Delaware State Innovation Model Design

1. Delaware State Innovation Model Design Health Care Commission March 28, 2013

2. Grant Specifics • Notice of award February 22, 2013 • Project period April 1- September 30, 2013 • Total award $2,485,118

3. Activities to Date • Notification of all participants to date • Weekly meetings of State team • Critical need procurement waiver • Working with CMMI to finalize contracting specifics

4. Anticipated schedule of deliverables Project set up and initial hypotheses Current state, best practice, and options Preferred option, design and planning Syndicate Finalize Strategic planning & project management 1.1 Define scope and team assignments 1.3 Define processes and communication mechanisms for all aspects of plan design 1.4 Schedule twice- weekly meetings 1.5 Assign workstream leads 1.9 Draft plan outline 1.6a Develop stakeholder map 1.6b Development stakeholder engagement plan 1.6c Develop core materials for stakeholders and maintain “grid” of key events 1.7 Monitor individual and collective workstream progress 1.8 Identify and carry out interventions to ensure progress 1.10 Incorporate work product of all workstreams 1.11a Draft plan (first draft) 1.11b Draft plan (second draft) 1.12 Dissemi- nate draft plan and obtain broad stake- holder feedback 1.13 Finalizeplan 1.14 Develop funding application 1.15 Submit application • 1 Payment model 2.1a Establish workstream charter and hold kickoff 2.1b Agree to goals and criteria for payment reform 2.1c Identify and analyze payment reform options 2.2a-c Identify, prioritize, and analyze peer state programs 2.3a Agree on preferred option and model potential impact 2.3b Identify and define changes in delivery, data and other systems needs 2.5a Draft plan (first draft) 2.5b Draft plan (second draft) 2.6 Obtain stake- holder feedback and revise plan 2.7 Finalize model • 2 Delivery system 3.1a Establish workstream charter and hold kickoff 3.1b Agree to goals of delivery system transformation 3.1c Obtain broad consumer and stakeholder input 3.2a Assess existing service delivery mechanisms 3.2b-d Identify, prioritize, and analyze peer state programs 3.3 Collect DE-specific and national data identifying utilization behaviors 3.4a Agree on preferred option and model potential impact 3.4b Identify and define changes to data and other system needs 3.6a Develop comprehensive service delivery plan (first draft) 3.6b Draft plan (second draft) 3.6c Develop action plan for integration of interventions 3.7 Obtain stake- holder feedback and revise plan 3.8 Finalize plan • 3 Data/ analytics 4.1a Establish workstream charter and hold kickoff 4.1b Agree to goals of data system reform 4.1c Inventory of existing health data sources 4.2 Inventory/assess existing analytic capacity 4.3a Analyze state health data systems and identify key gaps 4.3b Prioritize data and analytic gaps 4.4a-c Identify, prioritize, and analyze peer state programs 4.5 Engage health care providers 4.6 Identify data system linkages 4.7 Identify linkages to APCD 4.8 Conduct policy and legal research for creation of APCD 4.9a Agree on preferred option to fill data and analytic gaps and model potential impact 4.9b Design plan for actuarial capacity 4.11a Draft plan (first draft) 4.11b Draft plan (second draft) 4.12 Obtain stake- holder feedback and revise plan 4.13 Finalize plan • 4

5. Anticipated schedule of deliverables (cont’d) Project set up and initial hypotheses Current state, best practice, and options Preferred option, design and planning Syndicate Finalize 5.1a Establish workstream charter and hold kickoff 5.1b Agree to goals of policy research 5.1b Inventory of existing policy, licensure, and purchasing units 5.2a-c Identify, prioritize, and research peer state best practices 5.3 Define necessary statutory or regulatory updates 5.4 Identify levers appropriate in health benefit redesign 5.5 Define system improvements and projected cost savings 5.7a Draft plan (first draft) 5.7b Draft plan (second draft) 5.8 Obtain stake- holder feedback and revise plan 5.9 Finalize plan Policy research • 5 Workforce 6.1a Establish workstream charter and hold kickoff 6.1b Review data and recommendations of HCC Workforce working group 6.1c Align on roles/ responsibilities from HCC Workforce group 6.1d Agree to goals of workforce transformation 6.2 Identify state gaps in providers 6.3 Identify gaps in licensure, training, and recruiting 6.4a Review “physician extender” concept 6.4b-d Identify, prioritize, and analyze peer state programs 6.5a Agree on preferred option and model potential impact 6.5b Identify and define changes in delivery, data, and other system needs 6.5c Develop tasks, assignments, measures and timelines for preferred option 6.7a Draft plan (first draft) 6.7b Draft plan (second draft) 6.8 Obtain stake- holder feedback and revise plan 6.9 Finalize plan • 6 Population health 7.1a Establish workstream charter and hold kickoff 7.1b Review recommendations of Governor’s Council on Health Promotion and Disease Prevention 7.1c Align on roles/ responsibilities from Governor’s Council 7.1d Agree to goals of population health 7.2a-c Identify, prioritize, and research peer state and best practices of population health 7.3a Agree on preferred option and model potential impact 7.3b Identify and define changes in delivery, data, and other system needs 7.3c Attach tasks, budget, and timelines to recommendations 7.4 Design action plan to integrate individual and population health 7.6a Draft plan (first draft) 7.6b Draft plan (second draft) 7.7 Obtain stake- holder feedback and revise plan 7.8 Finalize plan • 7

6. High-level project sequence Vision & setup Delivery system Population health Payment model Data and analytics Workforce Policy Plan finalization Outline report First draft report Second draft report Final report & Testing proposal Weeks 1 to 2 Weeks 3 to 6 Weeks 7 to 10 Weeks 11 to 14 Weeks 15 to 22

7. Timeline for project plan Deliverable committed to CMS Final deliverable Apr May Jun Jul Aug Sep Phase Project set up Strategic plan-ning & project management 1.1,1.2 1.3-1.5 Current state and options 1.6a,b 1.6c-1.8 • 1 Preferred design and plan 1.9 1.11a 1.11b Syndication 1.12 Finalization 1.13-1.14 1.15 Payment model Project set up 2.1a,b Current state and options Preferred design and plan 2.2a,b 2.1c 2.2c • 2 2.5a 2.3 2.5b Syndication 2.6 Finalization 2.7 Delivery system Project set up 3.1a,b 3.1c Current state and options 3.2b,c 3.2a,d 3.3 • 3 Preferred design and plan 3.4a 3.4b 3.6a 3.6b,c Syndication 3.7 3.8 Finalization Data/analytics Project set up 4.1a,b Current state and options 4.4a,b 4.4c 4.1c-4.3, 4.6-4.8 • 4 Preferred design and plan 4.9a 4.11a 4.11b 4.5 4.9b Syndication 4.12 4.13 Finalization

8. Timeline for project plan (cont’d) Deliverable committed to CMS Final deliverable Apr May Jun Jul Aug Sep Phase Policy research 5.1 Project set up 5.2a,b Current state and options Preferred design and plan • 5 5.2c 5.7a 5.3-5.5 5.7b Syndication 5.8 Finalization 5.9 Workforce 6.1 Project set up Current state and options , 6.2, 6.4b,c 6.4a 6.3, 6.4d • 6 Preferred design and plan 6.7a 6.5a,b 6.7b 6.5c Syndication 6.8 6.9 Finalization Population health 7.1 Project set up Current state and options 7.2a,b 7.2c • 7 Preferred design and plan 7.3 7.6a 7.4 7.6b Syndication 7.7 7.8 Finalization

9. Next Steps • Finalize contract • Schedule project activities including • Workstream meetings • Stakeholder engagement and feedback