PREPARING FQHCS FOR DSRIP: DSRIP Projects. A Webinar with CohnReznick and Health Management Associates

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1 PREPARING FQHCS FOR DSRIP: DSRIP Projects A Webinar with CohnReznick and Health Management Associates

2 Today s Presentation DSRIP Background CHCANYS DSRIP Support for FQHCs DSRIP Projects PPS Project Selection Top DSRIP Project for FQHCs Where to Get More Information

3 New York State s Delivery System Reform Incentive Payment (DSRIP) Plan Background Delivery System Reform Incentive Payment (DSRIP) is the central focus on New York s $8 billion Medicaid Waiver approved by CMS $6.42 billion over 9 months of planning (Year 0) and 5 years for implementation. DSRIP is intended to transform the health care delivery and payment system. The plan includes elements that will have a significant and long-term impact on the role of FQHCs in the health care delivery system and FQHC Medicaid payment. 3

4 CHCANYS DSRIP Support As major Medicaid safety net providers, it is essential that FQHCs play a central role in the development and implementation of DSRIP Performing Provider Systems (PPSs) and projects. To support FQHCs role in DSRIP, CHCANYS is providing FQHCs with information, tools, and guidance that will help them proactively lead or participate in the development of DSRIP PPSs and DSRIP projects.

5 CHCANYS DSRIP Support - 2 DSRIP Planning Toolkit: CHCANYS has developed DSRIP fact sheets, summaries, and updates to ensure that FQHCs have the most up-to-date and actionable information, tools to assess and define an FQHC s value proposition in a Performing Provider System, and tools to assess projects and an FQHC s potential role in projects. FQHC Collaboration Meetings: CHCANYS is convening a series of meetings in select regions to share information and encourage collaboration among FQHCs. DSRIP Webinars: CHCANYS is conducting a series of webinars on key DSRIP planning topics such as governance and payment Top Five Deep Dive DSRIP Webinars: CHCANYS is conducting a series of webinars to support FQHCs in leading or participating in DSRIP projects. DSRIP Technical Assistance: CHCANYS is providing TA for target regions, including providing guidance on selecting and negotiating partnerships, governance, and payment issues.

6 CHCANYS DSRIP Support - 3 Advanced Data Analytics and Support: CHCANYS Center for Primary Care Informatics (CPCI) will provide advanced data analytics and support to help enable FQHCs to contribute to PPS planning and implementation, including: CPCI Data Tools and Analysis: data tools and analytic support to enable FQHCs to access, analyze, and present data on Medicaid populations in potential Performing Provider System service areas. DSRIP Data Webinars: webinars about key data that can be used to develop DSRIP applications. The goals of the webinars are to enable FQHCs to more easily assess, understand, and share information on populations. Technical Assistance Office Hours: regularly scheduled weekly office hours during which FQHCs can get technical assistance from CPCI data experts

7 DSRIP Projects Each PPS must select at least 5 and no more than 10 projects that it will implement from an approved list of 44 projects across three domains: System Transformation, Clinical Improvement, and Populationwide. Each project has a valuation score, which weights the amount of incentive dollars it can yield. Payment will be directly tied to achieving defined performance on these projects. Performance is pass-fail! No payment for partial achievement.

8 PPS Project Selection On June 26, 2014, every PPS must submit a Project Design Grant Application to DOH that identifies the projects they plan to implement. DOH will provide PPSs an opportunity to change their list of projects after submitting the application (during the DSRIP planning period, which ends December 16th)

9 PPS Project Selection It is critical that FQHCs are part of the project selection process, especially because payment will be tied to which projects are selected. Optimally, FQHCs should be the lead and/or central partners on projects. Selecting projects should be based on multiple factors, including but not limited to: Each projects valuation score Newness of the project and evidence of past success or failure in the community Having a sufficient performance gap The ability of your FQHC and partners to achieve performance targets Projects should be tied to DSRIP workforce plans. Payment needs to be commensurate with its investments, efforts, and contributions to outcomes.

10 Top DSRIP Projects for FQHCs CHCANYS selected DSRIP projects from Domains 2, 3, and 4 as Top DSRIP FQHC Projects and a few alternatives to consider. CHCANYS selected projects: That have good evidence for reducing avoidable hospitalizations and achieving other required outcomes For which FQHCs could or should play a significant role Starting in June, CHCANYS will be hosting a series of webinars on select Top Projects for FQHCs from Domains 2-4. Each webinar will present information on the evidence base for achieving the outcomes, design and implementation best practices, information on key data sources, and opportunities to use the CHCANYS CPCI statewide data warehouse to achieve the goals.

11 Domain 2: System Transformation Projects Performing Provider Systems (PPSs) can submit up to 4 projects from Domain 2 for valuation scoring purposes. All DSRIP plans must include at least two Domain 2 projects based on their community needs assessment. REQUIRED: At least one project must be from Strategy A. Create Integrated Delivery Systems (IDSs) AND at least one project must be from Strategy B. Implementation of Care Coordination and Transitional Care Strategies OR Strategy C. Connecting Settings

12 Top Domain 2 FQHC Projects B. Care Coordination and Transitions 2.b.ii: Development of co-located primary care services in the ED Valuation Score b.iv: Care transitions intervention model to reduce 30-day readmissions for chronic conditions Valuation Score - 43

13 Domain 3: Clinical Improvement Projects PPSs can submit up to 4 projects from Domain 3 for valuation scoring purposes All DSRIP plans must include at least two projects from Domain 3, based on their community needs assessment REQUIRED: At least one project must be from Strategy A. Behavioral health Other Strategies are: B. Cardiovascular Health; C. Diabetes Care, D. Asthma, E. HIV, F. Perinatal, G. Palliative Care, H. Renal Care

14 Top Domain 3 FQHC Projects A. Behavioral Health 3.a.i: Integration of behavioral health (BH) into primary care settings - Valuation Score - 39 C. Diabetes 3.c.i: Evidence-based strategies for disease management in high-risk populations (adults only) - Valuation Score - 30 F. Perinatal 3.f.i: Increase support programs for maternal and child health (including high-risk pregnancies) - Valuation Score - 29

15 Domain 4: Population-Wide Projects PPSs can submit up to 2 projects from Domain 4 for valuation scoring purposes All DSRIP plans must include at least one project from Domain 4, based on their community needs assessment DSRIP plans are not required to include a project from any one of the four Strategies The four Strategies are: A. Promote Mental Health and Prevent Substance Abuse (MHSA), B. Prevent Chronic Diseases, C. Prevent HIV and STDs, and D. Promote Healthy Women, Infants and Children

16 Top Domain 4 FQHC Projects D. Promote Healthy Women, Infants and Children 4.d.i: Reduce premature births- Valuation Score - 24 Related to 3f.i Perinatal project A. Promote Mental Health/Prevent Substance Abuse 4.a.i. Promote mental, emotional and behavioral (MEB) well-being in communities - Valuation Score - 23 Related to 3.a.i. Integration of behavioral health

17 For More Information CHCANYS DSRIP web page: ocs&ref=dsrip_resources&category=ny%20s tate%20policy NYSDOH DSRIP website: aid/redesign/delivery_system_reform_incenti ve_payment_program.htm

18 For More Information NYS DOH DSRIP Project Toolkit: aid/redesign/docs/dsrip_project_toolkit.pdf CHCANYS Center for Primary Care Informatics DSRIP office hours: Call Monday and Wednesday from 3:00-4:00 p.m. and Friday from 2:00-3:00 p.m. for ad hoc technical support from CHCANYS staff on DSRIP-related data questions

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