Prevention and Management of Chronic Illness in Vermont. Don Dickey Joint Fiscal Office January 16, 2007
|
|
- Robyn Harrington
- 8 years ago
- Views:
Transcription
1 1 Prevention and Management of Chronic Illness in Vermont Don Dickey Joint Fiscal Office January 16, 2007
2 2 Outline of Presentation Why the focus on chronic illness? Making health care more responsive to needs of people with chronic conditions Reducing the prevalence of chronic disease (reduces need for health care) Act 191 chronic care strategies / Blueprint for Health Challenges facing Act 191 / Blueprint
3 3 Why Chronic Illness? Chronic conditions are the leading cause of illness, disability, and death in Vermont Common chronic conditions in adults: diabetes hypertension (high blood pressure) asthma arthritis cancer cardiovascular disease respiratory diseases depression and other mental health disorders substance dependence
4 4 75% of Health Care Spending Over 50% of all Vermont adults have one or more chronic conditions 75-80% of the $3.7 billion spent on health care in VT this year Vermont can lower demand for medical services and overall cost if: Prevent/manage chronic conditions through more effective health care Reduce the prevalence of chronic illness
5 5 More Effective Health Care Only 55% of chronically ill Vermonters patients receive the right care at the right time Health care system not designed to make sure the many things that need to happen are happening System evolved to provide care for people with short-term, acute, and episodic health needs (e.g., injury, infectious disease)
6 6 Health Care Redesign Needed Patients with chronic conditions need many things to ensure a good outcome Frequent blood tests Adequate medication intensification Education so that they can manage aspects of their conditions themselves Prevention/management of chronic disease requires proactive, planned care and ongoing, productive relationship between the individual and provider team
7 7 What Change Is Required? New model of health care delivery and payment more responsive to chronic illness needs Based on the Chronic Care Model (Ed Wagner, MD, MPH) The essential elements of a health care system that supports high-quality chronic disease care
8 8 Key Elements of Chronic Care 1. Evidence-based guidelines 2. Clinical information systems (IT) 3. Payment incentives aligned with quality goals 4. Self management 5. Chronic care management 6. Health system change
9 9 1. Evidence-Based Care Evidence-based guidelines = scientific studies/consensus on quality care Right care at the right time for managing chronic illness Current system has insufficient tools and incentives to promote rapid adoption of best practices Key tools and incentives: IT systems and payment incentives
10 10 2. Information Technology Proactive tool to track and plan care and provide timely reminders about needed services Real time information when and where it s needed (where action can be taken) Must be easy-to-use in day-to-day practice Complete medical history (feeds from all providers), with ability to sort or analyze Interface with clinical guidelines/protocols
11 11 3. Aligning Payment Practices Payments encourage providers to deliver high quality care wisely and efficiently Provide incentives to use IT and consult evidence-based guidelines Current system offers few incentives to avoid overuse, underuse, or misuse of care, and does not reward efficiency Pay for performance is among many strategies in this highly complex area
12 12 4. Self Management Portfolio of tools and techniques, primarily education and skill development programs offered in the community People with chronic conditions make dayto-day decisions about their illnesses, but see physician only 15 minutes twice a year Individual s behavior and self-care are most important in slowing the onset and progression
13 13 5. Chronic Care Management Any systematic approach to improve both cost effectiveness and outcomes Identify individuals with one or more chronic conditions (using claims data) Conduct health risk assessments (HRAs) for all beneficiaries identified Stratify the population into high, middle, low risk groups Conduct care management interventions for each risk group (differing intensity)
14 14 6. Health System Change Shift system toward chronic care model Several different major payers, each with their own payment and delivery rules Medicaid State Employees (CIGNA) Blue Cross Blue Shield Medicare MVP Health Care Self-Insured Plans Other Payers
15 15 Not Just About Health Care! Chronic disease prevention/management is broader than health care alone Health care plays an important role in preventing chronic illness (child well-care) But many factors influence individual and population health, often more profoundly than health care Public health - use information to develop methods to prevent disease occurrence
16 16 Reducing the Prevalence of Chronic Disease Paramount long-term strategy to improve health and reduce costs of care Ounce of prevention is preferable to medically managing widespread chronic disease Important role of Public Health Community Health Improvement
17 17 Public Health Policies/Systems Traditional public health Immunizations, nutritional needs, food safety, infectious diseases, and (now) terrorism Coordination with clinical prevention services (e.g., immunizations and breast cancer screening) New role: Population-level health improvement, addressing multiple determinants of health (e.g., genetic, behavioral, social, and environmental)
18 18 Community Resources/Policies Mobilize community partnerships (businesses, schools, health providers, etc.) to identify and solve health problems Local level initiatives to address physical activity, nutrition, and other behaviors Must be effective in reaching members at risk and getting them to participate
19 19 Act 191: Chronic Care Strategies Blueprint for Health Chronic Care Management Program for Medicaid Align other state programs with Blueprint State employee health benefits plan Catamount Health Plans
20 20 Blueprint for Health Launched in 2004; Endorsed by Act 191 in 2006 Statewide system of care to improve the lives of individuals with and at risk for chronic conditions Preventing/managing chronic illness will reduce demand for high-cost medical services, moderating the rise in costs
21 Blueprint Care and Prevention Model Public Health Policies, Systems, Environment Community Resources and Policies Self- Management Support Delivery System Design Health System Health Care Organization Decision Support Clinical Information Systems Supportive Environment Informed, Activated Patient Productive Interactions Prepared, Proactive Practice Team Adapted from the chronic care model which is used by permission of Effective Clinical Practice. Improved Outcomes-Healthier People 21
22 22 Blueprint Key Components Public Health Community Activation (for health improvement) Patient Self-Management Evidence-Based Standards Information Systems Payment for Quality (e.g., pay for performance, financing for patient self-education) Health System Change
23 23 Core Goals of Blueprint Utilize the Chronic Care Model as the framework for system change Utilize a public-private partnership to facilitate and assure sustainability of the new system of care Facilitate alignment of Blueprint priorities and projects with other statewide health care reform initiatives
24 24 Blueprint - Organizational Structure Program of the Vermont Department of Health Public-private partnership to develop and implement strategy for cross-systems change Blueprint Executive Committee has advisory role (representation from state, providers, health plans) Stakeholder Workgroups - Self-Management - Community - Provider Practice - Information Technology - Health Systems - Evaluation
25 25 Strategic Plan Jan Provides implementation objectives, milestones, and timelines for next 5 years Many specifics remain to be fleshed out ( living document) Blueprint is a work in progress Blueprint funding in FY07 - $5 million Important oversight role for legislative committees
26 26 Six Communities Participating First two communities ( ) St. Johnsbury (Northeastern Vermont Regional Hospital) Bennington (Southwestern Vermont Medical Center) Four additional communities (July 2006) Windsor (Mt. Ascutney Hospital and Health Center) Springfield (Springfield Hospital) Berlin (Central Vermont Physician Hospital Organization) Burlington (Fletcher Allen Health Care)
27 27 Community Implementation Each community has work plan Practice redesign Information systems Self management Community health initiatives
28 28 Blueprint and State CCM Programs Act 191: Blueprint mandates standards for chronic care management in state programs: Medicaid chronic care management program State employee health benefit program Catamount Health Plans
29 29 Chronic Care Management in Medicaid Two related initiatives developed in consultation with the legislature Care Coordination initiative - begun in early 2006 Chronic Care Management Program - slated to begin July 1, 2007 Building staff capacity for CCM at OVHA
30 30 State Employees Health Benefits Summer 2006: contract rebid process for State s self-insured health care plan for employees Include chronic care management aligned with Blueprint CIGNA medical director added to Blueprint leadership committees New contract begins January 2007
31 31 Catamount Health Insurance carriers offering Catamount Health Plans Required to have chronic care management aligned with Blueprint Cost-sharing will be waived for enrollees who are actively participating March 7: Plans for CCM programs must be filed with BISHCA
32 32 Key Challenges for Blueprint 1. Challenge of building a chronic care system in a fragmented fee-for-service environment with multiple payers Payers operate in many other states Payers are market competitors Payers and providers often diverge on policy Medicare does its own thing
33 33 Key Challenges for Blueprint 2. Getting in front of ongoing chronic care delivery and payment initiatives and leading the change process 3. Reducing the prevalence of chronic disease Public health dollars in federal payment silos with strings attached Developing effective strategies at the level of public health and community
34 34 Key Challenges for Blueprint 4. Sustaining the investments needed Change will take time to implement Investments now, payoff later 5. Gaining investments from other stakeholders to accomplish Blueprint goals
35 35 Summary VT making progress on making health care more responsive to the needs of people with chronic conditions (right care at right time) Long term strategy for reducing the prevalence of chronic disease is vital, & deserves attention Blueprint / Act 191 must meet early implementation challenges to sustain energy and momentum QUESTIONS?
Health Care Affordability Act Catamount Health. Senator James Leddy, Chair Vermont Senate Health & Welfare Committee
Health Care Affordability Act Catamount Health Senator James Leddy, Chair Vermont Senate Health & Welfare Committee Principles of Health Care Reform in Vermont Established by Coalition 21 (January 2005)
More informationState of Vermont Agency of Administration. Overview of Vermont s Health Care Reform
State of Vermont Agency of Administration Overview of Vermont s Health Care Reform October, 2006 INTRODUCTION On May 25, 2006, Vermont Governor James Douglas signed into law Acts 190 and 191 (Acts Relating
More informationDevelopment of a Vermont Pilot Community Health System To Achieve the Triple Aims
Development of a Vermont Pilot Community Health System To Achieve the Triple Aims Webinar February 23, 2010 Jim Hester PhD Director Vermont Health Care Reform Commission Outline Context: Vermont Health
More informationTHE ROLE. Testimony United. of the. University. practicing. primary care. of care.
THE ROLE OF VALUE BASED INSURANCE DESIGN IN HEALTH CARE DELIVERY INNOVATION Testimony United States Senate Committee on Health, Education, Labor and Pensions A. Mark Fendrick, MD Professor of Internal
More informationDual Eligibles and State Innovations in Care Management
Dual Eligibles and State Innovations in Care Management Ann Kohler, Director of Health Services National Association of State Medicaid Directors American Public Human Services Association Ann.Kohler@aphsa.org
More informationHome Care Association of Washington Conference. MaryAnne Lindeblad, State Medicaid Director Washington Health Care Authority
Home Care Association of Washington Conference MaryAnne Lindeblad, State Medicaid Director Washington Health Care Authority April 25, 2013 Overview Overview of Health Care Authority Public Employees Benefits
More informationAccountable Care Organizations and Shared Savings Programs (What are they and how do they differ)
Accountable Care Organizations and Shared Savings Programs (What are they and how do they differ) Presentation to: House Health Care Committee January 30, 2015 Georgia Maheras, Esq. Director, Vermont Health
More informationKaiser Permanente: Health Education. Mei Ling Schwartz, MPH Director, Health & Physician Education Kaiser Permanente Panorama City Medical Center
Kaiser Permanente: Health Education Mei Ling Schwartz, MPH Director, Health & Physician Education Kaiser Permanente Panorama City Medical Center Who Is Kaiser Permanente? Founded in 1945, Kaiser Permanente
More informationI. Insurance Reforms and Expansion of Coverage. Implementation Date Plan years beginning on or after six months after passage of the Act.
University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI) Summary of Selected Tobacco, Prevention, and Public Health Provisions from H.R. 3590, the Patient Protection and Affordable
More informationMA Department of Public Health
MA Department of Public Health The mission of the Massachusetts Department of Public Health is to prevent illness, injury, and premature death, to assure access to high quality public health and health
More information1115 Medicaid Waiver Programs Section1115 of the Social Security Act allows CMS the authority to approve state demonstration projects that improve care, increase efficiency, and reduce costs related to
More informationIntegrated Health Systems: Promise And Performance
Integrated Health Systems: Promise And Performance Stephen M. Shortell, Ph.D. Blue Cross of California Distinguished Professor of Health Policy and Management Professor of Organization Behavior Dean, School
More informationSPRINGFIELD HOSPITAL COMMUNITY NEEDS ASSESSMENT UPDATE March 1, 2007
SPRINGFIELD HOSPITAL COMMUNITY NEEDS ASSESSMENT UPDATE March 1, 2007 PUBLIC MEETINGS As required by Act 53, Springfield Hospital held a combined community report and community assessment meeting on Monday,
More informationIdaho Health Home State Plan Amendment Matrix: Summary Overview. Overview of Approved Health Home SPAs
Idaho Health Home State Plan Amendment Matrix: Summary Overview This matrix outlines key program design features from health home State Plan Amendments (SPAs) approved by the Centers for Medicare & Medicaid
More informationStrengthening Community Health Centers. Provides funds to build new and expand existing community health centers. Effective Fiscal Year 2011.
Implementation Timeline Reflecting the Affordable Care Act 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access
More informationSingle Payer 101 Training Universal Health Care for Massachusetts
Single Payer 101 Training Universal Health Care for Massachusetts http://masscare.org What s Wrong With Our Health Care System? (the easy part) U.S. Has Lowest Life Expectancy in the Industrialized World
More informationSubstance Abuse Mental Health Services Administration Adolescent Substance Abuse Treatment Coordination Grant
Substance Abuse Mental Health Services Administration Adolescent Substance Abuse Treatment Coordination Grant William H. Janes Project Director Director, Florida Office of Drug Control Assistant Secretary,
More informationPreliminary Health Insurance Landscape Analysis
Preliminary Health Insurance Landscape Analysis Prior to addressing some of the issues listed under Section 3.1 3.5 of the HRSA State Planning Grant report template, here is some of the information available
More informationBenefit Design and ACOs: How Will Private Employers and Health Plans Proceed?
Benefit Design and ACOs: How Will Private Employers and Health Plans Proceed? Accountable Care Organizations: Implications for Consumers October 14, 2010 Washington, DC Sam Nussbaum, M.D. Executive Vice
More informationcaresy caresync Chronic Care Management
caresy Chronic Care Management THE PROBLEM Chronic diseases and conditions, including heart disease, diabetes, COPD and obesity, are among the most common, expensive, and preventable health problems in
More informationMaureen Mangotich, MD, MPH Medical Director
Maureen Mangotich, MD, MPH Medical Director Prepared for the National Governors Association Healthy America: State Policy Leaders Meeting, December 2005 Delivering value from the center of healthcare Pharmaceutical
More informationQuality Health Care. Centers of Excellence Improving Quality Pay for Performance Literature. Quality Health Care
. Quality Health Care Centers of Excellence Improving Quality Pay for Performance Literature Quality Health Care Centers of Excellence The term Center of Excellence has been widely used and in many different
More informationHEALTHCARE REFORM OCTOBER 2012
HEALTHCARE REFORM Tracking ACO Growth Nationally OCTOBER 2012 The enclosed slides are intended to provide you with a snapshot of how private sector accountable care organizations (ACOs) have formed since
More informationOverview of Shared Savings Programs (SSPs) and Accountable Care Organizations (ACOs) in Vermont
State Innovation Model 109 State Street Montpelier, VT 05609 http://healthcareinnovation.vermont.gov Overview of Shared Savings Programs (SSPs) and Accountable Care Organizations (ACOs) in Vermont July
More informationUnderstanding the Mental Health Parity Law An employer s guide to the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act
Understanding the Mental Health Parity Law An employer s guide to the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 Spring 2009 A b r i e f o v e r v i e w o f
More informationPHFAST Public Health Framework ASsessment Tool Adapted from the Public Health Framework for Action and STAR
LEADERSHIP: The state chronic disease prevention and control unit is the unifying voice for the prevention and control of chronic diseases. LS1 LS2 LS3 LS4 LS5 The unit is a key contact for others both
More informationACO s as Private Label Insurance Products
ACO s as Private Label Insurance Products Creating Value for Plan Sponsors Continuing Education: November 19, 2013 Clarence Williams Vice President Client Strategy Accountable Care Solutions Today s discussion
More informationAccountable Care Organizations: An old idea with new potential. Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010
Accountable Care Organizations: An old idea with new potential Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010 Impetus for ACO Formation Increased health care cost From
More informationOBJECTIVES AGING POPULATION AGING POPULATION AGING IMPACT ON MEDICARE AGING POPULATION
OBJECTIVES Kimberly S. Hodge, PhDc, MSN, RN, ACNS-BC, CCRN- K Director, ACO Care Management & Clinical Nurse Specialist Franciscan ACO, Inc. Central Indiana Region Indianapolis, IN By the end of this session
More informationState Innovations in Modernizing Health Insurance Coverage and Extending Coverage to the Uninsured. June 2008
State Innovations in Modernizing Health Insurance Coverage and Extending Coverage to the Uninsured June 2008 THIS PAPER IS A PRELIMINARY DRAFT REPORT ON INNOVATIVE STATE EFFORTS TO REDUCE THE NUMBER OF
More informationVermont Partners for Health Care Reform. From: Avalere Health. Date: November 14, 2013. Evaluation of Vermont Health Care Reform Financing Plan
To: Vermont Partners for Health Care Reform From: Avalere Health Date: Re: Evaluation of Vermont Health Care Reform Financing Plan EXECUTIVE SUMMARY The State of Vermont commissioned a study to estimate
More informationTestimony. Thomas A. Farley, MD, MPH Commissioner. and. Adam Karpati, MD, MPH Executive Deputy Commissioner, Division of Mental Hygiene
Testimony of Thomas A. Farley, MD, MPH Commissioner and Adam Karpati, MD, MPH Executive Deputy Commissioner, Division of Mental Hygiene New York City Department of Health and Mental Hygiene before the
More informationCommunity Health Centers and Health Reform: Issues and Ideas for States
Community Health Centers and Health Reform: Issues and Ideas for States Ann S. Torregrossa, Esq. Deputy Director & Director of Policy Governor s Office of Health Care Reform Commonwealth of Pennsylvania
More informationRising Health Care Costs, Prevention & Primary Care, and Personal Responsibility
Rising Health Care Costs, Prevention & Primary Care, and Personal Responsibility Marcia Nielsen, Ph.D., MPH Executive Director July Advisory Council Meetings Objectives To explore evidence regarding rising
More informationCare Coordination among DSRIP Partners
Care Coordination among DSRIP Partners John F. Skip Williams, Jr., MD, EdD, MPH Maureen Fahey, RN, MBA Thursday, June 25, 2015 3:00-3:30 pm OVERVIEW OF PRESENTATION New York State DSRIP Overview Brooklyn
More informationkaiser medicaid commission on and the uninsured May 2009 Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid
P O L I C Y B R I E F kaiser commission on medicaid SUMMARY and the uninsured Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid May 2009 Why is Community Care of North
More informationACC Program History. Colorado s Accountable Care Collaborative Phase II. Community Behavioral Health Services Program History.
Colorado s Accountable Care Collaborative Phase II An Overview ACC Program History Created in response to: Unsuccessful experience with capitated Managed Care 85% in an unmanaged Fee-For-Service (FFS)
More informationCosts of Vermont s Health Care System Comparison of Baseline and Reformed System. Initial Draft April 21, 2011
Costs of Vermont s Health Care System Comparison of Baseline and Reformed System Initial Draft April 21, 2011 Prepared by Vermont Legislative Joint Fiscal Office www.leg.state.vt.us/jfo Vermont Department
More informationPiloting an ACO: A Community Provider Network Which Achieves the Triple Aims
Piloting an ACO: A Community Provider Network Which Achieves the Triple Aims December 1, 2008 Jim Hester PhD Director VT Health Care Reform Commission Outline Pilot goals The context: Vermont Health care
More informationSenate Finance Committee Health Care Reform Bill
Senate Finance Committee Health Care Reform Bill Below is a review of those measures contained in the Senate Finance Committee s draft on health care reform that correspond to issues contained in the NLN
More informationWasteful spending in the U.S. health care. Strategies for Changing Members Behavior to Reduce Unnecessary Health Care Costs
Strategies for Changing Members Behavior to Reduce Unnecessary Health Care Costs by Christopher J. Mathews Wasteful spending in the U.S. health care system costs an estimated $750 billion to $1.2 trillion
More informationBlueprint Integrated Pilot Programs Evaluation & Financial Impact
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
More informationAn Integrated, Holistic Approach to Care Management Blue Care Connection
An Integrated, Holistic Approach to Care Management Blue Care Connection With health care costs continuing to rise, both employers and health plans need innovative solutions to help employees manage their
More informationFinding Common Ground: Vermont s Blueprint for Health and ACO Shared Savings Programs
Finding Common Ground: Vermont s Blueprint for Health and ACO Shared Savings Programs Presentation to: Rhode Island Care Transformation Collaborative February 27, 2015 Pat Jones, Health Care Project Director,
More informationHealthcare Reform Update Conference Call VI
Healthcare Reform Update Conference Call VI Sponsored by the Healthcare Reform Educational Task Force October 9, 2009 2:00-2:45 2:45 pm Eastern Healthcare Delivery System Reform Provisions in America s
More informationSubstance Abuse Treatment Services Objectives and Performance Measures Progress: First Annual Report
Report to The Vermont Legislature Substance Abuse Treatment Services Objectives and Performance Measures Progress: First Annual Report In Accordance with Act 179 (2014) Sec. E.306.2 (a)(1) Submitted to:
More informationMedical and Health Homes Provide Enhanced Care. Coordination for Elders with Complex Conditions. In recent years there has been a growing
Medical and Health Homes Provide Enhanced Care Coordination for Elders with Complex Conditions By Neva Kaye and Charles Townley Evidence shows the programs also save money, so expansion is in order. In
More informationGuide to Chronic Disease Management and Prevention
Family Health Teams Advancing Primary Health Care Guide to Chronic Disease Management and Prevention September 27, 2005 Table of Contents 3 Introduction 3 Purpose 4 What is Chronic Disease Management
More informationDSRIP, Shared Savings, and the Path towards Value Based Payment
Redesign Medicaid in New York State DSRIP, Shared Savings, and the Path towards Value Based Payment New York State Department of Health New York, New York The DSRIP Challenge Transforming the Delivery
More informationSummary: There are four major initiatives underway that address integration of substance abuse care with physical and mental health.
Summary: Section E.306.2(b)(1) requires the Secretary of Administration and the Chief of Health Care Reform to submit a report on current and additional strategies to achieve a more comprehensive health
More informationPerformance Results for Health Insurance Plans
WASHINGTON STATE COMMON MEASURE SET FOR HEALTH CARE QUALITY AND COST Performance Results for Health Insurance Plans DECEMBER 2015 Table of Contents Introduction... 3 About the Results... 4 How to Read
More informationAccountable Care and Value Based Payments 101: Government Programs Update
1 Accountable Care and Value Based Payments 101: Government Programs Update June 24 th, 2014 Dave Neiman, FSA, MAAA Senior Consulting Actuary DaveN@Wakely.com (720) 226-9806 2 Caveats Opinions expressed
More informationIdaho Medicaid and Service Delivery Model - Plans to Work together
Abstract Idaho Comprehensive Health Care Innovation Planning Grant Idaho Medicaid is one of the largest healthcare payers in Idaho, growing 75% over the last decade from 130,000 to 230,000 enrollees. Idaho
More informationQuality Improvement and Payment Reform
Quality Improvement and Payment Reform Mark McClellan, MD, PhD Senior Fellow and Director, Initiative on Value and Innovation in Health Care Brookings Institution Mark McClellan. All rights reserved. No
More informationCRITICAL SKILLS FOR OPTIMUM PATIENT CARE: Care Coordination and Health Literacy
Thursday, August 20, 2015 CRITICAL SKILLS FOR OPTIMUM PATIENT CARE: Care Coordination and Health Literacy Contributors to the Presentation: Steven A. Estrine, PhD, President & CEO Loan Mai, PhD, Director
More informationState Innovation Models Initiative:
Department of Health & Human Services Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 FACT SHEET FOR IMMEDIATE RELEASE Contact: CMS Media Relations
More informationQuality Oversight in the Health Care Marketplace, Spring 2010 Tufts Health Care Institute
Quality Oversight in the Health Care Marketplace, Spring 2010 Tufts Health Care Institute Session 16: C.1. Performance Reports National Reports Some reports present information on a category of providers
More informationFebruary 26, 2016. Dear Mr. Slavitt:
February 26, 2016 Mr. Andy Slavitt Acting Administrator Centers for Medicare & Medicaid Services (CMS) Department of Health and Human Services Attention: CMS-3321-NC PO Box 8016 Baltimore, MD 21244 Re:
More informationTRANSFORMING HEALTHCARE
TRANSFORMING HEALTHCARE FROM REACTIVE TREATMENT TO PROACTIVE HEALTH MANAGEMENT CRITICAL THInKInG AT THE CRITICAL TIME 1 Looking Forward Transforming Healthcare from Reactive Treatment to Proactive Health
More informationMedicare Value Partners
Medicare Value Partners Medicare Shared Savings ACO Program Frequently Asked Questions (FAQ) Q: What exactly is a Medicare Shared Savings Program ACO? A: Medicare Shared Savings Program accountable care
More informationPurchasers Efforts to Promote Better Information Technology
Purchasers Efforts to Promote Better Information Technology Peter V. Lee Pacific Business Group on Health The Health Information Technology Summit West March 7, 2005 Measuring Provider Quality and Cost-Efficiency
More informationANA ISSUE BRIEF Information and analysis on topics affecting nurses, the profession and health care.
ANA ISSUE BRIEF Information and analysis on topics affecting nurses, the profession and health care. New Care Delivery Models in Health System Reform: Opportunities for Nurses & their Patients Key Points
More informationACP Analysis of the Essential Health Benefits Bulletin, Issued by the HHS Center for Consumer Information and Insurance Oversight (CCIIO)
ACP Analysis of the Essential Health Benefits Bulletin, Issued by the HHS Center for Consumer Information and Insurance Oversight (CCIIO) Introduction and background: Summarizes the essential benefit package
More informationIssue Brief. Raising the Bar. Standards for Accountable Care Organizations to Truly Improve Health Care Quality and Affordability in the United States
Raising the Bar Standards for Accountable Care Organizations to Truly Improve Health Care Quality and Affordability in the United States Issue Brief Introduction Health care costs continue to rise at an
More informationPopulation Health Management: Advancing Your Position in the Journey to Value-Based Care
Population Health Management: Advancing Your Position in the Journey to Value-Based Care Webcast Session One: An Integrated Approach to Population Health Management 11 August 2015 Welcome & Introductions
More informationJuly 15, 2015. Dear April Leonhard:
July 15, 2015 April Leonhard Department of Human Services Office of Long Term Living, Bureau of Policy and Regulatory Management P.O. Box 8025 Harrisburg, PA 17105-8025 Dear April Leonhard: Thank you for
More informationHouse Committee on Healthcare. CMS Evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration
House Committee on Healthcare CMS Evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration HUD and ASPE Evaluation of Vermont s Support & Services at Home Program February 25, 2015 2008Q3
More informationSenate-Passed Bill (Patient Protection and Affordable Care Act H.R. 3590)**
Prevention and Screening Services Cost-sharing Eliminates cost sharing requirements for requirements for all preventive services (including prevention and colorectal cancer screening) that have a screening
More informationJohns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases
Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Epidemiology Over 145 million people ( nearly half the population) - suffer from asthma, depression and other chronic
More informationPopulation Health Refocusing Health Care
Population Health Refocusing Health Care The Population, The Payment, The Quality Karen Hacker, MD MPH Director, Allegheny County Health Department The Context of Health Care in the USA: A Time for Alignment
More informationArkansas Health Care Payment Improvement Initiative
Arkansas Health Care Payment Improvement Initiative Joseph W. Thompson, MD, MPH Arkansas Surgeon General Director, Arkansas Center for Health Improvement Arkansas System Transformation Strategy Workforce
More informationDetermining the Role for Value-Based Insurance Design in Healthy Michigan
Determining the Role for Value-Based Insurance Design in Healthy Michigan A. Mark Fendrick, MD University of Michigan Center for Value-Based Insurance Design www.vbidcenter.org @um_vbid Value-Based Insurance
More informationCHAPTER 535 HEALTH HOMES. Background... 2. Policy... 2. 535.1 Member Eligibility and Enrollment... 2. 535.2 Health Home Required Functions...
TABLE OF CONTENTS SECTION PAGE NUMBER Background... 2 Policy... 2 535.1 Member Eligibility and Enrollment... 2 535.2 Health Home Required Functions... 3 535.3 Health Home Coordination Role... 4 535.4 Health
More informationPopulation Health Management Program
Population Health Management Program Program (formerly Disease Management) is dedicated to improving our members health and quality of life. Our Population Health Management Programs aim to improve care
More informationPayment Models Workgroup July 13, 2015
Payment Models Workgroup July 13, 2015 Alternative Payment Models: WHAT Are Other SIM States Doing? 2 State Innovation Models (SIM) Initiative Evaluation - Model Test CMS contracted with RTI to develop
More informationVermont s Health Care System Overview: Payers & Players
1 Vermont s Health Care System Overview: Payers & Players (as we currently know it) Updated January 2015 Nolan Langweil, Joint Fiscal Office 2 Parts of a Health Care System Patients Providers Payers (Insurance
More informationPremier ACO Collaboratives Driving to a Patient-Centered Health System
Premier ACO Collaboratives Driving to a Patient-Centered Health System As a nation we all must work to rein in spiraling U.S. healthcare costs, expand access, promote wellness and improve the consistency
More informationUtah s All Payer Claims Dataset: A vital resource for health reform
TennCare Annual Meeting January19, 2011 Utah s All Payer Claims Dataset: A vital resource for health reform Keely Cofrin Allen, Ph.D. Director, Office of Health Care Statistics Utah Department of Health
More informationNuts and Bolts of. Frank G. Opelka, MD FACS American College of Surgeons. Vice Chancellor for Clinical Affairs Professor of Surgery LSU New Orleans
Nuts and Bolts of Accountable Care Organizations Frank G. Opelka, MD FACS American College of Surgeons ACS Advocacy & Health Policy, Vice Chancellor for Clinical Affairs Professor of Surgery LSU New Orleans
More informationMINISTRY OF HEALTH AND LONG-TERM CARE
THE ESTIMATES, 1 The Ministry provides for a health system that promotes wellness and improves health outcomes through accessible, integrated and quality services at every stage of life for all Ontarians.
More informationI am pleased to present the 2016-2020 Strategic Plan for the Idaho Department of Health and Welfare.
C.L. BUTCH OTTER Governor RICHARD ARMSTRONG Director OFFICE OF THE DIRECTOR 450 West State Street, 10 th Floor P.O. Box 83720 Boise, ID 83720-0036 PHONE 208-334-5500 FAX 208-334-5926 Dear Citizens, I am
More informationCommunity Paramedicine
Community Paramedicine A New Approach to Integrated Healthcare Prepared by a committee of: 600 Wilson Lane Suite 101 Mechanicsburg, PA 17055 (717) 795-0740 800-243-2EMS (in PA) www.pehsc.org 1 P age Community
More informationOctober 15, 2010. Re: National Health Care Quality Strategy and Plan. Dear Dr. Wilson,
October 15, 2010 Dr. Nancy Wilson, R.N., M.D., M.P.H. Senior Advisor to the Director Agency for Healthcare Research and Quality (AHRQ) 540 Gaither Road Room 3216 Rockville, MD 20850 Re: National Health
More informationHealth and Human Services Commission Department of State Health Services
Health and Human Services Commission Department of State Health Services Presentation to House Committee on Public Health February 17, 2015 Sonja Gaines, HHSC Associate Commissioner for Mental Health Coordination
More informationThe Patient Protection and Affordable Care Act. Implementation Timeline
The Patient Protection and Affordable Care Act Implementation Timeline 2009 Credit to Encourage Investment in New Therapies: A two year temporary credit subject to an overall cap of $1 billion to encourage
More informationPatient Protection and Affordable Care Act (HR 3590) Selected Prevention, Public Health & Workforce Provisions
Patient Protection and Affordable Care Act (HR 3590) Selected Prevention, Public Health & Workforce Provisions Selected Prevention and Public Health Provisions Essential Health Benefits Requirements (Sec.
More information2019 Healthcare That Works for All
2019 Healthcare That Works for All This paper is one of a series describing what a decade of successful change in healthcare could look like in 2019. Each paper focuses on one aspect of healthcare. To
More informationHCR 101: Your Guide to Understanding Healthcare Reform
HCR 101: Your Guide to Understanding Healthcare Reform Are You Ready for Healthcare Reform? By now, you ve probably been hearing a lot about the Affordable Care Act (also known as healthcare reform or
More informationAIMING HIGHER FOR HEALTH SYSTEM PERFORMANCE. A Profile of Seven States That Perform Well on the Commonwealth Fund s 2009 State Scorecard: Vermont
AIMING HIGHER FOR HEALTH SYSTEM PERFORMANCE A Profile of Seven States That Perform Well on the Commonwealth Fund s 2009 State Scorecard: Vermont OCTOBER 2009 Th e Co m m o n w e a l t h Fu n d The Commonwealth
More informationCommunity Care Collaborative Integrated Behavioral Health Intervention for Chronic Disease Management 307459301.2.3 Pass 3
Community Care Collaborative Integrated Behavioral Health Intervention for Chronic Disease Management 307459301.2.3 Pass 3 Provider: The Community Care Collaborative (CCC) is a new multi-institution, multi-provider,
More informationThe New Health Care Model. Axel Arroyo, MD MPH
The New Health Care Model Axel Arroyo, MD MPH Past Learning Objectives Which are the reasons behind these changes? To review the reasons of this transformation. To review Legislative initiatives (ARRA,
More informationSelection of Medicaid Beneficiaries for Chronic Care Management Programs: Overview and Uses of Predictive Modeling
APRIL 2009 Issue Brief Selection of Medicaid Beneficiaries for Chronic Care Management Programs: Overview and Uses of Predictive Modeling Abstract Effective use of care management techniques may help Medicaid
More informationWhat is an Accountable Care Organization. Amit Rastogi, MD President/CEO PriMed
What is an Accountable Care Organization Amit Rastogi, MD President/CEO PriMed Goals Why is U.S. healthcare undergoing dramatic change How reimbursement structures are likely to change What is the timeline
More informationGaidaid Medicaid - A Great Initiative to Improve Performance and Provide Disease
69 th Annual Meeting of the Southern Legislative Conference Medicaid Behavioral Health Homes Integrating Services- Overview and Implementation Advice Savannah, GA July 19, 2015 Michael S. Varadian, JD,
More informationHealth Insurance Reform at a Glance Implementation Timeline
Health Insurance Reform at a Glance Implementation Timeline 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access
More informationACO Definition Cont d 11/15/15. What is an Accountable Care Organization (ACO) Michelle S. McOmber, MBA, CAE CEO, Utah Medical Association
Michelle S. McOmber, MBA, CAE CEO, Utah Medical Association What is an Accountable Care Organization (ACO) Accountable Care Organizations were created through the Affordable Care Act. Definition: An ACO
More informationFact Sheet: The Affordable Care Act s New Rules on Preventive Care July 14, 2010
Fact Sheet: The Affordable Care Act s New Rules on Preventive Care July 14, 2010 Chronic diseases, such as heart disease, cancer, and diabetes, are responsible for 7 of 10 deaths among Americans each year
More informationSummary of the Final Medicaid Redesign Team (MRT) Report A Plan to Transform The Empire State s Medicaid Program
Summary of the Final Medicaid Redesign Team (MRT) Report A Plan to Transform The Empire State s Medicaid Program May 2012 This document summarizes the key points contained in the MRT final report, A Plan
More informationIdentifying High-Risk Medicare Beneficiaries with Predictive Analytics
Identifying High-Risk Medicare Beneficiaries with Predictive Analytics September 2014 Until recently, with the passage of the Affordable Care Act (ACA), Medicare Fee-for-Service (FFS) providers had little
More informationProven Innovations in Primary Care Practice
Proven Innovations in Primary Care Practice October 14, 2014 The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2014 Society for Healthcare
More information