1 / 39

Action Team Goals and Objectives

Action Team A Team Leader: Aileen Wehren Team Members: Shirley Arney*, Matt Burden*, Eric Crouse, Dana Frantz, Paul Kuczora, Laurie Nafziger, Sharyn Redding, Jerry Sheward , Tom Talbot*, Paul Wilson* *Sub-committee Chair. Action Team Goals and Objectives .

ghalib
Download Presentation

Action Team Goals and Objectives

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Action Team A Team Leader: Aileen WehrenTeam Members: Shirley Arney*, Matt Burden*, Eric Crouse, Dana Frantz, Paul Kuczora, Laurie Nafziger, Sharyn Redding, Jerry Sheward, Tom Talbot*, Paul Wilson**Sub-committee Chair

  2. Action Team Goals and Objectives • Goal #1: Develop Health Home and/or ACO Partnerships • Objective #1: Develop an inventory of state level associations and other organizations currently considering or developing a medical home or ACO concept in Indiana. Develop a communications plan that includes CMHCs as an essential component. • Objective #3: Identify the CMHC core business; improve access for the newly insured; consider changed relations and establish CMHC value; provide education re new clinical models. 2-9-11 ICCMHC Meeting

  3. Action Team A Goals and Objective continued • Objective #4: Develop and implement a training curriculum for member centers and staff that defines and focuses on core competencies needed for leadership and direct care staff in the new health care delivery environment • Objective #5: Provide overview and training on the accreditation standards with exploration of issues and options depending on the CMHC role selected (e.g. partner versus become a medical home) 2-9-11 ICCMHC Meeting

  4. Completed Deliverables • Developed a detailed action plan with owners and due dates for each of the assigned goals/objectives • Initial inventory of ACO and medical homes in the State • Initial review of state efforts (more comparison and detail required especially as more states look for savings in Medicaid and improved value for the investment) 2-9-11 ICCMHC Meeting

  5. Inventory of ACO and Medical Home Efforts in Indiana • Strategy 1&2. Identify associations and provider organizations currently considering or development ACOs and/or health homes: • Hospitals and hospital systems • Franciscan Alliance: NW IN, Indianapolis, Carmel, and Shelbyville (added Major Hospital) • FQHCs: HealthLinc, Heart City, Indiana Health Centers, Vermillion Parke (Part of a Patient Centered Medical Home Demonstration), Raphael Health Center • Multi-specialty medical groups • They’ll affiliate, move toward health home as payment structure changes largely driven by large payers • Hospital-owned • Large payers • Aetna, Anthem/Wellpoint, Medicare/Medicaid Identify categories of associations 2-9-11 ICCMHC Meeting

  6. Franciscan Alliance • St. Anthony Health - Crown Point • St. Anthony Health - Michigan City • St. Elizabeth Health - Crawfordsville • St. Francis Health, Beech Grove and Indianapolis; Mooresville, Indiana • St. Elizabeth Health, Lafayette • St. James Health, Chicago Heights and Olympia Fields, Illinois • St. Margaret Health, Hammond and Dyer, Indiana • Franciscan Physicians Hospital, Munster, Indiana • Also: Major Hospital, Shelbyville 2-9-11 ICCMHC Meeting

  7. State Efforts regarding Medical Home or Payment Change Development • Current Status • Tennessee • Integrated managed care (no carve-out) • Washington • Contracting w/ specialized MCOs • North Carolina, Vermont • Primary care case management (e.g., behavioral health coordinator; behavioral health “flags” in EMR; team approach—nurse, health coach, etc.) • Iowa, Massachusetts, Arizona • Behavioral health organizations take SMI and contract primary and behavioral healthcare • Pennsylvania • Capitated behavioral health carve-out, shared savings program; collaborative care management Identify categories of associations 2-9-11 ICCMHC Meeting

  8. State Efforts continued • Strategy 3. Researching other states’ efforts (cont.) • Missouri, Rhode Island • Health Homes • New York • Wisconsin Identify categories of associations 2-9-11 ICCMHC Meeting

  9. How Do CMHCs add Value to Medical Service Delivery • Strategy 4. How behavioral health can add value to ACOs, health homes, payment delivery models, etc. • Addictions and dual diagnosis care delivery and management, long term gains • Brief intervention in ambulatory care settings • Chronic Care Management • Consultative and educational resource for care referral • Early Intervention with medical conditions to decrease longer term care demands and provide cost avoidance • Emergency Room Diversion • Family and community based support and case (care) management • Helping hospitals avoid disincentives (re-admissions) • Helping payers w/ wellness and prevention • Medication assisted treatment – training of PCPs , management • Responsibility for individuals with serious mental illness under health home model Identify categories of associations 2-9-11 ICCMHC Meeting

  10. Other Considerations • Payment methodologies – Analysis and financial modeling to manage risk • Prevention and wellness – How do CMHCs establish a role • Integration and expansion of medical systems and purchases of medical practices • Elkhart and Memorial Hospital • Chronic care management and management of dual eligibles • Keeping kids in school, adults out of criminal justice system – system cost savings • Managing savings and penalties if funding changes are sequenced • Leveraging CMHC disease management expertise • If MRO remains not at risk these are dollars not in changed payment methodologies – leveraging this with providers 2-9-11 ICCMHC Meeting

  11. Promising Payment Reforms 2-9-11 ICCMHC Meeting

  12. Action Team A Goal 1 Objective 1: Develop an inventory of state level associations and other organizations currently considering or developing a medical home or ACO concept in Indiana. Develop a communications plan that includes CMHCs as an essential component of the ACO and medical home development and delivery system. 2-9-11 ICCMHC Meeting

  13. Action Plan 2-9-11 ICCMHC Meeting

  14. Action Plan 2-9-11 ICCMHC Meeting

  15. Action Plan 2-9-11 ICCMHC Meeting

  16. Action Plan 2-9-11 ICCMHC Meeting

  17. Action Plan 2-9-11 ICCMHC Meeting

  18. Action Plan 2-9-11 ICCMHC Meeting

  19. Action Plan 2-9-11 ICCMHC Meeting

  20. Action Plan 2-9-11 ICCMHC Meeting

  21. Action Plan 2-9-11 ICCMHC Meeting

  22. Action Team A Goal 1 Objective 3. Identify core business. Improve access for the newly insured. Consider changed relationships and establish value for behavioral health services. Provide education regarding the new clinical model(s). 2-9-11 ICCMHC Meeting

  23. Action Plan 2-9-11 ICCMHC Meeting

  24. Action Plan 2-9-11 ICCMHC Meeting

  25. Action Plan 2-9-11 ICCMHC Meeting

  26. Action Plan 2-9-11 ICCMHC Meeting

  27. Action Plan 2-9-11 ICCMHC Meeting

  28. Action Team A Goal 1 Objective 4. Develop and implement a training curriculum for member centers and staff that defines and focuses on core competencies needed for leadership and direct care staff in the new health care delivery environment. 2-9-11 ICCMHC Meeting

  29. Action Plan 2-9-11 ICCMHC Meeting

  30. Action Plan 2-9-11 ICCMHC Meeting

  31. Action Plan 2-9-11 ICCMHC Meeting

  32. Action Plan 2-9-11 ICCMHC Meeting

  33. Action Plan 2-9-11 ICCMHC Meeting

  34. Action Plan 2-9-11 ICCMHC Meeting

  35. Action Team A Goal 1 Objective 5. Provide overview and orientation/training regarding accreditation standards including Joint Commission, CARF and NCQA with exploration of options and issues based upon CMHC business choices, e.g. partnership versus becoming a medical home etc. 2-9-11 ICCMHC Meeting

  36. Action Plan 2-9-11 ICCMHC Meeting

  37. Action Plan 2-9-11 ICCMHC Meeting

  38. Action Plan • Develop template to distribute to membership for more details on local changes in healthcare environment so each CMHC can manage relations • Take list of ways in which we add value, transform into usable communication plan for contact and negotiations w/ local providers and payers • Getting success stories • Develop resources to gain expertise in understanding of different impacts of payment methodologies • How do we fit into shared risk model? Bundled payments? Evaluative pricing and negotiations? • Be part of change process w/ OMPP, DMH, DOH, others • Regional and state partnerships to talk w/ big payers 2-9-11 ICCMHC Meeting

  39. Feedback Requested • As an entire group we need to determine overlap and which group will manage those specific items, including the possibility of creating additional workgroups or subcommittees for those items 2-9-11 ICCMHC Meeting

More Related