Developing Our Service Package(s) (Pennsylvania Partners for Care)

Service packages Major services/service packages that will meet our customers’ needs: Prevention – Evidence Based Health practices – Wellness – Nutrition assessment and Counseling – Home modification – -peer to peer support – Med-management – Health safety assessment Care Coordination – Care Transitions -Comprehensive assessment- hospital visit, home visit, develop service plan and follow-up -Benefits check up Nursing home diversion Major services/service packages that will meet our contracting org’s needs: Health coaching In-home Assessment and intervention Options counseling Care Coordination Care Transitions Care Giver counseling and support Vendor management 2

Network capacity Current network partners, capacity and strengths Organization nameService competenciesStrengths AAA’sAssessment, service planning, caregiver support, evidence based health services vendor management, coordination of service, options counseling and I&A Ombudsman, mediation and problem solving care transitions\nursing home transition Lots of boots on the ground Work with many High risk users Have Statewide foot print and ramp up capacity Decades of experience and are trusted entities In-depth knowledge of formal and informal resources Holistic and inclusive approach Well established network of providers Access point for other services Skilled in supporting caregivers Provide numerous Evidenced based chronic disease management programs 3

Network capacity Current network partners, capacity and strengths Organization nameService competenciesStrengths Centers for Independent Living peer to per counseling, skills training and advocacy nursing home transitions service coordination personal assistance services assistive technology, DME, environmental modifications consumer directed (fiscal management Consumer direction and control Statewide foot print and capacity disability awareness training & reasonable accommodation technical Assistance Access point for other services 4

Network capacity New network partners to be added Need a data partner for metrics and analytics Taking a closer look at this may be a list of advisors. Marketing analysis, select senior centers, Universities, transportation- private industry (what do you mean) Medical transportation company Technology- i.e., Carnegie Mellon In-home physician 5

Service value definition Result(s) we commit to deliver 1.Supporting consumers who are eligible for nursing home place to remain in the community 2.Falls Prevention/reduction – In-home safety assessment – Falls prevention training How we will measure 1.Track the length of time they are able to remain in the community – Look at the type and cost of services to keep them in the community compare to other types of care 2.How many complete the training program and the in- home assessment. Do a 6 and 12 month follow-up to determine falls 6

Service value definition Level of satisfaction we commit to deliver Contractor perspective- High satisfaction with improved health outcomes Consumer perspective- safe in home How we will measure Look at the HEDIS and Patient activation measure results Consumer Survey at different points, initial visit, 3 month, six month, annual 7

Service value definition Early thoughts on possible pricing for your service package? We do not know 8

Insights Our biggest insight(s) from this session on Developing Service Packages is/are… We have so many considerations in the air that we need to begin to narrow them down 9

Action Steps The action step(s) we will take in the next month to develop our service package(s) are: Undertake a Market analysis Take one or two services and look at a service and work through definition and the excel sheet shared with the folks in Cincinnati. Purge out old requirements. Uniform way of coming up with the cost. Look at the Community Road Map. Does it make sense to be a per member per month or per episode, and some be for fee for service. Market base – will not be uniform across the state. Grid, unbundle, price them out and then play them out at what makes sense on pricing. Are we even in the ball park? 10

Action Steps (Continued) The action step(s) we will take in the next month to develop our service package(s) are: Establish a pricing team – need to get people to work on – pricing team needs to work with the measurement group. Have people responsible for certain task. Have information completed prior to the meeting Need to help keep us moving along - Core group as a leadership team and work out form there Need to have our next meeting be a working meeting 11

Parking Lot (Issues for later, additional questions for speakers) Lynn Kellogg on the bundling and unbundling Scan foundation – for pricing The pyramid and the business model Have a ta person for each group to help us move along. We vote on Mary for Pennsylvania 12