April 27, 2018 UMC Neighborhood Health Clinic El Paso, Texas Stakeholders Forum April 27, 2018 UMC Neighborhood Health Clinic El Paso, Texas THGuest

Your FEEDBACK/Comments are extremely important! Oscar Perez DSRIP Program Manager Text To: 22333 Text: OSCARPEREZ394 Go to your Browser or Smart Phone: http://pollev.com/oscarperez394 OR

AGENDA Welcome and Introductions Overview of Texas 1115 Waiver & Renewal RHP 15 Plan Requirements Process and Timeline Community Needs Assessment Learning Collaborative Access to the Plan Engagement Open Discussion Adjourn

INTRODUCTIONS Regional Healthcare Partnership (RHP) University Medical Center of El Paso Texas Tech University Health Sciences Center El Paso Children’s Hospital Hospitals of Providence Emergence Health Network City of El Paso Department of Public Health Las Palmas Del Sol Healthcare

What is DSRIP? Delivery System Reform Incentive Payments Accomplished through an 1115 Waiver Original Plan Submitted on December 31, 2012 Waiver Renewed on December 21, 2017 “Texas Transformation Waiver”

More Terminology DY = Demonstration Year (Oct 01 – Sep 30) PY – Performance Year (Jan 01 – Dec 31) Used for metrics

REGION 15

Texas Medicaid 1115 Waiver Overview

RHP 15 DSRIP Allocations (DY2-DY6) About 4.4% of Total State Allocations

RHP 15 DSRIP Allocations (DY7- DY8)

DY2-DY6 Project Focused Model

RHP 15 Projects (DY2-DY6) Category 1 – Infrastructure Development Expanded Primary Care Increased Training of Primary Care Workforce Implemented Chronic Disease Mgt Registries Enhanced Interpretation Services & Culturally Competent Care Collected REAL data to reduce disparities Implemented Telemedicine/Telehealth Enhanced Dental Services Expanded Specialty Care

RHP 15 Projects (DY2-DY6) Category 2 – Innovation & Redesign Enhanced Medical Homes Expanded Chronic Care Management Models Implemented Health Promotion Programs Implemented Disease Prevention Programs Improved Quality/Efficiency of Processes Established and/or expanded Patient Care Navigation Programs Expanded use of Palliative Care Programs Expanded Medication Management Programs Implemented Care Transitions Programs Provided Intervention Programs for Targeted Behavioral Health Populations

RHP 15 Projects (DY2-DY6) Category 3 – Quality Initiatives (Metrics) Primary Care & Chronic Disease Management Potentially Preventable Readmissions 30-Day Rates Potentially Preventable Complications, Health Acquired Conditions & Patient Safety Patient Satisfaction Perinatal Outcomes & Maternal Child Health Right Care, Right Setting Behavioral Health / Substance Abuse Care Primary Prevention Oral Health

RHP 15 Projects (DY2-DY6) QPI Quantifiable Patient Impact 483,225 Patient Encounters 61,250 Unique Patients

New DSRIP- Protocol NEW Community Needs Assessment Categories A : Core Activities (0% allocation) B : Patient Population by Provider (PPP) (10%) C : Outcome Measures (bundles) (75%) D: Statewide Reporting (15%) Focus on Medicaid / Low Income Uninsured Patient Metric Goals: Gap Reduction - 10% DY7 12% DY8 QISMC - Quality Improvement System for Managed Care IOS – Improvement on Self DY9 and DY10 reduced funding DY11 no funding – transition to managed care program(s)

Community Needs Assessment

DY7-DY8 Outcomes Focused Model

Measure Bundle Selections DY7-8 A1 Chronic Disease Management – Diabetes UMC A2 Chronic Disease Management – Heart Disease UMC, Las Palmas Del Sol B1 Care Transitions & Hospital Readmissions UMC B2 Patient Navigation & ED Diversion Las Palmas Del Sol C1 Primary Care Prevention – Healthy Texans UMC, Texas Tech D1 Pediatric Primary Care Texas Tech

Measure Bundle Selections DY7-8 D3 Pediatric Hospital Safety EP Childrens Hospital, Las Palmas Del Sol E1 Improved Maternal Care Texas Tech, Las Palmas Del Sol E2 Maternal Safety Providence Memorial, Sierra Providence East G1 Palliative Care UMC H3 Chronic Non-Malignant Pain Management UMC J1 Hospital Safety Las Palmas Del Sol, Providence Memorial, Sierra Providence East

RHP 15 Projects (DY7-DY8) PPP Patient Population by Provider Category B Patients seen in the entire “system” Goals:

Learning Collaborative Plan July 13, 2018 (Friday) El Paso Community College Administration Building (Viscount) 9:00am to 3:00pm Lunch Served Diabetes Care Behavioral Health Health Data Exchange

Engagement Monthly Meetings Last Wednesday of each Month 1:00pm Medical Centers of the Americas (Cardwell Collaborative) Next Meeting: May 30, 2018

Timeline April 20th - Provider Templates DUE to Anchor April 27th - Stakeholder’s Forum April 30th - HHSC Reviews RHP 15 Plan May 30th – Deadline for RHP 15 Plan Survey July 01st - Payment from HHSC for Plan Submittal Oct 30th - DY7 Reporting (Baselines & Improvements) Jan 2019 – Payment from HHSC for DY7 R1

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OPEN DISCUSSION oscar.perez@umcelpaso.org