Blueprint Integrated Pilot Programs Evaluation & Financial Impact
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- Linda Hancock
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1 Blueprint Integrated Pilot s Academy and CommonWealth Fund State Institute May 27 28, 2009 Craig Jones MD Director, Vermont Blueprint for craig.jones@vdh.state.vt.us 1 Coordinated System Hospitals Mental & Substance Use Disorders Team Nurse Coordinator Social Workers Dieticians Workers OVHA Coordinators Specialist IT Framework Global Information Framework Evaluation Framework Operations 2 1
2 Coordinated System Hospitals Behavioral & Substance Abuse Team Nurse Coordinator Social Workers Dieticians Workers OVHA Coordinators Specialist Information Framework System Information Framework Framework Operations & Uses Framework s Practice Systems Hospital Information Systems s Practice Systems Hospital Information Systems Multi-payer claims database bases Chart reviews NCQA Scores Expenditures ROI Indicators Evaluation Activation / Policy 3 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 4 2
3 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 5 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 6 3
4 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 7 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 8 4
5 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 9 Evidence Based ing & Storage & Uses s used for bases transmission & or & Support used for base & base bases & Report Surveys & bases Analytic base 10 5
6 Why measure? Average = 7.46 Average = 7.36 Group 1 Good Disease Control Group 2 Intermediate Disease Control Group 3 Poor Disease Control Percentage of Vermont population participating 6.7% 9.8% 13.0% 20.0% 40.0% Participating population 42,179 61,880 82, , ,852 # Teams
7 Model Microsoft Office el Worksh Microsoft Office d Docum Model Double click to open Key Assumptions Double click to open 13 Building a Scalable Model Build a multidimensional evaluation framework Support patient care & population management Support ongoing quality improvement Evaluate trends in clinical outcomes Evaluate trends of financial impact Support sustainability & expansion 14 7
8 Additional Slides 15 Blueprint Integrated Pilot Summary 1. Financial reform (2 major components - includes MCAID & commercial insurers) - Payment to practices based on NCQA score - Shared costs for Teams 2. Multidisciplinary care support teams (CCT Teams) - Local care support & population management 3. Information Technology - Web based clinical tracking system () - Visit planners & population reports - Electronic prescribing - Updated s to match program goals and clinical measures in - information exchange network 4. Activation & - specialist as part of CCT - profiles & risk assessments - Evidence based interventions 5. Evaluation - NCQA score (process quality) - process measures - status measures - Multi payer claims data base - Indicators 16 8
9 & Payment $3.00 $ PPPM per provider $2.50 $2.00 $1.50 $1.00 $0.50 PPPM Payment 5 of 10 MP 10 of 10 MP $ NCQA Score 17 Team Physicians Nurse Practitioners Physician Assistants Behavioral Specialist Connections VT Department of COMMUNITY CARE TEAM PRIMARY CARE OFFICE Chronic Coordinator Managers (OVHA, AAA, Umbrella, etc.) 18 9
10 Building a Scalable Model Build a model for effective and sustainable reform Multi Insurer Financial Reform (PCP payment, CCTs) Financial Incentives (balance volume & quality) Environment (, CCTs, PH specialists, IT) Focus (quality, wellness, prevention) Evaluation (multidimensional, routine) Culture (self management, engaging yet objective) 19 10
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