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RHP 12 Learning Collaborative.  RHP 12 Learning Collaborative  Project Highlight  Waiver Updates.

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Presentation on theme: "RHP 12 Learning Collaborative.  RHP 12 Learning Collaborative  Project Highlight  Waiver Updates."— Presentation transcript:

1 RHP 12 Learning Collaborative

2  RHP 12 Learning Collaborative  Project Highlight  Waiver Updates

3  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

4  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

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

6 North South

7  Lynn County Hospital  Donna Raindl, Comptroller  Pete Paniagua, Patient Navigator  Project 2.9.1 – 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)

8 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)

9 Bobbye Hrncirik

10  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

11  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

12  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.

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

14  Medicaid/CHIP Quality and Efficiency Improvement Website ◦ HHSC launched a Medicaid and CHIP Quality and Efficiency Improvement website to increase transparency and public reporting: http://www.hhsc.state.tx.us/hhsc_projects/ECI/ind ex.shtml http://www.hhsc.state.tx.us/hhsc_projects/ECI/ind ex.shtml ◦ Goal – Serve as a one-stop information resource on Medicaid/CHIP quality improvement efforts for healthcare providers, health plans, & the public ◦ Questions: email HPCS_Quality@hhsc.state.tx.usHPCS_Quality@hhsc.state.tx.us

15  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

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