1 / 14

Changing the Way We Do Business: The Potential Role Grantees Play in Shaping a Changing Healthcare System

Changing the Way We Do Business: The Potential Role Grantees Play in Shaping a Changing Healthcare System. Presented by: CIHS Staff SAMHSA GPO. Target : Enrollment=100% Reassessment=100% Grant Requirement Cutoff: Reassessment=80% Administrative Review Cutoff: Enrollment=70%

jinelle
Download Presentation

Changing the Way We Do Business: The Potential Role Grantees Play in Shaping a Changing Healthcare System

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. Changing the Way We Do Business: The Potential Role Grantees Play in Shaping a Changing Healthcare System Presented by: CIHS Staff SAMHSA GPO

  2. Target : Enrollment=100% Reassessment=100% Grant Requirement Cutoff: Reassessment=80% Administrative Review Cutoff: Enrollment=70% Reassessment=50%

  3. National DataEnrollment n=56

  4. National DataReassessment N=56

  5. Technical Assistance ThemesOctober – December 2011 n=54, HIT Supplemental TA (n=63) not included

  6. How You Can Use the Data You’re Collecting • Data at your disposal • NOMs, including Section H data, demographic data, clients served, reassessment rates • IPP data • Quarterly reports • How you can use this data • Measure burden of illness in the population you serve (Section H) • Identify and prioritize populations at risk (Demographic Data) • Plan effective and targeted wellness interventions (Section H and NOMS Data) • Evaluate specific wellness activities and outcomes (Section H, NOMS, IPP) • Develop and/or change policies that improve client recruitment, engagement (IPP Data, Clients served and Reassessment Rates) • Requesting funds (ALL DATA)

  7. Using Data for Decision Making:-GPO Perspective-Grantee Perspective

  8. Health Home Services – Section 2703 • 90% Federal match rate for the following services during the first 8 fiscal year quarters when the program is in effect: • Comprehensive care management • Care coordination and health promotion • Comprehensive transitional care from inpatient to other settings • Patient and family support • Referral to community and social support services • Use of health IT to link services (as feasible/appropriate)

  9. Health Home Update • State with Planning Grants: • DC (in process); AL; AZ; AK; CA; ID; ME; MI; NC; NJ; NM; NV; WA; WI; WV • States with approved State Plan Amendments: • Missouri • Ohio • Rhode Island (2 SPAs) • “On the clock:” MO (2nd SPA); NY; NC; WA

  10. Key to Supporting New Service Deliveryand Payment Models:Accountable Care Organization

  11. ACOs Defined • Generally – ACOs are a group of providers who are held accountable for improving health care quality while lowering the rate of growth in health care spending • Medicare Shared Savings Program ACO – a legal entity that is recognized and authorized under applicable State law…comprised of an eligible group of ACO participants that work together to manage and coordinate care for Medicare fee-for-service beneficiaries…established a mechanism of shared governance that provides all ACO participants with an appropriate proportionate control over the ACOs decision-making process

  12. Accountable Care Organization Update • 1. Allina Hospitals & Clinics Minnesota and Western Wisconsin • 2. Atrius Health Services Eastern and Central Massachusetts • 3. Banner Health Network Phoenix, Arizona Metropolitan Area (Maricopa and Pinal Counties) • 4. Bellin-Thedacare Healthcare Partners Northeast Wisconsin • 5. Beth Israel Deaconess Physician  Eastern Massachusetts • 6. Bronx Accountable Healthcare Network (BAHN) New York City (the Bronx) and lower  Westchester County, NY • 7. Brown & Toland Physicians San Francisco Bay Area, CA • 8. Dartmouth-Hitchcock ACO New Hampshire and Eastern Vermont • 9. Eastern Maine Healthcare System Central, Eastern, and Northern Maine3 • 10. Fairview Health Systems Minneapolis, MN Metropolitan Area • 11. Franciscan Health System Indianapolis and Central Indiana • 12. Genesys PHO Southeastern Michigan • 13. Healthcare Partners Medical Group Los Angeles and Orange Counties, CA • 14. Healthcare Partners of Nevada Clark and Nye Counties, NV • 15. Heritage California ACO Southern, Central, and Costal California • 16. JSA Medical Group, a division of HealthCare Partners Orlando, Tampa Bay, and surrounding South Florida • 17. Michigan Pioneer ACO Southeastern Michigan • 18. Monarch Healthcare Orange County, CA • 19. Mount Auburn Cambridge Independent Practice Association (MACIPA) Eastern Massachusetts • 20. North Texas Specialty Physicians Tarrant, Johnson and Parker counties in North Texas • 21. OSF Healthcare System Central Illinois • 22. Park Nicollet Health Services Minneapolis, MN Metropolitan Area • 23. Partners Healthcare Eastern Massachusetts • 24. Physician Health Partners Denver, CO Metropolitan Area4 • 25. Presbyterian Healthcare Services -Central New Mexico Pioneer Accountable Care Organization Central New Mexico • 26. Primecare Medical Network Southern California (San Bernardino and Riverside Counties) • 27. Renaissance Medical Management Company Southeastern Pennsylvania • 28. Seton Health Alliance Central Texas (11 county area including Austin) • 29. Sharp Healthcare System San Diego County • 30. Steward Health Care System Eastern Massachusetts • 31. TriHealth, Inc. Northwest Central Iowa • 32. University of Michigan Southeastern Michigan

  13. PBHCI Grantee Engagement in Health Homes and ACOs • Discussion

More Related