Medi sked & the future of DD Services in new york
32
Continuing the Conversation MediSked & the future of DD services in NYS
-
Upload
medisked -
Category
Healthcare
-
view
156 -
download
5
description
We outline the managed care initiatives for DD Services in New York State and how MediSked working towards providing a complete solution from providers to Discos and managed care companies.
Transcript of Medi sked & the future of DD Services in new york
Continuing the Conversation
MediSked & the future of DD services in NYS
2
Agenda
• About us• The goal in New York State• Overview of Connect• How Connect fits in with the new
model of care• Our Premier Knowledge Transfer
Coaching process
3
More than just a software company, we are advocates for provider agencies through our technology & advisement solutions. Our products & services span the complete spectrum of DD Service provision – from
oversight & insurance organizations down to the provider level.
from Alaska to Maine…
with provider partners in counties across NY, from Erie to Suffolk
National reach Experts & thought leaders in human services. Regular speakers at…
© Copyright 2014 MediSked, LLC
Leader in the country & NYSThe partnership between PHP and MediSked developed the Electronic HL7 Standards for DD Care Coordination in NYS.MediSked is the DD software representative in the international HL7 Object Management Group Healthcare Services Specification Program (HSSP) & the care coordination service work.
5
The long-term goal of New York is for all Medicaid members to be enrolled into comprehensive, fully integrated managed care plans.
© Copyright 2014 MediSked, LLC
New York’s Medicaid program is working toward the Triple Aim: better care, better health, and lower costs through Governor Cuomo’s Medicaid Redesign Team’s (MRT) initiative of Care Management for All
6
What is an Agency Management Platform?
7
Client Care Centric
8
Built in Workflows & Document Tracking
9
Billing Claim Lifecycle Management
10
Living System
Real Time Reporting
11
12
Integrated HR Management
13Everyone Uses It
14
© Copyright 2014 MediSked, LLC
MediSked & the new managed care model
15
What is Connect Exchange?
MediSked Connect Exchange is the first Business Intelligence Platform specifically for I/DD Provider Agency groups, MCO/Insurance
Companies and Oversight
© Copyright 2014 MediSked, LLC
16
With a multi agency business intelligence platform; liberate core financial, clinical and BI data. Set up key alerts.
Link with Care Plan Manager, EHR
Assessments and Evaluations
Status Change
Documentation
Charts/Observations
Medication Administration
Monthly Summaries
ClinicalEncounters
Eligibilities
Service Authorizations
Billing
FinancialLife Plan Updates
Predictive Analytics
Personal Outcome Measure: Prompts and Results Analytics
Demographic Tracking
Waiting Lists/ Referrals
Business Intelligence
example data warehouse uses
Links to RHIO/HIEs are possible
© Copyright 2014 MediSked, LLC
17
Connect Exchange Data Feed and Message Formats
Financial Data
Clinical Data
BI Data
© Copyright 2014 MediSked, LLC
18
Connect Exchange Data Transactions
Bi-Directional
Real time alerts
Proactive Decision Support
© Copyright 2014 MediSked, LLC
Platform agnostic: Providers can use electronic records from any vendor, as long as they are able to send and receive compliant HL7 clinical, financial, and BI data with the Exchange
Care Management Data + DD Data (via MediSked Connect Exchange)
Provider data inputs
HL7-Compliant
Agency Management
Platform (AMP)
© Copyright 2014 MediSked, LLC
DISCO/MCO
Agency X Agency Y
OPWDD Person Center Planning
http://www.opwdd.ny.gov/opwdd_services_supports/person_centered_planning/understanding-person-centered-planning
Person-centered planning centers around a Life Plan
• Demographics and Profile• CQL Personal Outcome Measures• Health and Safety Supports• Individual Protective Oversight Plan• Service AuthorizationsDISCOs – Responsible for:Quality AssuranceGrievances and AppealsInformed ChoicePerson-Centered PlanningCare CoordinationMarketing of Programs and Services
© Copyright 2014 MediSked, LLC
Managed Care TasksMember EnrollmentProvider EnrollmentPrior Approval and Authorization of CareClaims Processing and PaymentInternal Compliance and AuditingContinuous Quality Improvement
21
Life Plan & Life Plan Updates
The Life Plan is central to the individuals being served at providers. Receiving it from the MCO and documenting on it in real time is essential. Each time the Life Plan has a change made and is certified – that update is pushed to the provider into Connect. The Life Plan is truly a living document.
Provider
22
The Life Plan automatically assigns the Person-Centered CQL Personal Outcome Measures which are instantly presented to the DSPs to document on in the service note area of Connect. Each service the individual receives will have a different set of POMs based on the unique goals in the service.
Personal Outcome Measures
23
Health & safety supports and individual protective oversight measures listed in the Life Plan are alerted directly to providers via Connect for immediate implementation and documentation. They can be pulled up at any time when working with the client, including mobile and tablet devices.
Health & Safety Supports, IPOPs
24
Based on a client’s Life Plan, specific charts and logs might be necessary (e.g. sleep, weight, food intake, seizure, etc). When the clinical team makes a request for observational data, a specific chart will automatically be created in Connect for data to be collected. Aggregate data collection will help the clinical team be proactive in spotting trends or abnormalities in a person’s health.
Observation Logs
25
Receive alerts in Connect when units are authorized or updates are made from PHP. All of the information necessary to provide services comes pre-packaged with the alert, including the POMs and goals service note templates, total units and plan information.
Service Authorizations
Provider
MCO/DISCO
26
The clinical team at the MCO and agency staff sends alert messages to all authorized parties for changes to behavior, demographics, health, and natural supports. These messages include a reason for change, priority level, immediate safeguard/action, recommended follow-up and also free-form notes.
Notification of Change Alerts
27
Provider agency staff capture real-time data on outcomes, staff supports, prompt levels, and progress on a constant basis. This data is summarized on a monthly basis to help the care coordination team in ensuring that the best services are being outlined via the life plan.
Monthly Summaries
Personal Outcomes offer a progress menu with the following values (MONTHLY)• No Progress• Regression• Progress Made• Achieved/Met
When maintaining or actively attending, outcome is written to reflect this.
Staff can send a priority comment to the care coordinator about this outcome
28
How do you get from here…
Dial in: 877-216-1555Passcode: 1064079#
29
… to here
Dial in: 877-216-1555Passcode: 1064079#
30
Premier Knowledge Transfer Coaching
Dial in: 877-216-1555Passcode: 1064079#
Go Live
31
32
THANK YOU!
From this meeting, we will follow up with a tech survey to learn how you are currently managing your data and operations.
Please feel free to reach out to us at [email protected] or 866-633-4753
