2015 DSRIP: OPPORTUNITIES AND QUESTIONS

Agenda: 2  What is DSRIP?  What are the 10 DSRIP projects?  What are the opportunities

What is DSRIP? 3  Delivery System Reform Incentive Payment program  5-year program – planning started in 2014  Goal of 25% reduction in avoidable hospital admissions by year 5  State will fund 10 projects designed to help keep people out of the hospital and from being re- admitted

What is the BLHC PPS? 4  Bronx Lebanon Hospital Center Performing Provider System  A PPS is a coalition of providers and organizations all coming together to meet the DSRIP goal  Bronx Lebanon is the PPS lead entity  ~200 partners in the BLHC PPS  25 PPSs statewide – providers can be in more than one unless they signed an exclusive agreement

Steering Committee Finance and Payment Reform Committee Workforce Committee Project Development and Implementation Committee IT Committee Community Needs Assessment Committee Bronx Lebanon PPS Organizational Structure Dr. John Coffey:, BLHC P: (718) E: Dr. Abayomi Salako, BLHC P: (718) E: Selena Griffin-Mahon, BLHC P: (718) E: Ellen Stoller, FEGS E: Victor DeMarco, BLHC P: (718) E Alison Connelly-Flores, UHP P: (718) E: Alison.Connelly- Dan Figueras, UHP P: (718) plan.org Jessica Diamond, Project Samaritan P: (718) ext an.org Samuel Shutman, BLHC E: PAC (Project Advisory Committee) PAC (Project Advisory Committee)

What types of providers are in the BLHC PPS? 6  Bronx Lebanon hospital  IPAs  Private practice physicians – primary and specialty care  FQHCs (Federally Qualified Health Centers)  Home health agencies  Behavioral health providers  Nursing homes  Care coordination agencies  Community-based organizations (i.e., housing)  Dental providers

BLHC PPS Clinical Projects selected based on the results of the comprehensive PPS Community Needs Assessment 7  The funding flows from the state to the PPS for these projects:  2.a.i. Create Integrated Delivery Systems that are focused on Evidence Based Medicine / Population Health Management  2.a.iii Health Home At-Risk Intervention Program –Proactive management of higher risk patients not currently eligible for Health Homes through access to high quality primary care and support services.  2.b.i Ambulatory Intensive Care Units  2.b.iv. Care transitions intervention model to reduce 30 day readmissions for chronic health conditions, including the INTERACT model for SNIFF  3.a.i. Integration of primary care services and behavioral health  3.c.i Evidence-based strategies for disease management in high risk/affected populations (adults only)  3.d.i. Expansion of asthma home-based self-management program  3.f.i Increase support programs for maternal & child health (including high risk pregnancies)  4.a.iii Strengthen Mental Health and Substance Abuse Infrastructure Across Systems  4.c.ii Increase Early Access to and Retention in HIV care

Funding opportunities 8  The PPS will receive funds for each of the ten projects and will distribute a portion to the providers working on the project  The PPS may fund care coordinators, health navigators, peer educators, or other non-clinical staff that supports patients with the highest needs  There are funds for project implementation and for performance over time (incentive payments)  The providers on the project must meet specific targets to qualify for incentive payments  Number of patients served  Clinical outcomes  PCMH level 3

DSRIP funds allocation by category over five years 9 CategoryDY1DY2DY3DY4DY5 5 Year Average Percentage Admin12% 11%10%9% 11% Project implementation20%25%20%13%3% 16% Performance (metrics and milestones) 50%40% 42% Bonus payments (incentive payments to high- performing providers) 5% Sustainability5%10%15%25%35% 18% Contingency5% 6%4%5% Other3%

10 DISCUSSION AND QUESTIONS