Region 15 Regional Healthcare Partnership Third Public Meeting

1. Region 15Regional Healthcare PartnershipThird Public Meeting Wednesday, June 27, 2012 University Medical Center of El Paso Anchor Hospital

2. Regional Healthcare Partnership (RHP) Regions

3. Confirmation of Participants

4. Confirmation of Participants • El Paso Children’s Hospital • El Paso Coalition for the Homeless • El Paso County Juvenile Justice Center • El Paso County Medical Society • El Paso Department of Public Health • El Paso Psychiatric Center • El Paso Specialty Hospital • Emergence Health Network

5. Confirmation of Participants • Hospice El Paso, Inc. • Hudspeth County • International Aids Empowerment • Las Palmas Del Sol Healthcare • PDN Health Information Exchange • Project Vida Health Center • Providence Memorial Hospital • Rescue Mission of El Paso

6. Confirmation of Participants • San Vicente Centro Familiar De Salud • Sierra Medical Center • Sierra Providence East Medical Center • Tender Care Home Health • TTUHSC School of Medicine • VNA Home Healthcare and Hospice

7. Current HHSC Information Stanley Stewart Project Director of Transformation Waiver Operations, HHSC

8. Regional Strategic Health Framework • Phase 1 – Needs Assessment Report • Phase 2 – Priority Ranking • Phase 3 – Intervention Planning • Paso del Norte Blue Ribbon Committee • http://www.elpasotexas.gov/health/_documents/ BRCGapBook.pdf

9. PDN Blue Ribbon Needs Assessment Report

10. RHP 15 DSRIP Projects • See Handout

11. New Draft DSRIP MenuCategory I Project Areas • Expand Primary Care Capacity • Increase Training of Primary Care Workforce • Implement and Utilize Disease Management Registry Functionality • Enhance Interpretation Services and Culturally Competent Care • Collect Accurate Race, Ethnicity and Language (REAL) Data to Reduce Disparities • Enhance Urgent Medical Advice

12. New Draft DSRIP Menu Category I Project Areas (cont.) • Introduce Telemedicine • Enhance Coding and Documentation for Quality Data • Expand Specialty Care Capacity • Enhance Performance Improvement and Reporting Capacity • Expand Behavioral Health Services • Expand Dental Services • Expand or Enhance Emergency Medical Transportation Services

13. New Draft DSRIP MenuCategory II Project Areas • Expand Medical Homes • Expand Chronic Care Management Models • Redesign Primary Care • Redesign to Improve Patient Experience • Redesign for Cost Containment • Establish/Expand a Patient Care Navigation Program

14. New Draft DSRIP MenuCategory II Project Areas (cont.) • Apply Process Improvement Methodology to Improve Quality/Efficiency • Improve Patient Flow in the Emergency Department/Rapid Medical Evaluation • Use Palliative Care Programs • Conduct Medication Management • Implement/Expand Care Transitions Programs • Health Promotion and Disease Prevention

15. New Draft DSRIP MenuCategory III Project Areas • Severe Sepsis Resuscitation and Management • Potentially Preventable Admissions • Congestive heart failure admission rate • Diabetes, short-term complications, admission rate • Diabetes, uncontrolled diabetes, admission rate • Behavioral health potentially preventable admissions • Chronic obstructive pulmonary disease or asthma in adults admission • Hypertension admission rate • Diagnosis and management of asthma • Potentially Preventable Readmissions • All cause readmission rate • Congestive heart failure readmission rate • Diabetes readmission rate • Behavioral health readmission • COPD readmission • Stroke readmission

16. New Draft DSRIP MenuCategory III Project Areas (cont.) • Potentially Preventable Complications • Perinatal Outcomes • Birth trauma rates • Elective pre 39-week delivery • Diabetes Composite Measure • Hemoglobin A1c (National Quality Forum (NQF) 0059) • Blood Pressure (NQF 0061) • Low-Density Lipoprotein Cholesterol (NQF 0064) • Retinal or dilated eye exam (NQF 0055) • Foot exam (NQF 0056) • Nephropathy screening (NQF 0062).

17. New Draft DSRIP MenuCategory IV Project Areas • Potentially Preventable Admissions • Congestive heart failure admission rate • Diabetes, short-term complications, admission rate • Diabetes, uncontrolled diabetes, admission rate • Behavioral health potentially preventable admissions • Chronic obstructive pulmonary disease or asthma in adults admission • Hypertension admission rate • Diagnosis and Management of Asthma • 30-Day Readmissions • All-cause readmission rate • Congestive heart failure readmission rate • Diabetes readmission rate • Behavioral health readmission • COPD readmission • Stroke readmission • Pediatric asthma

18. New Draft DSRIP MenuCategory IV Project Areas (cont.) • Provider Preventable Complications • Patient-centered Health Care • Patient satisfaction • Medication management • Emergency Department • Admit decision time to ED departure time for admitted patients • Diabetes Composite Measures • Hemoglobin A1c • Blood Pressure • Low-Density Lipoprotein Cholesterol • Retinal or dilated eye exam • Foot exam • Nephropathy screening

19. Medicaid Waiver Timelines

20. Medicaid Waiver Timeliness • Program Funding & Mechanics (PFM) and the RHP/DSRIP protocol • HHSC send to CMS June 29, 2012 • Send out to RHPs for comments back by July 13, 2012 (they will provide a form for feedback) • July 15, 2012 – Submit RHP Chapters to Anchor • Please use the format in the draft RHP15 document located on the UMC El Paso RHP website • RHP Planning Summit – early August, Austin, TX • Sept. 1 – Submit RHP to HHSC (4 year plans) • DY1 payment based upon submission of RHP • HHSC reviews RHPs during the month of September. • Return to Regions for changes in first two weeks of October.

21. Medicaid Waiver Timeliness • October 31 – HHSC Submit Final RHP to CMS • December 15, 2012 - CMS completes review • RHPs returned for revisions during the 30 day period • January 15th, 2013 - Revised RHP Plans to CMS • February 1st, 2013 - CMS Final Decision

22. Roundtable

23. Contact Information • Waiver Website & Email Address: • http://www.hhsc.state.tx.us/1115-waiver.shtml • TXHealthcareTransformation@hhsc.state.tx.us • UMC Website: • http://www.umcelpaso.org • RHP 15 • Paso del Norte Blue Ribbon Committee Needs Assessment: • http://www.elpasotexas.gov/health/_documents/BRCGapBook.pdf