September 28, 2017

NYP Queens PPS PAC Meeting

Agenda

1. Welcome

2. DSRIP Updates- Key Upcoming Dates

- Independent Evaluator

- VBP University

3. PPS Updates- PMO Staffing

- Funds Flow Update

- Medical Record Review

- Rapid Cycle & MY Performance

- MAX Project

- Clinical Project Updates

4. Next Steps

NYP/Q PPS PAC Meeting2

NYP Queens PPS PAC Meeting

NYPQ PPS PAC Meeting3

DSRIP Updates

DSRIP UpdatesKey Dates

• 9/26: Medical Record Review Begins

• 9/30: End of DY3, Q2

September

• 10/2: DY3, Q3 Begins

• 10/2: PC:BH Committee Meeting

• 10/11: Asthma Committee Meeting

• 10/23: LTC Committee Meetings

• 10/31: DY3, Q2 MAPP Reports Due

October

• 11/8: DSRIP Town hall Meeting

November

NYP/Q PPS PAC Meeting4

DSRIP UpdatesIndependent Evaluator Partner Survey

NYPQ PPS PAC Meeting5

The Center for Human Services Research (CHSR) at SUNY Albany is acting at the

DSRIP Independent Evaluator (IE) to determine the effectiveness of the DSRIP

program in DY3-DY5.

Goals of the evaluation:

Capture PPS partner-level insights about DSRIP and project implementation

Key research activities include time-series design, quantitative data analysis

and qualitative methods.

Engage in informant interviews, web-based surveys, and focus groups.

The IE has completed interviews with all PPS senior leadership teams in Aug. 17

Next Steps

PPS partner web based surveys will begin in September 2017

More information on the evaluation plan from DOH can be found at:

https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/evaluation.htm

DSRIP UpdatesVBP University

DOH has launched VBP University

https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_u/index.htm

Online semesters require an 80% on quiz to pass

Semester 1 – VBP 101

Foundation curriculum for VBP including risk levels an contracting arrangements

Semester 2 – Topic / Role Specific

Topic specific information around categories of importance in VBP including

governance, stakeholder engagement, business strategy, finance, and data

Semester 3 – Pending release from DOH (anticipated Sept. 2017)

Semester 4 – VBP Bootcamps

Regional learning series created by the DOH to equip VBP contractors and interested

parties such as MCOs, Providers, Associations, and CBOs with the knowledge

necessary to implement payment reform

Designed to be an interactive training session that will give participants a thorough

understanding of VBP.

NYP/Q PPS PAC Meeting6

DSRIP UpdatesVBP University

Date Region Location Address

October 10,

2017

Capital Region The Egg-Swyer

Theater

1 Empire State Plaza, S

Mall Arterial, Albany, NY

12203

October 18,

2017

New York City The New York

Academy of Medicine

1216 5th Ave, New York,

NY 10029

October 23,

2017

North Country High Peaks Resort 2384 Saranac Ave, Lake

Placid, NY 12946

November

3, 2017

Central New York Rochester Radisson

Riverside

120 E Main St, Rochester,

NY 14604

November

15, 2017

Long Island The Long Island

Marriott

101 James Doolittle Blvd,

Uniondale, NY 11553

NYPQ PPS PAC Meeting7

VBP Bootcamps are being held in October & November 2017

Registration available at:

https://www.eventbrite.com/e/vbp-bootcamp

NYP Queens PPS PAC Meeting

NYPQ PPS PAC Meeting8

PPS Updates

NYPQ PPS PAC Meeting9

PPS UpdatesPMO Staffing

PPS PMO has been recruiting to fill vacant positons

New Team Members/Roles:

o PMO Director - Marlon Hay

o Project Manager - Coleen Dunkley

o Data Analyst – Jenny Wong

Currently Recruiting:

o Nurse Manager

o Patient Navigators

o Population Health Manager

o Project Coordinator

Payment #5 will be dispersed to partners in Sept. / Oct. 2017

$1,663,658.08 will be distributed to partners in this payment

Payment categories include:

Revenue Loss

Non-Covered Services

Incentives

o Patient engagement

o RHIO connectivity

o HIV collaborative engagement

CBO partnership

NYPQ PPS PAC Meeting10

PPS UpdatesFunds Flow

NYPQ PPS PAC Meeting11

PPS UpdatesMedical Record Review

Goal is to locate and abstract data on randomly selected sample of patients to populate

the measures we selected for DSRIP project

Kickoff meeting was completed in August 2017, the vendor will work directly with the

providers to perform the sample pull and record reviews

PPS Updates

Rapid Cycle

NYPQ PPS PAC Meeting12

Rapid Cycle Team has been educating project committee members and presenting

quality data at project committee meetings

Goals of RCE team include:

Share actionable data with PPS partners

Collect and study partner feedback

Develop intervention and solutions based on feedback.

PPS UpdatesRapid Cycle – Asthma Heat Maps

NYPQ PPS PAC Meeting13

PPS UpdatesMY2 Performance Results

Measurement Year 2 (MY2) was July

2015 through June 2016

Measures included both Pay for

Performance(P4P) and Pay for Reporting

(P4R)

The PPS was graded on 68 measures

across the DSRIP projects

Achieved 33 Measure (43%)

Did Not Achieve 32 Measures

(56%)

PPS Average Achievement was 36.6%

PPS received high performance

funds (HP) and additional high

performance funds (AHP) for MY 2

performance

PPS % Met % Missed

AHI 29.17% 70.83%

ACP 51.61% 48.39%

Albany Med. 53.33% 46.67%

AFBC 43.33% 56.67%

Bassett Medical Center 33.33% 66.67%

Bronx-Lebanon 42.42% 57.58%

Care Compass Network 45.83% 54.17%

Central NY Care Collab. 45.83% 54.17%

FLPPS 26.92% 73.08%

Maimonides 50.00% 50.00%

Millennium 34.62% 65.38%

Montefiore 36.67% 63.33%

Mount Sinai PPS 52.00% 48.00%

NQP 56.00% 44.00%

NYP Queens PPS 43.33% 56.67%

NYU Lutheran 48.39% 51.61%

Refuah 37.50% 62.50%

Samaritan Medical 32.00% 68.00%

SBH Health System 41.94% 58.06%

Sisters of Charity 38.46% 61.54%

SIPPS 44.00% 56.00%

Suffolk Care Collab. 29.03% 70.97%

NYP PPS 45.83% 54.17%

One City Health 40.00% 60.00%

Westchester 32.26% 67.74%

NYPQ PPS PAC Meeting14

Performance data is available as of MY 3 Month 7 (January 2017)

NYPQ PPS PAC Meeting15

PPS UpdatesScorecard/Dashboard Available

PPS UpdatesMAX Project

NYPQ PPS PAC Meeting16

PMO is working with NYS DOH to implement the MAX program at NYP Queens

hospital

Goal of the program is to reduce high utilization of the inpatient & ED

High Utilizers (HU) are defined as having 5+ visits

Interventions for HUs include:

Identification of High Utilizers

Warm Handoff

SNF Capabilities List

Inpatient Root Cause Analysis

Health Homes Onsite

High Utilizers Case Conferences

The PPS has reduced utilization by 0.8% since January 2017

PPS Updates

MAX Dashboard

NYPQ PPS PAC Meeting17

PPS Updates2.a.ii – PCMH

NYP/Q PPS PAC Meeting18

The PPS has meet speed and scale (36 providers)

42 providers are PCMH 2014 Level 3 certified to date

All remaining providers have purchased survey tools and are on track for

submission by the NCQA deadline of 2018.

The PMO is currently rolling out health home and substance abuse trainings for

PCMH partners.

PMO completed Train-the-Trainer Health Home trainings from QCCP and are

training PCMH sites to increase eligible Medicaid patients referrals to health

homes.

Elmcor has completed 2 NYP Queens Clinic trainings and will conduct trainings

for the remaining PCMH sites on substance abuse screenings.

PPS Updates2.b.v, 2.b.v.ii, 2.b.v.ii 3.g.ii – LTC Projects

NYP/Q PPS PAC Meeting19

2.b.v – SNF

Silvercrest and NYP Queens have successfully implemented a warm handoff policy

and are planning to roll out the process to all 24 remaining SNFs

The Warm Hand off compliance rate increased from 30% in August to 54% in Sept.

Collaborating with HANYs on an initiative with 7 SNFs to decrease readmissions to

the hospitals through SNF specific action plans

2.b.vii – INTERACT

The PMO has collected hospital readmission reports from all 24 SNFs and 8 CHAAs

to use as a benchmark for trending readmissions

2.b.viii – Home Care

PPS is launch RCAs with partners to create action plans to reduce readmissions

3.g.ii – Palliative Care

EPEC has completed all 12 sessions; PPS will be offering new topic sessions and

make up sessions

Mock Ethics committee meeting on 10/19 to educate SNF partners

PPS Updates3.a.i – PCBH, 3.b.i – Cardio, 3.d.ii – Asthma, 4.c.ii – HIV

NYP/Q PPS PAC Meeting20

3.a.i – PC/BH Integration

Behavioral health partners are currently recruiting BH providers for co-location

Waiver

3.b.i – Cardiovascular

In process of creating a patient stratification system in Athena to identify patients

who have repeated elevated blood pressure but no diagnosis

3.d.ii – Asthma

Goal of having all PPS partners in the asthma project connected to the RHIO and

using direct mail before the project due date of DY3, Q4

4.c.ii – HIV

PMO is working with CBO’s to launch several educational campaigns to improve

health literacy in at risk populations including Hispanics, lesbian, gay, bi-sexual

and transgender community

NYP/Q PPS PAC Meeting21

Questions