RHP 12 State of the Region

Jeff DaneExecutive Vice President & Chief Financial Officer

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Region 12Region 12

Anchor: UMC47 Counties

DSRIP Funding 4 Yr Projects: $406 million3 Yr Projects: $ 43 million

38 Participating Providers:• 22 Rural Hospitals• 6 Urban Hospitals• 1 Local Health Department• 2 Physician Practices (HSC)• 1 Physician Practice (Non

HSC)• 1 Psychiatric Hospital

CAT 1 & 2 Projects: 99CAT 3 Outcomes: 152

Regional Events DY4 Reporting Transformational Impact Summaries Mid-Point Assessment/Compliance

Monitoring◦ CAT 1 & 2 Mid-Point Assessment 4 Year Projects◦ CAT 3 Baseline Audits◦ CAT 1 & 2 Mid-Point Assessment 3 Year Projects

3- year project change requests Today’s LC Event

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What has happened since our last Learning Collaborative?

Reporting Workshops April 16, 2015 - Amarillo – TTUHSC April 17, 2015 - Lubbock – McInturff Conference Center

DSRIP in Action Events◦ June 2015 - Medical Arts Hospital, Lamesa

Specialty Annex Project –◦ August 2015 - Childress Regional Medical Center, Childress

Palliative Care Project

2nd DY4 Regional LC Event –Today, Lubbock, TX

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Regional Events

Primary Care

ExpansionRedesign

25 projects43 CNs

Patient Navigation

Care Coordination

Care Transitions19 Projects

53 CNs

Behavioral Health

18 Projects38 CNs

Chronic Care Managemen

t8 Projects

15 CNs

Process Improvemen

tPatient

Experience 7 Projects

23 CNs

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RHP12 Top Project Types Addressing Critical & Urgent Community Needs

Critical Community Needs•CN1 – Severe primary care provider shortage – 56 projects

•CN2 – Lack of mental health services – 32 projects

•88 Total

Urgent Community Needs•CN3 – Poor Insurance – 20 projects•CN4 – High obesity, diabetes, & heart disease – 20 projects•CN5 – Need for specialist to assist in chronic disease care – 19 projects•CN6 – Need for cancer screening – 7 projects•CN7 – Insufficient Maternal & prenatal care – 2 projects

•68 Total

29 providers reported achievement on 131 metrics with an acceptance rate of 99.24% with only 1 project receiving a NMI request

33.8 million approved for payment during April reporting DY4– $24,136,473 DY3 CF-$8,353,213 DY3 NMI approved 1,263,580

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DY 4 Reporting

493 TIS (transformational impact summaries) submitted to HHSC, 24 TIS (transformational impact summaries) from Region 12

Of the 493 TIS submitted 41 were selected as most transformational and highlighted at the SLC event. Of the 41 selected 3 were from Region 12 Yoakum County Hospital, Plains Clinic – Telemedicine Amarillo Public Health Dept – ARAD (Amarillo Recovery from

Alcohol & Drugs Collingsworth – Coordinate care for patients with chronic disease

250 of the 493 were interested in Poster presentations 56 were selected, 1 from RHP 12 UMC – IP Medication Management for adult diabetic

patients

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Transformational Impact Summaries

All RHP Plans are subject to potential audits, including review by the independent assessor during the mid-point assessment and ongoing compliance monitoring.

The Performing Providers shall have available

for review by HHSC and CMS, upon request, all supporting data and back-up documentation evidencing performance as described under an RHP Plan for DSRIP incentive payments.

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Mid Point Assessment & Compliance Monitoring

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Mid Point Assessment ResultsCAT 1 & 2 - 4 year projects

RHP

# of Providers in

RHP# of Projects

in RHP

Allocated CAT 1-2 DY 2-5

DSRIP Funds ($)

# of Projects in Mid-Point

Assessment

% of Projects in Mid-Point

Assessment

# of Site Visits in

RHP

Low - Moderate

Ranking (1-3)

High Risk Ranking

(4-5)7 10 77 494,880,423 35 45% 2 100% 0%

12 38 100 315,369,790 33 33% 1 91% 9%6 25 128 882,370,495 61 48% 2 90% 10%

15 8 59 380,598,629 34 58% 2 88% 12%8 12 41 90,438,511 14 34% 1 86% 14%4 20 91 315,542,183 37 41% 2 84% 16%

10 29 126 829,731,893 61 48% 4 83% 17%19 14 37 78,695,333 18 49% 1 83% 17%20 8 25 75,409,165 11 44% 1 82% 18%17 11 32 66,392,053 15 47% 1 80% 20%13 17 38 60,188,246 13 34% 1 77% 23%14 12 58 192,195,137 17 29% 1 76% 24%11 19 44 94,068,543 20 45% 1 75% 25%

2 15 85 293,444,017 30 35% 2 74% 26%16 8 35 118,148,410 11 31% 1 73% 27%

3 28 179 1,683,843,730 109 61% 4 72% 28%9 26 131 1,083,956,688 74 56% 2 71% 29%5 12 79 481,197,517 32 41% 1 69% 31%

18 7 23 95,408,770 13 57% 1 69% 31%1 28 103 337,353,431 39 38% 2 59% 41%

TOTALS 347 1491 7,969,232,964 677 33

RHP12Round 1 20 outcomes from 14 providers selected & reviewed. Round 2 3 projects from 3 providers selected & reviewed After October reporting Myers and Stauffer

will be conducting more reviews. If you have not yet had a CAT 3 baseline audit

please expect one after October reporting.

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Category 3Baseline Audits

RHP1214 - 3 Year projects included in Mid-Point

AssessmentLow to Moderate Risk = 78.5% or 11

projectsHigh Risk = 21.4% or 3 projectsAt Risk projects could be asked to be

removed/replaced for Waiver 2.0

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Mid-Point Assessment Results CAT 1 & 2 – 3 year projects

In July, providers had the opportunity to submit changes to their 3-Year projects

2 providers submitted change request related to their projects◦ Both change request were approved

recently

This was an easy and stress free process by Waiver standards.

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3 Year Project Change Requests

Lean Six Sigma- Waste Walk Update Peer to Peer Discussions/ Interactive

Discussions Networking Lunch Provider Presentations Panel Discussion: Patient Navigation Panel Next Steps for Waiver 2:0

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Today’s Agenda

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Comments/Questions?