Better Health Together Transformation Plan Templates Hadley Morrow

Better Health Together: Transformation Plan Templates Hadley Morrow Director of Engagement

Reminder of Medicaid Transformation Project requirements Today’s Webinar Overview of Transformation Plans and their purpose 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.

How many $s are there? Year 1 FIMC Funds $3. 32 M Project Funds $11. 3 M Year 2 Year 4 Year 5 $17. 9 M $7. 8 M at risk $11. 7 M $500 k $1. 29 M Totals $8. 3 M $4. 98 M $400 K $46 M in IGT Domain 1 Investment Year 3 $10. 4 M $600 k $2. 39 M $5. 1 M $700 k $4. 18 M $58. 6 M ($56. 4+$2. 2 M VBP Incentives) $7. 86 M at Risk 55% to Collaboratives 30% to regional infrastructure $6. 2 M $9. 9 M $6. 5 M $5. 7 M $2. 8 M $31. 1 M $3. 4 M $5. 4 M $3. 5 M $3. 1 M $1. 5 M $16. 9 M 10% to Community Resilience Fund $1. 1 M $1. 8 M $1. 2 M $1 M $516 k $5. 6 M 5% to ACH Administrative Cost $565 k $896 k $589 k $516 k $258 k $2. 8 M

Funds Flow Dollars so far We have made no additional decisions on how Project dollars will be allocated to providers other than: 55% to Collaborative for: • • MOUs by setting for Collaboratives Volume and Equity Accelerators MTP Assessments plans for BH/PC MTP Implementation plans for BH/PC 30% to Regional Infrastructure • • Pathways Investments Collaborative Lead Organizations 10% to Community Resiliency Fund • No decision on how these funds will be distributed, we expect to bring proposal to board in October for distribution of funds in early 2019. 5% for BHT Admin

Funds Flow FIMC The first round of FIMC funding was designed to prepare BHO contracted Medicaid Providers and Tribal BH Providers for financial integration in 2019 • • BHO Contracted Medicaid Providers regardless of volume or geography earned $70 k Tribal BH Providers regardless of volume or geography earned $45 K

Funds Flow Future Decisions Project Allocations for Year 2 -5 will be established in late 2018 or early 2019 • Waiting on input from Collaborative and Provider Plans • Expect blend of Pay for Reporting and Pay for Performance Providers should build their financial plans with a view towards weaving together funding to meet setting requirements, not “pitching” discrete project ideas. • For instance, if Provider x is able to meet all of the Pay for Reporting and Pay for Performance metrics they would earn 100% of dollars allocated to those activities. These dollars could be expended to support future support work. BH/PC Providers should be developing their plan with eye towards partnership necessary to meet the setting requirements, this may include bi-directional partners and social determinants of health partners. Social Determinant of Health partners should be developing value propositions to assist BH/PC providers to meet their setting requirements and VBP goals.

Collaboratives by County 7 unique partners 13 settings Funds earned YTD: $197, 000 11 unique partners 18 settings Funds earned YTD: $322, 000 11 unique partners 17 settings Funds earned YTD: $158, 000 12 unique partners 19 settings Funds earned YTD: $266, 000 50 unique partners 72 settings Funds earned YTD: $2, 693, 000 8 unique partners 17 settings Funds earned YTD: $233, 000

Transformation Project Implementation • Implementation for these project areas will begin January 2019, but the planning work must begin now. • 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

• 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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• 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. Example

Chronic Disease Management & Prevention

Opioid Response

For Primary Care Providers ONLY ACH Priority Areas Activities recommended by Provider Champions Council in alignment with ACH priorities of reducing unintended pregnancies and improving oral health Respond to Long Acting Reversible Contraceptive (LARC) Strategy Respond to Application of Fluoride Varnish in Primary Care Setting Strategy

Partnering Provider Plan Template Please hold questions until the end, and we’ll open up the Word Doc Template

Budget Overview of Excel Budget Template

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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Upcoming Webinars Visit www. betterhealthtogether. org/collaboratives for registration links. Bi-directional Integration of Care Presenter: Anne Shields, MHA, RN • AIMS Center Tuesday, June 19 @ 9 am Chronic Disease Management Presenter: Ron Stock, MD • Health Management Associates Wednesday, June 20 @ 9 am Addressing the Opioid Crisis Presenter: Corey Waller, MD • Health Management Associates Monday, June 25 @ 9 am Pathways Model Presenter: Jenny Slagle, BHT Tuesday, June 26 @ 2 pm Budget for Partnering Provider Plans Presenter: Cathy Homkey, Health Management Associates Friday, July 13 @ 9 am

• 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?