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DBHIDS Executive Directors Quality and P4P

DBHIDS Executive Directors Quality and P4P . December 4, 2013. Topics. How do we Determine the Measures Measurement Schemas Where are we in the process What are some of the results What to look for in the upcoming month What will we be doing for next year Gold Standards

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DBHIDS Executive Directors Quality and P4P

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  1. DBHIDS Executive DirectorsQuality and P4P December 4, 2013

  2. Topics • How do we Determine the Measures • Measurement Schemas • Where are we in the process • What are some of the results • What to look for in the upcoming month • What will we be doing for next year • Gold Standards • Quality Improvement • New Measures

  3. How Do we Determine Measures?

  4. Quality is Multi-DimensionalDimensions of Quality • Safety • Access • Timeliness of Services • Equitable • Clinical Effectiveness • Person/Family/Community Centered • Cost Effectiveness

  5. Dimensions of Quality Embedded in the Practice Guidelines • Assertive Outreach & Engagement • Access, Timeliness of Services, Equitable • Screening, Assessment, Service Planning and Delivery • Safety, Person/Family Centered, Equitable, Clinical Effectiveness, Engagement, Cost Effective • Continuing Support and Early Re-Engagement Continuity of Care across Levels of Care and w Physical Health • Community Connections and Mobilization • Community Centered; Peer Culture

  6. Where are we in the process?

  7. Pay for Performance:2013 Levels of Care • Adult Inpatient • Child Inpatient • EAC • Children’s RTF • Host Home • CIRC • Journey of Hope • Residential Rehab • RINT • Outpatient D&A • Outpatient Mental Health • RTFA • IOP (New) • BHRS Wraparound • BHRS STS • TCM

  8. Major Activities beginning in Jan 2013 • Review of measurements and thresholds with subject matter experts for all LOC’s • Gold Standard Discussion • Distribution of threshold revisions to providers • Development of IOP measures • Complete revision of change measure scoring • Provider meetings • 17 meetings, with at least one meeting for each participating level of care • Providers could attend either in person or via a webinar

  9. Status as of December 4, 2013 • Measurements are Completed • Increase in Providers Meeting Gold Standards on various measures • Reviewing local norms for “below standard performance” • Reminder of Measurement Changes • Change Scores • Outpatient re Engagement • Thresholds may be less strict in some areas and more strict in others • Weight assignments reflect strategic vision, maturity of the measurements • DBHIDS Executive Level Reviews of the Measures are Completed • In the Process over the next two week of Reviewing Dollars

  10. And Results?

  11. Impact of P4P on National Measures This graph shows CBH’s performance on the nationally-normed HEDIS and PA-normed State measures of 30-day follow-up after Inpatient. We can see steady improvement on this measure, particularly after 2007, when provider profiling began for this level of care.

  12. Impact of P4P on National Measures We also see a trajectory of improvement in the similar 7-day follow-up measures, though we have not incentivized our providers on this measure directly.

  13. Timeliness of Service: BHRS STS

  14. Timeliness of Service: BHRS Wraparound

  15. Early Engagement: Mental Health Outpatient

  16. Early Engagement: D&A Outpatient

  17. Retention: D&A Outpatient

  18. ENGAGEMENT Gaps: BHRS STS

  19. ENGAGEMENT Gaps: BHRS Wraparound

  20. Continuity of Care: Children’s RTF

  21. Continuity of Care: Adult Inpatient

  22. Continuity of Care: Mental Health Outpatient (Low)

  23. Continuity of Care: TCM

  24. Continuity of Care: TCM

  25. Continuity of Care: Journey of Hope

  26. Continuity of Care: Rehab

  27. Outcomes: Rehab

  28. What to look for in the upcoming month

  29. What to Expect in December • Provider Profiles • Detail Matrices in Spread Sheet Format • Summary data beyond P4P • Complaint and Incident Rates • Feedback from Survey re: • Smoking Cessation • Integrated PH/BH • Best Practices re Continuity of Care • Participation in Community Outreach • National Depression Screening • P4P Awards

  30. What will we be doing for next year

  31. Looking Ahead: 2014 And Beyond • Reviewing Measurement Schemas for Gaps and Generation of new Measures • Receipt of Physical Health Data and contextual measures • Input from People we Serve: Inclusion of Complaint Rates as well as input on Clinical Effectiveness • Public Health Initiatives • Smoking cessation and Depression Screening in 2014 • Adding NIAC results • Gold Standards and Review of system level local norms that are TOO Low • Discussion of Best Practices that can Impact Measures • Continued Focus on Readmissions • Clinical Change scores and impact • A quality improvement project when scores are too low • Increase capacity for faster reporting • Not Matrices but Data for 2013 sooner • Trend History for Multiple Years

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