplan
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Emerson TAP
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Empire City Laboratories
Federation of Organizations •
for NYS Mentally Disabled
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Fresenius
God's Love We Deliver, Inc
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Guidance Center of
Brooklyn
Health Homes
Homecrest Community
Services, Inc
ICL
ICM Brooklyn
Jewish Board of Family and
Children's Services
John J. Pershing
Intermediate School 220
Lawton Street Community
Residence
Linden House Community
Residence
Livonia Avenue
LUTHERAN MEDICAL
CENTER
Marizza Dulfo, PT
Menorah Center for
Rehabilitation and Nursing
Care
MJHS Long Term Care
New York Congregational
Nursing Center
New York Psychotherapy
and Counseling Center
NEW YORK THERAPEUTIC
COMMUNITIES, INC
Ohel Childrens Home and
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Family Services
Phoenix House Foundation,
Inc.
Phoenix Houses of New
York, Inc.
Postgraduate Center for
Mental Health
Preventive Diagnostics
Rockaway Park Center
Shiel Medical Laboratory
St. Joseph's Hospital
St. Mark's MICA Supported
Housing
St. Mark's Scattersite
Supported Housing
Steinway Child and Family
Services, Inc.
Steppingstone Congregate
Treatment
Summit Home Health Care
Supported Housing for
Women with HIV/AIDS
SUS
Tillary Street Women's
Shelter
Williamsburg Physical
Therapy
Manhattan
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181 Street Medical PC
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3rd Street Men's Shelter
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ACMH, Inc
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Alberto De Castro, PT
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Aleksey Kleyman, LAC
Americhoice
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Amerigroup MLTC
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Amerigroup/Healthplus
Asian American Accountable Care
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Organization, LLC
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Balance Medical ACO
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Balance Medical IPA, Inc
Beacon of Hope House
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BETH ISRAEL MEDICAL CTR
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Bridge Back to Life Center, Inc.
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CareNext
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Center for Alternative Sentencing
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and Employment Services
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Center for Urban Community
Servcies
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Charles B. Wang Community
Health Center
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Chinese American IPA, Inc.
Chinese Community Accountable •
Care Organization
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CL Healthcare Inc
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Community Access Inc.
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Community Association of
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Progressive Dominicans (ACDP)
Comunilife Inc
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Coordinated Behavioral Care, Inc •
Pathways to Wellness HH
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Corinthian Medical IPA, Inc
Diana Badillo
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Doshi Diagnostic Imaging
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Services, P.C.
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Elizabeth Uzor
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Elmont Open MRI
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Empire State Dental
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Geffner House
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Good Sheperd Services
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Gouverneur Healthcare Services - •
Skilled Nursing Facility
Gramercy Park Digestive Disease •
Center, LLC
Greenwich House, Inc.
Harlem East life Plan
Healthfirst
Heritage Health Home Network
Heritage Healthcare Network
ICL Broadway Community
Residence
Isabella Nursing Home
Jason Waterman
Jewish Board of Family and
Children's Services
Kenneth Ged
Kenton Hall Men's Shelter
L&L Orthotics, LLC
Manhattan Supportive Housing
Mary Claire Arbilo, PT
MARY MANNING WALSH
Melida Knibbs
Metroplus Health Plan
Metropolitan Center for Mental
Health
Metropolitan Jewish Home Care
Inc. d/b/a MJHS Home Care
Manhattan (continued)
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MIH Experience LTD
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Mitzy Baldovino, PT
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MJHS Hospice and Palliative Care •
National Association on Drug
Abuse Problems, Inc.
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New York Dialysis Services, Inc. •
New York eHealth Collaborative •
(NYeC)
NEW YORK EYE & EAR
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INFIRMARY
Ninel Platsman, PT
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Palladia, Inc.
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Phoenix House Foundation, Inc.
Postgraduate Center for Mental •
Health
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Project Renewal
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Rapid Care Solutions
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Rowell Arguelles, PT
Salcare Home Health Services,
Inc
SCAN New York
Senior Health Partners
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Senior Whole Health
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Seong Chul Ha, LAC
Service Program for Older People, •
Inc.
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Shiel Holdings, LLC
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Shiel Medical Laboratory
ST LUKES ROOSEVELT HOSP- •
ROOSEVELT HOSP
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ST LUKES ROOSEVELT HOSPST LUKES HOSP
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St. Nicholas House
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SUS- Mental Health Programs,
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Inc.
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TERENCE CARDINAL COOKE
The Bridge
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The Fifth Avenue Counseling
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Center, Inc.
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The First Chinese Presbyterian
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Community Affairs Home
Attendant Corp.
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THE MOUNT SINAI HOSPITAL
The National Alliance for the
Mentally Ill of New York City, Inc.
The PAC Program of The Bronx,
Inc
United Rx Buying Group LLC
University Settlement Early
Intervention Program
Vidyasagar Pamulapati, PT
Vijayalakshmi P. Davuluri, PT
Visiting Nurse Service of New York
Home Care
VNS Choice
VNSNY
VNSNY Behavioral Health
VNSNY Hospice and Palliative
Care
Washington Heights Imaging
WellCare Health Plan
WellCare MLTC
Weston United Community
Renewal, Inc.
Women In Need
Queens
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ACMH, Inc.
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Alvin Orodio, Pt
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Amber Court Of Westbury
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Arms Acres, Inc
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Bleuler Psychotherapy Center,
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Inc.
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Bridge Back To Life Center, Inc.
Catholic Charities
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Center For Urban Community
Services/Rikers Island Single Stop •
CL Healthcare Inc
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Conifer Park, Inc
Cornerstone Medical Arts Center •
Hospital
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Cuatro Llc Dba Access Medicare
Ny
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Doshi Diagnostic Imaging
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Services, P.C.
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Dr. William O. Benenson Rehab •
Pavilion
Eastern Chinese American
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Physicians Ipa
Excelsior Medical IPA
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Fed Of Org For Nys Mentally
Disabled
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Fidelis Care
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Fishman Center Total Eye Care •
Flushing Manor Care Center
Flushing Manor Dialysis Center •
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Flushing Manor Nursing Home
Goodwill Industries
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Holliswood Center For
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Rehabilitation And Healthcare
Jewish Board Of Family And
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Children'S Services
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Liberty Physical Medicine &
Rehab
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Long Island Care Center
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Long Island Consultation Center •
Margaret Tietz Nursing And
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Rehabilitation Center
Michael K.T. Mangubat, Pt
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Milestone Supportive Housing
New Horizon Counseling Center •
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New York Psychotherapy And
Counseling Center
Ohel Childrens Home And Family •
Services
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Parker Jewish Institute For
Healthcare & Rehabilitation
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Phoenix House Foundation, Inc.
Phoenix Houses Of New York, Inc.
Postgraduate Center For Mental
Health
Qsa Services, Inc.
Queens Center For Rehabilitation
& Residential Health Care
Queens County Ipa
Queens Treatment Apartment
Program
Samaritan Village
Samuel Field YM/YWCA
Shiel Medical Laboratory
South Shore Physician Group
St Joseph's Hospital
Steinway Child And Family
Services, Inc.
Supportive Services For Veteran
Families
Sus- Mental Health Programs, Inc.
The Mount Sinai Hospital Of
Queens
Union Plaza Nursing Home Dba
Union Plaza Care Center
Venture House
Xeron Labs
THE PHYSICIAN AND DSRIP:
ABOUT
DSRIP
• Delivery System Reform Incentive Payment
• Incentive payments are performance based
• Patient engagement is KEY for incentive payment
calculation which starts 01/01/2015
• Goals are to achieve transformation of the health care
safety net provider system, improving healthcare quality,
improving population health, reducing avoidable hospital
and ED use, and lowering healthcare cost.
ACHIEVING THE GOAL
• Implementing collaborative models of patient care
• Enhanced care coordination and care management
models
• Monitoring specific performance measures
• Adherence to evidence-based protocols
• Adherence to standardized processes across the PPS
• EDI and PCMH level 3 certification
Projects Selection
2.a.i
Integrated Delivery System
2.a.iii
Health Home At-Risk Intervention Program
2.b.iii
ED care triage for at-risk populations
2.b.iv
Care Transition
3.a.1
Integration of Primary Care & Behavioral Health
3.b.1
Cardiovascular Disease Management
3.c.1
Diabetes Disease Management
3.d.iii
Asthma Management
4.b.i
Tobacco Use Cessation
4.b.ii
Increase Access to High Quality Chronic Disease Preventive Care and
Management in Both Clinical and Community Settings
PATIENT ENGAGEMENT:
PCMH (2014 Version) Level 3 by
2017
2014
2015
3/31/2015
Action
Attest
Adopt,
Implement, AIU to
Upgrade
Certified AIU
(AIU) to 2014 EHR
Certified EHR
2016
Data
Action
3/31/2016
Attest
2017
Data
Action
3/31/2017
Attest
Data
Use
any 90-day Use
MU Stage1-Y2 &
any 90-day period
Certified MU Stage 1-Y1 period from Certified meet MU Stage 2 full yr. 2016
from 2014
EHR
2015
EHR
criteria
EHR
PCMH
Upgrade to
PCMH 2014
version
MU Stage 1-Y1
any 90-day period
from 2014
MU Stage 1-Y2 full yr. 2015
MU Stage 2-Y1
full yr. 2016
MU Stage 1-Y2
any 90-day period
from 2014
MU Stage 2-Y1 full yr. 2015
MU Stage 2-Y2
full yr. 2016
MU Stage 2-Y1
any 90-day period
from 2014
MU Stage 2-Y2 full yr. 2015
MU Stage 3-Y1
full yr. 2016
Prepare PCMH Level 3
Submit PCMH Level 3
Achieve PCMH Level 3 by 6/2017
Support Team
• Lidia Virgil
212-567-4918
[email protected]
• John Dionisio
212-740-8294
[email protected]
• Susan Lau
212-965-9888
[email protected]
• Liz Webb
212-740-8294
[email protected]
Q&A