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Advancing Outcomes June 3, 2014

Advancing Outcomes June 3, 2014 . Jackey Matson Director, Bureau of Performance Improvement and Patient Safety. Managed Long-Term Care – Assessment and Quality. Semi Annual Assessment of Members in 2005 Based on OASAS Used to determine eligbility First report in 2011

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Advancing Outcomes June 3, 2014

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  1. Advancing Outcomes June 3, 2014 Jackey Matson Director, Bureau of Performance Improvement and Patient Safety

  2. Managed Long-Term Care – Assessment and Quality • Semi Annual Assessment of Members in 2005 • Based on OASAS • Used to determine eligbility • First report in 2011 • Not publicly reported • Feedback loop and buy-in from the MLTC plans • Publicly reported in 2012 and 2013 • http://www.health.ny.gov/health_care/managed_care/mltc/reports.htm

  3. Managed Long-Term Care – Consumer Surveys • “In House” survey developed 2007 • Two more in 2011 and 2013 • Satisfaction • Access • Timlieness • Ratings of care managers, nurses, personal care, home care, Etc. • Advanced Directives - 2011 • “Quality of Life” – 2013 • http://www.health.ny.gov/health_care/managed_care/mltc/reports.htm

  4. OPWDD Population Measurement • Quality Assurance Reporting Requirements (QARR)/HEDIS • Quality performance data collected from MMC plans since 1994 • Women’s Health, Children’s Health, Chronic Illness • Numerators/Denominators • Medicaid: MEMBER level • Allows for matching to Medicaid data • Voluntarily enrolled OPWDD members • Compared OPWDD performance to non-OPWDD

  5. OPWDD Population Measurement – Results, 2012 • Compared to rest of MMC, mostly no statistically significant differences • Lower performance in some cancer screenings • Higher performance in some well child visits and asthma management • Will publish and repeat the process for 2013 data

  6. Cross Agency Work Group to Implement Olmstead Outcome Measures

  7. Background • Determine applicability of each of 64 measures for each agency and population served – M. DeMasi • Determine availability of data sources • Identify need for additional measures • Develop a set of common measures • Determine whether development may need 2015-2016 budget request • 5 Agencies. 4 Responses. • OMH/OASA combined response

  8. Populations • DOH • MLTC, ALP, Personal Care, CDPAP, LTHHCP, TBI, Adult Day Health, Care at Home and NH Transition and Diversion waivers • OMH • BHOs, HARPs • OPWDD • All eligible individuals • OASAS • HARPs, BHOs • SOFA

  9. Instruments • DOH • Uniform Assessment System (UAS) • OPWDD • Coordinated Assessment System (CAS) • OMH • In development (core set comprised of UAS and CAS) • OASAS • In development (UAS and CAS) • SOFA • Comprehensive Assessment for Aging Network Community Based Long Term Care Services (COMPASS)

  10. Issues and Decisions • What is long term care? – 120 days of care – NA to SOFA clients • Medicaid only? – no, i.e., SOFA included • Children and Adult? - Adult initially • Institutions as well as community based – Ideally yes • Employment measures’ applicability to older populations (SOFA and MLTC)

  11. Results: Summary Olmstead Focus

  12. Results: Summary of Data Sources for Measure “Domains”

  13. Results: Measure Summary • Applicable Populations • Data Exist • If not should it be collected? • Data sources • UAS • Administrative • Interview • Satisfaction Survey

  14. Going Forward • Choose set of measures with data that touch many agencies to begin “dashboard.” • Discuss data collection needs for “gaps.” • Other measures necessary? • Transportation • Self-directed data

  15. Jacqueline Matson Jacqueline.Matson@health.ny.gov 518-486-9012

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