WELCOME! Healthcare Transformation Learning Session May 23, 2014 8:30-11:30AM
Please set up your mobile device to participate in audience polling • Step 1: confirm internet connection via cell service or use WiFi@osu
What will it take to successfully implement Ohio's Public-Private • Step 2: enter Healthcare Innovation Plan in pollev.com/hcgc Greater Columbus? in your web browser Lead Support
Major Support
Please save the dates for scheduled learning sessions • Webinar: 6/25, 1-2PM Choosing Wisely • Webinar: 7/23, 1-2PM Open Notes • In-person: 8/22 & 12/5 8:30-11:30AM
Additional Support 100% of our Board of Directors & Staff Individual & Corporate Donations
www.hcgc.org
WELCOME!
Lead Support
Major Support
Additional Support 100% of our Board of Directors & Staff Individual & Corporate Donations
www.hcgc.org
Our Public-Private Board of Directors • Ivery Foreman (Board Chair), Vorys, Sater, Seymour & Pease, United Way of Central Ohio Representative • Mike Stull (Board Vice Chair), Employers Health Coalition, Business Representative • Bill Wulf, M.D. (Board Treasurer), Central Ohio Primary Care, Columbus Medical Association Representative • Dianne Radigan (Board Secretary), Cardinal Health, Franklin County Representative • Jeff Biehl (President), non-voting, ex-officio • Doug Anderson, Bailey Cavalieri, City of Columbus Representative • Dianne Biggs, Labor Representative • Sarah Durfee, RN, Ohio Public Employees Retirement System, Purchaser Representative • Jerry Friedman, The Ohio State University Wexner Medical Center, Hospital Representative • Diana Riggsby Gardner, The Dispatch Printing Company, Purchaser Representative • Jeff Geppert, Battelle, Health Care Representative • Thomas Hadley, Wells Fargo Insurance Services, Chamber of Commerce Representative • Sister Barbara Hahl, Mount Carmel Health System, Hospital Representative
• Kevin Hinkle, Anthem Blue Cross & Blue Shield, Health Plan Representative • Thomas Horan, Columbus Neighborhood Health Center, Community Health Centers Representative • Isi Ikharebha, Physicians CareConnection, Consumer Representative • Doug Knutson, M.D., OhioHealth, Hospital Representative • Teresa Long, M.D., Columbus Public Health, Health Department Representative • Julie Erwin Rinaldi, Syntero, Behavioral Health Representative • Valerie Ruddock, Nationwide Children’s Hospital, Hospital Representative • Olivia Thomas, M.D., Nationwide Children’s Hospital, Community Philanthropic Representative • Dana Vallangeon, M.D., Lower Lights Christian Health Center, Consumer Representative • Bruce Wall, M.D., The Ohio State University Health Plan, Columbus Medical Association Representative • Todd Weihl, D.O., OhioHealth, Columbus Osteopathic Association Representative
Our Collaborative Process
Build collaborations with consumers, providers, and purchasers ~trust~
Apply collaborative learning ~spread knowledge~
Measure actionable results
Transform Healthcare
in Greater Columbus with consumers, providers & purchasers
~collective impact~
~awareness~
Convene diverse stakeholders ~exploration~
Coordinate activities that transform healthcare delivery and value www.hcgc.org
Catalyze best practices
~commitment~
Activity Update
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2
Transform Healthcare in Greater Columbus
www.hcgc.org
5 areas of transformational activity Value-based Healthcare Delivery Value-based Healthcare Reporting Value-based Healthcare Literacy Apply Collaborative Learning Collaborative Grant Applications
3 4 5 value = (quality/cost) + patient experience
Patient-Centered Medical Homes (PCMH) in Greater Columbus
‌ community health centers, hospital affiliated and private practices serving people with Commercial insurance, Medicare, Medicaid and the uninsured www.hcgc.org
Open Notes – a new standard of care emerging in Greater Columbus OpenNotes is a national initiative working to give patients access to the visit notes written by their doctors, nurses, or other clinicians.
Nationwide Children’s Hospital became the first children’s hospital in the U.S. to offer OpenNotes access to its Primary Care Network patients earlier this month as part of the hospital’s MyChart patient portal. Initially focusing on patients from birth through 12 years of age, patients and their families are educated about OpenNotes at each appointment and college students will be available in each Primary Care Center this summer to encourage patients and families to access OpenNotes and walk them through the access process.
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‌ coordinating regional activities to spread awareness and adoption of Choosing WiselyŽ to help physicians, patients, and other healthcare stakeholders in Greater Columbus think and talk about appropriate use of healthcare resources.
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A number of no-cost resources are available for our partners in Greater Columbus that wish to incorporate Choosing Wisely® into their own communication campaigns. • Communications tools – co-branded micros-sites, digital communication tips, and social media resources to incorporate into health and wellness programs • Clinical Decision Support - incorporating evidence-based guidelines into clinical pathways
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Participating Central Ohio Primary Care Franklin County Ohio Public Employees Retirement System The Ohio State University Health Plan Emerging Participants Columbus Public Health InHealth Mutual Medical Group of Ohio Medical Mutual of Ohio National Church Residences Nationwide Insurance OhioHealth Schools Employees Retirement System of Ohio Syntero
Patient Engagement Education & Training
…helping people learn how to use the right questions to receive high-quality healthcare at a lower cost
Using best practices and tools from the following experts:
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Our phased approach working in collaboration with regional partners
PILOT PHASE (Q2-Q3/2014) Conduct in-person education-training sessions hosted by our partners
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SPREAD PHASE (Q4/2014) Apply learning from pilot to create online/on-demand education-training option
ENHANCE PHASE (2015) Create new education-training modules based on best practices and tools
WELCOME!
Please introduce yourself to some new… … share why you joined us today!
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Clarity of Today’s Purpose WHAT will it take to successfully implement Ohio's Public-Private Healthcare Innovation Plan in Greater Columbus? Why do we need Ohio need a healthcare innovation plan? What is Ohio’s 5 year goal for aligning public-private payments? (a.k.a. State Innovation Model or SIM) BREAKING NEWS – CMS announces Round 2 of SIM funding Sharing lessons learned from SW Ohio on implementing Comprehensive Primary Care in a multi-payer environment Sharing lessons learned on implementing episode-based payments in a multi-payer environment Sharing reflections on the value of implementing Ohio's Public-Private Healthcare Innovation Plan in Greater Columbus
$10,000
Health Care Spending per Capita by State (2011) in order of resident health outcomes (2009) Ohioans spend more per person on health care than residents in all but 17 states
$9,000 $8,000 $7,000 $6,000 $5,000 $4,000 $3,000 $2,000 $1,000 $0
MN HI CT UT CA MA IA VT WI ND CO ID WA NH NE WY NY OR NJ RI AZ TX ME MD MT FL AK VA NM SD KS IL PA DE MI IN GA NV NC MO OH SC OK KY LA AL AR TN WV MS
36 states have a healthier workforce than Ohio Sources: CMS Health Expenditures by State of Residence (2011); The Commonwealth Fund, Aiming Higher: Results from a State Scorecard on Health System Performance (October 2009).
Aligning Public and Private Payment Innovation
Source: Catalyst for Payment Reform www.catalyzepaymentreform.org
CMMI: State Innovation Model (SIM)
• development and testing of statebased models for multi-payer payments • health care delivery system transformation with the aim of improving health system performance for residents of participating states.
CMMI: State Innovation Model (SIM) – February 2013 Model Testing Awards
Model Pre-Testing Awards
Model Design Awards
CMMI: State Innovation Model (SIM) – February 2013 Model Testing Awards
Model Pre-Testing Awards
Model Design Awards
Over $250 million in Model Testing awarded to support six states that are ready to implement their State Health Care Innovation Plans.
CMMI: State Innovation Model (SIM) – ROUND 1 Model Testing Awards
Model Pre-Testing Awards
Model Design Awards
Three states that will receive pre-testing assistance will use the funding to continue to work on a comprehensive State Health Care Innovation Plan.
CMMI: State Innovation Model (SIM) – February 2013 Model Testing Awards
Model Pre-Testing Awards
Model Design Awards
• The 16 States that will receive Model Design funding to produce a State Health Care Innovation Plan. • States will use these Health Care Innovation Plans to apply for an anticipated second round of Model Testing awards. • States will have six months to submit their State Health Care Innovation Plans to CMS.
Ohio’s Public-Private Healthcare Innovation Plan – November 2013
5-Year Goal for Payment Innovation Goal State’s Role
Year 1
Year 3 Year 5
80-90 percent of Ohio’s population in some value-based payment model (combination of episodes- and population-based payment) within five years
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Shift rapidly to PCMH and episode model in Medicaid fee-for-service Require Medicaid MCO partners to participate and implement Incorporate into contracts of MCOs for state employee benefit program
Patient-centered medical homes
Episode-based payments
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In 2014 focus on Comprehensive Primary Care Initiative (CPCi)
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Payers agree to participate in design for elements where standardization and/or alignment is critical
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State leads design of five episodes: asthma (acute exacerbation), perinatal, COPD exacerbation, PCI, and joint replacement
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Multi-payer group begins enrollment strategy for one additional market
Payers agree to participate in design process, launch reporting on at least 3 of 5 episodes in 2014 and tie to payment within year
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Model rolled out to all major markets 1. ▪ 2. 50% of patients are enrolled 3. 4. ▪ Scale achieved state-wide 5. 80% of patients are enrolled
Perinatal 20 episodes defined and launched across Asthma payers acute exacerbation COPD exacerbation Joint replacement 50+ episodes defined and launched across Percutaneous coronary intervention (PCI) payers
Ohio’s Payment Innovation Partners:
THANK YOU! • Thank you for joining us today! • Thanks to our speakers and regional partners! • Thanks to our funding partners! • Please respond to the evaluation question via poll
Please save the dates for scheduled learning sessions • Webinar: 6/25, 1-2PM Choosing Wisely • Webinar: 7/23, 1-2PM Open Notes • In-person: 8/22 & 12/5 8:30-11:30AM
Lead Support
Major Support
Additional Support 100% of our Board of Directors & Staff Individual & Corporate Donations
www.hcgc.org