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Explore governance, administration structure, staffing, and operational strategies for SustiNet in 2011. Key issues include representation, advisory committees, operational rules, benefit design, and state law changes.
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SustiNet Board of Directors December 2, 2010 Part II – Possible additional questions for board discussion Note: this is not an exhaustive list of issues the board will need to address in the future, but it includes some topics about which the board might wish to make legislative recommendations for action in 2011
Outstanding questions: governance and administration (1 of 2) • What additional representation should be added to the board? • Stakeholder groups? • Specific expertise? • Elected or appointed officials (e.g. Comptroller or DSS Commissioner)? • Who should appoint additional board members? • What advisory committees should be established? • AC/TFs recommended: PCMH coordinating council, Health Care Quality, Health Care Safety, Preventive Health, Health Disparities & Equity, HIT Coordination • How much of this should be spelled out in statute? How much left to the discretion of the Board?
Outstanding questions: governance and administration (2 of 2) • If SustiNet is administered by a quasi-governmental agency, which rules (if any) that ordinarily apply to state agencies should also apply to SustiNet? What other rules (if any) should apply? • What kind of staffing should SustiNet have? • Should the Board have authority to hire an Executive Director for the SustiNet Plan? Should the Board have a role in hiring other administrative leadership?
Outstanding questions: operations and implementation • Should the SustiNet Plan be authorized to use one or more third-party administrators? If so, on what terms? • Should the Board be required or authorized to take steps for SustiNet to become licensed? • Board members agree the SustiNet plan should be required to implement multi-year campaigns to achieve measurable, specific goals related to racial and ethnic disparities, chronic illness, wellness, health care costs, etc. Should the Board adopt other key metrics to assess progress?
Outstanding issues: benefit design and delivery system reform • Does the Board need any additional authority to implement benefit design changes or delivery system reforms that will slow cost growth and improve care delivery? Should particular reforms be prioritized? How much flexibility should the Board have to respond to changing evidence? • Are other state law changes needed to facilitate delivery system reforms? • Example: a safe harbor from malpractice liability for following approved clinical guidelines