RHP 12 Learning Collaborative

 RHP 12 Learning Collaborative  Project Highlight  Waiver Updates

 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

 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

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

North South

 Lynn County Hospital  Donna Raindl, Comptroller  Pete Paniagua, Patient Navigator  Project – 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)

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)

Bobbye 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

 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 1 st through May 1 st 2015  Please let us know if you are considering withdrawing a project

 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.

 Clinical Champions work group had first meeting on January 22,2015  Next Clinical Champion Meeting – February 19 th  No additional information at this time

 Medicaid/CHIP Quality and Efficiency Improvement Website ◦ HHSC launched a Medicaid and CHIP Quality and Efficiency Improvement website to increase transparency and public reporting: ex.shtml ex.shtml ◦ Goal – Serve as a one-stop information resource on Medicaid/CHIP quality improvement efforts for healthcare providers, health plans, & the public ◦ Questions:

 Early February – Change Request determination from HHSC  Late February – HHSC Completion of Category 3 Review  February 26 th – Regional LC Event, Lubbock TX  Late February/Early March – NMI for “provisionally approved” DY3 October Reporting metrics  April Reporting – April 1 st – April 30th