1. Region 15 Regional Healthcare Partnership 6th Public Meeting
Wednesday, September 26, 2012
University Medical Center of El Paso
Anchor Hospital

2. Confirmation of Participants
Role Call

3. UMC Projects Refer to RHP Website DSRIP Projects
Parallel Universe Projects
Questions
Next Steps

4. HHSC Webinar Updates RHP Planning Protocol Webinar 9/25/12
Project options
Continuous Quality Improvement
QI Milestones are included with each project that requires QI under Process Milestones. For example, for Project 1.3 Implement a Chronic Disease Management Registry you can find these process milestones on pg 35 starting with P-12 – P-14
Category 3 – 13 Outcome Domains (OD)
1 stand alone measure
1 stand alone measure and 1 non-stand alone measure
3 non-stand alone measures
Or create a measure that meets the definition of ‘outcomes measure’
Or To Be Determined TBD
We will report on Category 3 Measures on an annual basis
Category 4 – 5 Required Reporting Measures
One was just added as optional – Adult or Child Core Measures for CHIP/Medicaid Population
Non-Hospital Performing Providers – No Category 4 Reporting Requirements

5. HHSC Webinar Updates RHP Plan Template Webinar 9/26/12

6. Final DSRIP Menu Category I Project Areas
Expand Primary Care Capacity
Increase Training of Primary Care Workforce
Implement a Chronic Disease Management Registry
Enhance Interpretation Services and Culturally Competent Care
Collect Valid and Reliable Race, Ethnicity and Language (REAL) Data to Reduce Disparities
Expand Access to Urgent Care and Enhance Urgent Medical Advice
Introduce, Expand, or Enhance Telemedicine / Telehealth
Increase, Expand, and Enhance Dental Services

7. Final DSRIP Menu Category I Project Areas (cont.)
Expand Specialty Care Capacity
Enhance Performance Improvement and Reporting Capacity
Implement technology-assisted services (telehealth, telemonitoring, telementoring, or telemedicine) to support, coordinate, or deliver behavioral health services
Enhance service availability (i.e., hours, locations, transportation, mobile clinics) to appropriate levels of behavioral health care
Development of behavioral health crisis stabilization services as alternatives to hospitalization.
Develop Workforce enhancement initiatives to support access to behavioral health providers in underserved markets and areas (e.g., psychiatrists, psychologists, LMSWs, LPCs and LMFTs)

8. Final DSRIP Menu Category II Project Areas
Enhance / Expand Medical Homes
Expand Chronic Care Management Models
Redesign Primary Care
Redesign to Improve Patient Experience
Redesign for Cost Containment
Implement Evidence-based Health Promotion Programs
Implement Evidence-based Disease Prevention Programs
Apply Process Improvement Methodology to Improve Quality / Efficiency
Establish / Expand a Patient Care Navigation Program
Use of Palliative Care Programs
Conduct Medication Management

9. Final DSRIP Menu Category II Project Areas (cont.)
Implement / Expand Care Transitions Programs
Provide an intervention for a targeted behavioral health population to prevent unnecessary use of services in a specified setting (i.e., the criminal justice system, ER, urgent care etc.)
Implement person-centered wellness self-management strategies and self directed financing models that empower consumers to take charge of their own health care
Integrate Primary and Behavioral Health Care Services
Provide virtual psychiatric and clinical guidance to all participating primary care providers delivering services to behavioral patients regionally
Establish improvements in care transition from the inpatient setting for individuals with mental health and / or substance abuse disorders
Recruit, train and support consumers of mental health services to provide peer support services
Develop Care Management Function that integrates primary and behavioral health needs of individuals

10. Sample Project Milestones and Metrics
Choose Category 1 or 2
Choose Project within that Category
Choose Project Option
Include all elements from RHP Plan DSRIP Narrative Section (pg 7-15)

11. Category 1 and 2 Process Milestones
Choose minimum of One Process Milestone for the first two years (you can choose more) P-1, etc.
You must choose the metric associated with the chosen process milestone to assess or implement within the first two years. P-1.1, etc.
You can also keep process milestones through the 4 years if you want (not sure if that’s beneficial)

12. Category 1 and 2 Improvement Milestones
Choose minimum of One Improvement Milestone for the last two years (you can choose more) I-1, etc.
You must choose the metric associated with the chosen improvement milestone to assess or improve upon in the last two years. I-1.1, etc.
You can choose the same measure and metric to improve more upon in the last year.

13. Category 3 Process Measures to fit with Category 1 and 2 Projects
In years DY 2 and DY3, we must choose a Category 3 Process Milestone for each project and provide a narrative of goals and rationale:
Category 3 Process Milestones:
P-1 Project Planning – engage stakeholders, identify current capacity and needed resources, determine timelines and document implementation plans
P-2 Establish Baseline Rates
P-3 Develop and Test Data Systems
P-4 Conduct PDSA Cycles to Improve Data Collection and Intervention Activities
P-5 Disseminate Findings, including Lessons Learned and Best Practices, to Stakeholders
P-7 Other activities not described above
These Milestones may be redundant / complimentary to Category 1 and 2 Milestones

14. Category 3 Improvement Measures or Outcomes Domains to fit with Category 1 and 2 Projects
Outcome Improvement Targets
DY4 and DY5 Outcomes/Improvement Targets:
OD-1 Primary Care and Chronic Disease Management
OD-2 Potentially Preventable Admissions
OD-3 Potentially Preventable Readmissions (30 Day Readmission Rates)
OD-4 Potentially Preventable Complications and Health Care Acquired Conditions
OD-5 Cost of Care
OD-6 Patient Satisfaction
OD-7 Oral Health
OD-8 Perinatal Care
OD-9 Right Care in Right Setting and Patient Centeredness
OD-10 Functional Status
OD-11 Health Disparities
OD-12 Primary Care and Primary Prevention
OD-13 Palliative Care
Can also Propose Outcomes not included in the list, i.e. outcomes that fit the ‘outcomes definition’
Improvement Targets can also start in earlier years

15. Category 4 Reporting Measures
Hospital Performing Providers Only
Pay for Reporting
5 Required Domains:
RD-1 Potentially Preventable Admissions (PPA)
RD Day Readmissions
RD-3 Potentially Preventable Complications (PPC)
RD-4 Patient Centered Healthcare
RD-5 Emergency Department
1 Optional Domain
Initial Core Set of Health Care Quality Measures for Children (CHIP) or Adults (Medicaid) eligible

16. Performing Provider Workbooks
Walk-through
Questions

17. UC Tool Due 10/26/12 to HHSC
Walk-through
Questions

18. Medicaid Waiver Timelines
As of 9/24/12, HHSC has formal approval from CMS for:
PFM Protocol
RHP Planning Protocol
RHP Plan Template
As of 9/25/12, the final UC Tool was released for Provider Input
Due to HHSC 10/26/12
Two weeks after approval – IGT Entities and Private Hospitals submit their final Chapter of Projects to Anchor
– Due to Anchor 10/12/12
October 31, 2012 – Submit RHP to HHSC (4 year plans)
December 15, CMS completes review
RHPs returned for revisions during the 30 day period
January 15, Revised RHP Plans to CMS
February 1, CMS Final Decision

19. Roundtable

20. Contact Information
Waiver Website & Address:
UMC Website:
Region 15 - RHP
Paso del Norte Blue Ribbon Committee Needs Assessment: