Delaware State Innovation Model Design Health Care Commission

Delaware State Innovation Model Design Health Care Commission March 28, 2013

Grant Specifics • Notice of award February 22, 2013 • Project period April 1 - September 30, 2013 • Total award $2, 485, 118

Activities to Date • • Notification of all participants to date Weekly meetings of State team Critical need procurement waiver Working with CMMI to finalize contracting specifics

Anticipated schedule of deliverables Project set up and initial hypotheses 1. 1 1. 3 1 Strategic planning & project management 1. 4 1. 5 1. 9 2 3 4 Payment model Delivery system Data/ analytics Define scope and team assignments Define processes and communication mechanisms for all aspects of plan design Schedule twiceweekly meetings Assign workstream leads Draft plan outline Current state, best practice, and options 1. 6 a Develop stakeholder map 1. 6 b Development stakeholder engagement plan 1. 6 c Develop core materials for stakeholders and maintain “grid” key events 1. 7 Monitor individual and collective workstream progress 1. 8 Identify and carry out interventions to ensure progress 2. 1 a Establish workstream charter and hold kickoff 2. 1 b Agree to goals and criteria for payment reform 2. 1 c Identify and analyze payment reform options 2. 2 a-c Identify, prioritize, and analyze peer state programs 3. 1 a Establish workstream charter and hold kickoff 3. 1 b Agree to goals of delivery system transformation 3. 1 c Obtain broad consumer and stakeholder input 3. 2 a Assess existing service delivery mechanisms 3. 2 b-d Identify, prioritize, and analyze peer state programs 3. 3 Collect DE-specific and national data identifying utilization behaviors 4. 1 a Establish workstream charter and hold kickoff 4. 1 b Agree to goals of data system reform 4. 1 c Inventory of existing health data sources 4. 2 Inventory/assess existing analytic capacity 4. 3 a Analyze state health data systems and identify key gaps 4. 3 b Prioritize data and analytic gaps 4. 4 a-c Identify, prioritize, and analyze peer state programs 4. 5 Engage health care providers 4. 6 Identify data system linkages 4. 7 Identify linkages to APCD 4. 8 Conduct policy and legal research for creation of APCD Preferred option, design and planning 1. 10 Syndicate Finalize Incorporate work product of all workstreams 1. 11 a Draft plan (first draft) 1. 11 b Draft plan (second draft) 1. 12 Disseminate draft plan and obtain broad stakeholder feedback 1. 13 Finalize plan 1. 14 Develop funding application 1. 15 Submit application 2. 3 a Agree on preferred option and model potential impact Identify and define changes in delivery, data and other systems needs Draft plan (first draft) Draft plan (second draft) 2. 6 Obtain stakeholder feedback and revise plan 2. 7 Finalize model Agree on preferred option and model potential impact Identify and define changes to data and other system needs Develop comprehensive service delivery plan (first draft) Draft plan (second draft) Develop action plan for integration of interventions 3. 7 Obtain stakeholder feedback and revise plan 3. 8 Finalize plan Agree on preferred option to fill data and analytic gaps and model potential impact Design plan for actuarial capacity Draft plan (first draft) Draft plan (second draft) 4. 12 Obtain stakeholder feedback and revise plan of 2. 3 b 2. 5 a 2. 5 b 3. 4 a 3. 4 b 3. 6 a 3. 6 b 3. 6 c 4. 9 a 4. 9 b 4. 11 a 4. 11 b 4. 13 Finalize plan

Anticipated schedule of deliverables (cont’d) Project set up and initial hypotheses 5 6 7 Policy research Workforce Population health Current state, best practice, and options 5. 1 a Establish workstream charter and hold kickoff 5. 1 b Agree to goals of policy research 5. 1 b Inventory of existing policy, licensure, and purchasing units 5. 2 a-c Identify, prioritize, and research peer state best practices 6. 1 a Establish workstream charter and hold kickoff 6. 1 b Review data and recommendations of HCC Workforce working group 6. 1 c Align on roles/ responsibilities from HCC Workforce group 6. 1 d Agree to goals of workforce transformation 6. 2 Identify state gaps in providers 6. 3 Identify gaps in licensure, training, and recruiting 6. 4 a Review “physician extender” concept 6. 4 b-d Identify, prioritize, and analyze peer state programs 7. 1 a Establish workstream charter and hold kickoff 7. 1 b Review recommendations of Governor’s Council on Health Promotion and Disease Prevention 7. 1 c Align on roles/ responsibilities from Governor’s Council 7. 1 d Agree to goals of population health 7. 2 a-c Identify, prioritize, and research peer state and best practices of population health Preferred option, design and planning Syndicate 5. 3 Define necessary statutory or regulatory updates Identify levers appropriate in health benefit redesign Define system improvements and projected cost savings Draft plan (first draft) Draft plan (second draft) 5. 8 Obtain stakeholder feedback and revise plan 5. 9 Finalize plan Agree on preferred option and model potential impact Identify and define changes in delivery, data, and other system needs Develop tasks, assignments, measures and timelines for preferred option Draft plan (first draft) Draft plan (second draft) 6. 8 Obtain stakeholder feedback and revise plan 6. 9 Finalize plan Agree on preferred option and model potential impact Identify and define changes in delivery, data, and other system needs Attach tasks, budget, and timelines to recommendations Design action plan to integrate individual and population health Draft plan (first draft) Draft plan (second draft) 7. 7 Obtain stakeholder feedback and revise plan 7. 8 Finalize plan 5. 4 5. 5 5. 7 a 5. 7 b 6. 5 a 6. 5 b 6. 5 c 6. 7 a 6. 7 b 7. 3 a 7. 3 b 7. 3 c 7. 4 7. 6 a 7. 6 b Finalize

High-level project sequence Vision & setup Delivery system Population health Payment model Data and analytics Workforce Policy Plan finalization Outline report Weeks 1 to 2 First draft report Weeks 3 to 6 Weeks 7 to 10 Weeks 11 to 14 Second draft report Weeks 15 to 22 Final report & Testing proposal

Timeline for project plan Deliverable committed to CMS Phase Apr May Jun Jul Final deliverable Aug Sep Project set up 1. 1, 1. 2 1. 3 -1. 5 Current state and options 1 Strategic planning & project management 1. 6 a, b 1. 6 c-1. 8 Preferred design and plan 1. 9 Syndication 1. 11 a 1. 11 b 1. 12 Finalization 1. 13 -1. 14 1. 15 Project set up 2. 1 a, b 2 Payment model Current state and options Preferred design and plan 2. 2 a, b 2. 1 c 2. 2 c 2. 5 a Syndication 2. 3 2. 5 b 2. 6 Finalization 2. 7 Project set up 3. 1 a, b 3. 1 c Current state and options 3 Delivery system 3. 2 b, c 3. 2 a, d 3. 3 Preferred design and plan 3. 4 a Syndication 3. 4 b 3. 6 a 3. 6 b, c 3. 7 3. 8 Finalization Project set up Current state and options 4 Data/analytics 4. 1 a, b 4. 4 c 4. 1 c-4. 3, 4. 6 -4. 8 Preferred design and plan 4. 9 a 4. 11 b 4. 5 4. 9 b Syndication 4. 12 Finalization 4. 13

Timeline for project plan (cont’d) Phase Project set up Apr May Jun Jul Final deliverable Aug Sep 5. 1 5. 2 a, b Current state and options 5 Policy research Deliverable committed to CMS Preferred design and plan 5. 2 c 5. 7 a 5. 3 -5. 5 Syndication 5. 7 b 5. 8 Finalization 5. 9 Project set up 6. 1 Current state and options 6 Workforce Preferred design and plan , 6. 2, 6. 4 b, c 6. 4 a 6. 3, 6. 4 d 6. 7 a Syndication 6. 5 a, b 6. 7 b 6. 8 Finalization Project set up 6. 5 c 6. 9 7. 1 Current state and options 7 Population health Preferred design and plan Syndication Finalization 7. 2 a, b 7. 2 c 7. 3 7. 6 a 7. 4 7. 6 b 7. 7 7. 8

Next Steps • Finalize contract • Schedule project activities including • Workstream meetings • Stakeholder engagement and feedback