Developing Our Service Package(s)(Pennsylvania Partners for Care)

Service packages

Major services/service packages that will meet our customers’ needs:

• Prevention – Evidence Based Health practices– Wellness – Nutrition assessment and Counseling– Home modification– -peer to peer support– Med-management– Health safety assessment

• Care Coordination– Care Transitions- Comprehensive assessment- hospital visit, home

visit, develop service plan and follow-up- Benefits check up

Nursing home diversion

Major services/service packages that will meet our contracting org’s needs:

Health coachingIn-home Assessment and

interventionOptions counselingCare CoordinationCare TransitionsCare Giver counseling and

supportVendor management

2

Network capacity

Current network partners, capacity and strengths

Organization name Service competencies Strengths

AAA’s Assessment, service planning,caregiver support, evidence based health servicesvendor management, coordination of service, options counseling and I&AOmbudsman, mediation and problem solvingcare transitions\nursing home transition

Lots of boots on the groundWork with many High risk usersHave Statewide foot print and ramp up capacityDecades of experience and are trusted entitiesIn-depth knowledge of formal and informal resourcesHolistic and inclusive approachWell established network of providersAccess point for other services Skilled in supporting caregivers Provide numerous Evidenced based chronic disease management programs3

Network capacity

Current network partners, capacity and strengths

Organization name Service competencies Strengths

Centers for Independent Living

•peer to per counseling,•skills training and advocacy•nursing home transitions• service coordination• personal assistance services• assistive technology, DME, • environmental modifications• consumer directed (fiscal management

•Consumer direction and control•Statewide foot print and capacity•disability awareness training & reasonable accommodation technical Assistance•Access point for other services

4

Network capacity

New network partners to be added• Need a data partner for metrics and analytics• Taking a closer look at this may be a list of advisors.

Marketing analysis, select senior centers, Universities, transportation- private industry (what do you mean)

• Medical transportation company • Technology- i.e., Carnegie Mellon• In-home physician

5

Service value definition

Result(s) we commit to deliver1. Supporting consumers who

are eligible for nursing home place to remain in the community

2. Falls Prevention/reduction– In-home safety assessment

– Falls prevention training

How we will measure1. Track the length of time

they are able to remain in the community – Look at the type and cost of

services to keep them in the community compare to other types of care

2. How many complete the training program and the in-home assessment. Do a 6 and 12 month follow-up to determine falls

6

Service value definition

Level of satisfaction we commit to deliver

Contractor perspective- High satisfaction with improved health outcomes

• Consumer perspective - safe in home

How we will measure• Look at the HEDIS and Patient activation measure

results• Consumer Survey at

different points, initial visit, 3 month, six month, annual

7

Service value definition

Early thoughts on possible pricing for your service package?•We do not know

8

Insights

Our biggest insight(s) from this session on Developing Service Packages is/are… •We have so many considerations in the air that we need to begin to narrow them down

9

Action Steps

The action step(s) we will take in the next month to develop our service package(s) are:•Undertake a Market analysis•Take one or two services and look at a service and work through definition and the excel sheet shared with the folks in Cincinnati. Purge out old requirements. Uniform way of coming up with the cost.•Look at the Community Road Map.•Does it make sense to be a per member per month or per episode, and some be for fee for service.•Market base – will not be uniform across the state. •Grid, unbundle, price them out and then play them out at what makes sense on pricing. Are we even in the ball park?

10

Action Steps (Continued)

The action step(s) we will take in the next month to develop our service package(s) are:•Establish a pricing team – need to get people to work on – pricing team needs to work with the measurement group. Have people responsible for certain task. •Have information completed prior to the meeting•Need to help keep us moving along - •Core group as a leadership team and work out form there•Need to have our next meeting be a working meeting

11

Parking Lot (Issues for later, additional questions for speakers)

• Lynn Kellogg on the bundling and unbundling• Scan foundation – for pricing• The pyramid and the business model• Have a ta person for each group to help us move along. We

vote on Mary for Pennsylvania

12