Better Health Together Transformation Plan Templates Cathy Kaufmann
Better Health Together: Transformation Plan Templates Cathy Kaufmann, MSW Health Management Associates
Reminder of Medicaid Transformation Project requirements Overview of Transformation Plans and their purpose Today’s Webinar Collaborative Transformation Plan Requirements Partnering Provider Transformation Plan Requirements Timeline and submission Technical assistance and support Q & A
• ACHs were required to select project areas from the ”Toolkit” developed by the state. Medicaid Transformation Project Requirements • Each project area has an approved list of models from which ACHs and their Partnering Providers can select • Each project comes with required reporting and performance metrics • Over time, more and more of an ACHs funding is determined by their performance on these metrics.
• Last fall, the BHT Board selected 4 project areas from the state Toolkit: • Bidirectional Integration of Care • Chronic Disease Management Project areas selected by BHT • Addressing Opioid Public Health Crisis • Community-Based Care Coordination • In addition to the four project areas, the BHT Board approved four local goals: • Reduce unintended pregnancies • Improve oral health • Increase behavioral health access • Reduce jail recidivism
Funding for Medicaid Transformation Projects Approximately, $61. 7 million is available to the BHT region to support implementation of these plans over the five years of the Medicaid Transformation Project. Funding over the years is based on pay-for-reporting and pay-for-performance metrics.
Applies to … Bi-directional Integration Opioids Communitybased Care Coordination Chronic Disease Antidepressant Medication Management X Child and Adolescents’ Access to Primary Care X X Comprehensive Diabetes Care: Eye Exam (retinal) performed X X Comprehensive Diabetes Care: Hb. A 1 c Testing X X Comprehensive Diabetes Care: Medical attention for nephropathy X X X X X Inpatient Hospital Utilization Medication Management for People with Asthma X X X X Mental Health Treatment Penetration Outpatient Emergency Department Visits X X X Percent Homeless Plan All-Cause Readmission Rate Substance Use Disorder Treatment Penetration X X X Substance Use Disorder Treatment Penetration (Opioid) X Patients on high-dose chronic opioid therapy X Patients with concurrent sedatives prescriptions X MTD Pay-for-Performance Measures Follow-up After Discharge from ED for Alcohol or Other Drug Dependence Follow-up After Discharge from ED for Mental Health Follow-up After Hospitalization for Mental Illness Statin Therapy for Patients with Cardiovascular Disease X 6
• Implementation for these project areas will begin January 2019, but the planning work must begin now. Transformation Project Implementation • BHT required to report to the state on plans: • Semi-Annual Report due to state over the summer • Implementation Plan due to state in fall • Partnering Provider contracts need to be signed by the end of the year
• Transformation Plans are the road map for Collaboratives and Partnering Providers in the BHT region. Overview of Transformation Plans • They are the plans describing how work in the four project areas selected and in support of the four local goals will be implemented. • There are two levels of Transformation Plans: • Collaborative Transformation Plan: plan developed across all Partnering Providers in the Collaborative • Partnering Provider Transformation Plan: plans developed by Partnering Providers with primary care and behavioral health settings (in partnership with emergency department, SDo. H providers, etc. )
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• Each of the 6 County Collaboratives must develop a Collaborative Transformation Plan to guide and coordination activities across its Partnering Providers. Collaborative Transformation Plans • This plan will serve as the framework for plans developed by Partnering Providers • Partnering Providers will still have autonomy and choice, but will be expected to reflect and support the framework and priorities in the Collaborative plan. • Key goals of the Collaborative Transformation Plan are to break down silos, develop cross-sector collaborations, identify local priorities and approaches (within the state framework), as well as resources and gaps.
• Describe Collaborative governance (submit final charter) • Community strengths and needs Collaborative Transformation Plans continued • How does the Collaborative want to approach Communitybased Care Coordination? • Pathways HUB for target pops or other approach? • Framework / Priorities / Shared strategies for Bidirectional Integration, Chronic Disease and Opioids and four local goals • What functions/ role will the Collaborative play? What value does the Collaborative bring to Partnering Providers?
Why alignment matters Alignment across projects not only makes for a strong project portfolio, it helps create a stronger region. Cohesive Project Portfolio § Strongest plans will demonstrate alignment and shared framework Outcome Metrics Targeted Resources § Focused rather than scatter shot approach makes successful implementation easier to achieve § Aligning along populations and metrics increases likelihood BHT will meet performance targets in later years Sustainability § Strong alignment builds strong foundation for sustainability in year 6 12
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• Partnering Provider Transformation Plans describe plans (strategies/activities, goals, timeline and budget) for Bidirectional Integration, Chronic Disease and Opioids. Partnering Provider Transformation Plans • These plans are for Partnering Providers with Primary Care and Behavioral Health settings. • Partnerships with emergency departments, SDo. H partners and/or other provider types should be included to support project measures and BHT goals. • Partnering Providers who participate in more than one Collaborative will need to submit a plan for each Collaborative. • However, multiple settings can be included in one plan
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• Describe strategies/activities, target population(s), goals, timeline and budget for Bidirectional Integration, Chronic Disease and Opioids transformation areas. • Specific aims statements for each transformation area Partnering Provider Transformation Plans continued • For each of the key elements of the model identified in the toolkit: • Current state: What current capacity exists? What resources, processes are currently in place that support achievement of the key element of the model? What gaps exist? • Implementation Year 1: What resources, improvements, activities are planned for year 1? How do they support the model and connect to strengths and gaps identified in current state? Include milestones and timelines. • Plans for Years 2 -4: What further improvements are planned in future years of the MTP? Less detail is expected for plans in these years, but a basic road map should be provided.
Bi-directional Integration section
Bi-directional Integration section continued
Bi-directional Integration section continued
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• Webinars • Regularly updated FAQ • Relevant documents / links of Collaborative web page: How BHT will help you develop these plans • HCA Toolkit • Performance measures and baseline data • Office hours: call BHT staff with questions, subject matter experts available for T. A. calls / questions about the models • What requests for additional support do you have?
Questions? We will answer as many questions as we can on this call. All questions will receive an answer in writing through FAQ document that will be sent out early next week.
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