Harry Potter Settings By: Jessica, & Breanne. Muggle World Dursley’s house Zoo King’s Cross Station.
Breanne Laughery - cpaawa.org
Transcript of Breanne Laughery - cpaawa.org
Questions?
Breanne LaugheryDirector of Partnerships,
Upstream Washington
(206) 915-1257
Table Discussion
Questions:
o What improvements could you make in your practice to make it
easier for women to access all methods of contraception, same
day?
o What types of assistance do patients or clients need in order to
access all methods of contraception?
o How can the Technical Assistance from Upstream USA help
CPAA meet their goals? Is this an opportunity for CPAA to pursue?
Cascade Pacific Action AllianceMedicaid Transformation Project Funds Flow Proposal – May 2018
Management & Admin. (10%),
Contingency (5%)
Capacity Building (health systems and
community)
Year 1 Project Funds Flow Chart – Revised, May 2018
Provider Engagement
Provider Engagement -
Tribes
Project Funds$ 11,758,942
8%
2% 3%
15%
Wellness Fund
8%
Special Projects
Capacity Building (health systems &
community) - Tribes
31%
3%
30%
Provider Performance
Wellness Fund
Capacity Building (health systems and
community, including tribes)
Year 1 Project Funds Flow Chart – Revised, May 2018
Partner Engagement (including special
projects, local forums & tribes)
Partnering Providers (project implementation,
bonus payments & Centers for Transformation)
Project Funds$ 11,758,942
Approx. 8%Approx. 34% Approx. 12%Approx. 31%
Management & Admin. (10%),
Contingency (5%)
The Big Picture
Plan/Test
2018
• Initial Funds Flow (Engagement)
• Portfolio of coordinated projects (planning)
• Network of partners
• Learning communities
• Formation of Proto Centers for Transformation (C4T)
Implement/Scale
2019/20
• Modified Funds Flow (Performance)
• Project portfolio Implementation
• Deepen learning communities
• Identify C4T Leads
• Align partners w/ C4T
• Meet Pay for Reporting/Pay for Performance goals through C4T
Spread/Sustain
2021+
• Sustainable health delivery system reform > Medicaid Transformation by meeting value-based purchasing goals
• Integrated delivery system to address population health
• Better health in all 7 counties
• Whole person health
• Smarter spending
Medicaid Transformation Project - Funding Principles
• Support sustainability of the project
• Improve health equity/reduce health disparities
• Address social determinants of health to the greatest extent possible
• Provide sufficient incentive for providers (clinical and non-clinical) to participate
• Reward relative contribution to desired outcomes
• Invest in rural and urban areas
• Invest in all seven counties
• Reward truly transformative efforts over marginal improvements
• Establish a regional Wellness Fund (Innovation Fund) to support investments in key health improvement areas
Evolving Funds Flow Emphasis Over Time
Year 1 Provider
Engagement
Year 2+ Provider
PerformanceAchievement
• Engaging Partners• Organizing Projects• Forming C4Ts
• Activating C4Ts• Implementing Projects• Scaling Projects
Centers For Transformation (C4T)
Establish Centers For Transformation that will serve as a cohesive, effective regional framework for population health improvements.
Provisional Definition:
A cluster of independent organizations that agree to work together across community sectors in a given location to advance health system transformation. The Centers for Transformation provide leadership, support, and guidance to help their partners implement best practices and work standards to improve population health. Additionally, through their partners, Centers for Transformation provide well-coordinated population health focused services across sectors.
C4Ts are virtual clusters, not physically integrated or co-located.
Centers for Transformation - Request for Proposals Process
Draft
Medicaid Transformation Project - Year 1 Funds Flow – April DRAFT
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Use Category Action % $Project Management/Administration Spend 10% 1,175,894 Reserve/Contingency Hold 5% 587,947 Regional Wellness Fund Hold 8% 940,715 Special Projects Fund Disburse 2% 235,179 Sub-Total 25% 2,939,736
Health Systems & Comm. Cap. Bldg (D1) Invest Centrally 31% 3,645,272 Health Systems & Comm. Cap. Bldg (Tribes) Disburse 3% 352,768 Sub-Total 34% 3,998,040
Provider Engagement Disburse 30% 3,527,683 Provider Engagement (Tribes) Disburse 3% 352,768 Provider Performance (Implementation Plan) Disburse 8% 940,715 Sub-Total 41% 4,821,166
Grand Total 100% 11,758,942
NON-TRIBAL PROVIDER ENGAGEMENT 3,527,683 A. Basic Engagement 85% 2,998,530 Base PaymentsAssessment Survey Pre RFP 5% 176,384 Standard Agreement Post RFP 5% 176,384 Project Participation Post RFP 25% 881,921
Bonus PaymentsAttribution (Medicaid Lives Served) Post RFP 30% 1,058,305 Equity Post RFP 10% 352,768 Rural Post RFP 5% 176,384 Local Community Forums Post RFP 5% 176,384
B. Centers of Excellence Hold or Disburse 15% 529,152
PROVIDER PERFORMANCE 940,715
First-Year Funds Flow: Provider Engagement
Provider Engagement
Tribes
Base Pay
Assessment
Agreement
Participation
Bonus Potential
Attribution
Equity
RuralCapacity
Fund
C4T
Local Forums
Items in Green = Determined by Request for Proposals (RFP)
*Earned in 2017, disbursed in 2018
RFP Timeline
Basic Design Approval 5/10
RFP Release 5/30
Letter of Intent Due
6/14
RFP Responses Due 7/15
Network Partners
Selected 8/15
Key RFP Design Consideration
• As simple as possible, yet providing sufficient information to identify the strongest project proposals and applicants.
• One response per partner, i.e., partners address multiple projects in one application and explain how the proposed activities are mutually reinforcing.
• RFP serves to identify strongest possible project designs that will move Medicaid Transformation outcome metrics.
• Once the most capable partners with most effective project designs have been identified through the RFP process, bonus pools (attribution, equity and rural) come into play.
• Preserve flexibility for strategic adjustments to rankings to ensure broad participation across sectors and counties, and ensure key partners for project success are engaged.
Key RFP Design Elements
RFP Sections
Section Subject
Section 1 Information about the Applicant
Section 2 Projects and Interventions (select any of 6 projects)
Section 3 Implementation Readiness (partnership, coordination, etc.)
Section 4 Individuals Served
Section 5 Contribution to Equity
Section 6 Rural Representation
The majority of points are generated in Section 2.
Sections 4-6 are not scored. They are used to determine the allocation of bonus funds.
Key RFP Design Elements
Up to 45 total organizations will be selected in two rounds
• Round One: The highest-scoring organizations within each major category
• Clinical Providers / Hospitals
• Community-Based Organizations
• Pathways partners
• Round Two: The remaining slots will be assigned based on strategic considerations
• A panel consisting of ACH staff, MCO representatives, HCA representatives, and others
• Considerations
• Importance to project success
• Strength of partnering
• Strength of current or proposed investment in projects
• County representation
Key RFP Design Elements
Allocation of Bonus Payments
Attribution
• Clinical
o Number and percentage of individuals on Medicaid
• Non-Clinical
o Number and percentage of individuals who are at or below 310% of the federal poverty level
Rural and Equity
• Zip codes of residence for the individuals served and the number of individuals served in each zip code
• Rural designation based on National Center for Education Statistics
• Equity designation based on the Community Needs Index
First-Year Funds Flow: Provider Payments
Provider Payments
Base Pay
Assessment*
Agreement
Participation
Bonus Potential
Attribution
Equity
RuralPerformance
Capacity Fund
C4T
Goal: AVG MIN Pymt per Partnering Provider: approx. $70,000 = 35-45 Partners
*One payment per EIN
First-Year Funding: Projected Direct Payments to Providers
PROVIDER ENGAGEMENTDisbursement
Timing
Proposed Funds
Allocation
Proposed Funding Amount
Projected No. of
Partners
Projected MIN Disbursement Per
Partnering Provider
A. Basic Engagement 80%
Base Payments
Assessment Survey Pre RFP 5% 176,384 65 $2,714
Standard Agreement Post RFP 5% 176,384 35-45 $5,040-$3,920
Project Participation Post RFP 35% 1,234,689 35-45 $35,277-$27,438
Total Base Payments 45% 1,587,457 $43,030-$34,071
Bonus Payments
Attribution (Medicaid Lives Served) Post RFP 18% 634,983 ? ?
Equity Post RFP 10% 352,768 ? ?
Rural Post RFP 7% 246,938 ? ?
Total Bonus Payments 35% 1,234,689 ? ?
TOTAL PROVIDER ENGAGEMENT 100% 3,527,683 ? ?
PROVIDER PERFORMANCE (Implementation Plan) Post RFP 8% 940,715 35-45 $26,878-$20,905
Total MIN Distributable to Partnering Providers in 2018* 3,762,861 $69,908-$54,976
*Excluding C4T and Local Community Forum allocations
Summary of Funds Flow Changes
• Special Projects Fund renamed Capacity Development Fund: Provides limited funding to potential future partnering providers rather than supporting one-off projects.
• Centers of Excellence renamed Centers For Transformation (C4T); formation of C4T delayed until after RFP closes to allow sufficient time for meaningful partnering; funds for lead organizations potentially carried into 2019.
Use Category Previously Now Change
Capacity Dev. Fund $235,179 (2%) $335,179 (3%) $100,000 (+1%)
Project Participation $881,921 (25%) $1,234,689 (35%) $352,768 (+10%)
Attribution $1,058,305 (30%) $634,983 (18%) ($440,960) (-12%)
Equity $352,768 (10%) $352,768 (10%) No Change
Rural $176,384 (5%) $246,938 (7%) $70,554 (+2%)
Revised First-Year Funds Flow: PROPOSED – May 2018
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Use Category Action % $Project Management/Administration Hold 10% 1,175,894 Reserve/Contingency Hold 5% 587,947 Regional Wellness Fund Hold 8% 940,715 Capacity Development Fund Disburse 3% 335,179 Sub-Total 26% 3,039,736
Health Systems & Comm. Cap. Bldg (D1) Invest Centrally 30% 3,545,272 Health Systems & Comm. Cap. Bldg (Tribes) Disburse 3% 352,768 Sub-Total 33% 3,898,040
705,537 / 7Provider Engagement Disburse 30% 3,527,683 Provider Engagement (Tribes) Disburse 3% 352,768 Provider Performance (Implementation Plan) Disburse 8% 940,715 Sub-Total 41% 4,821,166
Grand Total 100% 11,758,942
NON-TRIBAL PROVIDER ENGAGEMENT 3,527,683 A. Basic Engagement 85% 2,998,530 Base PaymentsAssessment Survey Pre RFP 5% 176,384 Standard Agreement Post RFP 5% 176,384 Project Participation Post RFP 35% $1,234,689
Bonus Payments
Attribution (Medicaid Lives Served) Post RFP 18% $634,983
Equity Post RFP 10% $352,768
Rural Post RFP 7% $246,938 Local Community Forums Post RFP 5% 176,384
B. Centers For Transformation Hold 15% 529,152
Management & Admin. (10%),
Contingency (5%)
Capacity Building (health systems and
community)
Year 1 Project Funds Flow Chart – Revised, May 2018
Provider Engagement
Provider Engagement -
Tribes
Project Funds$ 11,758,942
8%
2% 3%
15%
Wellness Fund
8%
Special Projects
Capacity Building (health systems &
community) - Tribes
31%
3%
30%
Provider Performance
Wellness Fund
Capacity Building (health systems and
community, including tribes)
Year 1 Project Funds Flow Chart – Revised, May 2018
Partner Engagement (including special
projects, local forums & tribes)
Partnering Providers (project implementation,
bonus payments & Centers for Transformation)
Project Funds$ 11,758,942
Approx. 8%Approx. 34% Approx. 12%Approx. 31%
Management & Admin. (10%),
Contingency (5%)
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Questions? Comments?
Summary and Next Steps Main meeting outcomes
What worked? What can we do better next time? What do we need to bring to our local forums?
Next Council Meeting:
Thursday, June 14, 2018, 12:00-3:00 PMLocation: Great Wolf Lodge,
Grand Mound, WA
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