Monthly Status Update Call January 2015

RHP 12 Learning Collaborative

RHP 12 Learning Collaborative Project Highlight Waiver Updates

Agenda

February 26,2015 Tentative Agenda

◦ 8:00-9:30 - Registration & Breakfast◦ 8:30-9:30 - Breakout Session#1 – Prevention Cohort◦ 9:30-9:45 – Break – Poster Presentations◦ 9:45-10:00 – Welcome/Introductions◦ 10:00-11:30 – Lean Six Sigma – 5 projects within 1◦ 11:30-1:00 – Networking lunch & Posters◦ 1:00-2:00 – Provider Presentations◦ 2:00 – 2:15 – Poster Break◦ 2:15-3:15 – DSRIP Reporting◦ 3:15-3:45 – Closing Comments◦ 3:45 – 4:45 – Breakout Session#2 – QOL Surveys

RHP 12 Learning Collaborative

Current Registration◦ Main Session – 65◦ NEW Focused Cohorts

Prevention - 18 QOL Surveys – 15

◦ Poster Presentations FreeStyle-2 Template-4

We want to highlight as many projects as possible via a poster. If you haven’t signed up to highlight at least one of your projects and you are not presenting a project, Please consider submitting poster info for one of your projects

RHP 12 Learning Collaborative

Welcome & Introductions Cohort Participation Expectations Timeline Challenges Marshmallow Challenge Establish AIM Statements Set Goals PDCA

Agenda for Cohort Meetings

Cohort Timeline

North South

Lynn County Hospital Donna Raindl, Comptroller Pete Paniagua, Patient Navigator

Project 2.9.1 – Patient Navigator Project Focus on Indigent patients Connects patients to PCP

through ED visits for all identified private pay patients

Patients also referred through the clinics

Enrollment and Navigation involves an intake, collecting documentation, referrals to community services (PAP & SSI)

Project Spotlight-Lynn County Hospital

Lynn County Continued

Challenges, Successes, Lesson’s Learned

Patient Story

Challenges Only 1 patient Navigator Contacting patients

Successes Introduces himself as a social

worker/navigator Builds rapport Looks for solutions for everyone Patients connecting with PCP Less ED utilization

“The value this program brings to the community is greater than the DSRIP funding”(Donna Raindl)

Waiver UpdatesBobbye Hrncirik

Change Request CAT 3 baseline Updates submitted January 15th October NMI submitted January 16th October DY3 DSRIP Payments Received October DY3 CAT 3 Review in process

◦ Anticipated completion - End of February October DY3 Provisionally Approved

◦ Late February – Early March◦ No News is Good News

Change Request ProcessPlan Mods and Technical Change Requests

Based on the PFM, providers will have a time after the mid-point assessment to determin if the provider wishes to continue with a project

HHSC has proposed to CMS that the window to withdraw projects be from February 1st through May 1st 2015

Please let us know if you are considering withdrawing a project

Project Withdrawal Window

HHSC does not have further information from CMS on the waiver amendment request to access DY2 DSRIP funds.

CMS indicated that UC deferral was one obstacle to approving the amendment along with lateness in the waiver term.

Unlikely that CMS will approve this amendment.

Unspent DY2 DSRIP Funds

Clinical Champions work group had first meeting on January 22,2015

Next Clinical Champion Meeting – February 19th

No additional information at this time

Waiver Renewal

Medicaid/CHIP Quality and Efficiency Improvement Website ◦ HHSC launched a Medicaid and CHIP Quality and

Efficiency Improvement website to increase transparency and public reporting: http://www.hhsc.state.tx.us/hhsc_projects/ECI/index.shtml

◦ Goal – Serve as a one-stop information resource on Medicaid/CHIP quality improvement efforts for healthcare providers, health plans, & the public

◦ Questions: email HPCS_Quality@hhsc.state.tx.us

Additional Info

Early February – Change Request determination from HHSC Late February – HHSC Completion of Category 3 Review February 26th – Regional LC Event, Lubbock TX Late February/Early March – NMI for “provisionally approved”

DY3 October Reporting metrics April Reporting – April 1st – April 30th

Timeline

Thank you!