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RHP 12 State of the Region Jeff Dane Executive Vice President & Chief Financial Officer
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2 Region 12 Anchor: UMC 47 Counties DSRIP Funding 4 Yr Projects: $406 million 3 Yr Projects: $ 43 million 38 Participating Providers: 22 Rural Hospitals 6 Urban Hospitals 1 Local Health Department 2 Physician Practices (HSC) 1 Physician Practice (Non HSC) 1 Psychiatric Hospital CAT 1 & 2 Projects: 99 CAT 3 Outcomes: 152
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Regional Events DY4 Reporting Transformational Impact Summaries Mid-Point Assessment/Compliance Monitoring ◦ CAT 1 & 2 Mid-Point Assessment 4 Year Projects ◦ CAT 3 Baseline Audits ◦ CAT 1 & 2 Mid-Point Assessment 3 Year Projects 3- year project change requests Today’s LC Event 3
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Reporting Workshops April 16, 2015 - Amarillo – TTUHSC April 17, 2015 - Lubbock – McInturff Conference Center DSRIP in Action Events ◦ June 2015 - Medical Arts Hospital, Lamesa Specialty Annex Project – ◦ August 2015 - Childress Regional Medical Center, Childress Palliative Care Project 2 nd DY4 Regional LC Event –Today, Lubbock, TX 4
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Primary Care Expansion Redesig n 25 projects 43 CNs Patient Navigation Care Coordination Care Transitions 19 Projects 53 CNs Behavioral Health 18 Projects 38 CNs Chronic Care Management 8 Projects 15 CNs Process Improvement Patient Experience 7 Projects 23 CNs 5 Critical Community Needs CN1 – Severe primary care provider shortage – 56 projects CN2 – Lack of mental health services – 32 projects 88 Total Urgent Community Needs CN3 – Poor Insurance – 20 projects CN4 – High obesity, diabetes, & heart disease – 20 projects CN5 – Need for specialist to assist in chronic disease care – 19 projects CN6 – Need for cancer screening – 7 projects CN7 – Insufficient Maternal & prenatal care – 2 projects 68 Total
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29 providers reported achievement on 131 metrics with an acceptance rate of 99.24% with only 1 project receiving a NMI request 33.8 million approved for payment during April reporting DY4– $24,136,473 DY3 CF-$8,353,213 DY3 NMI approved 1,263,580 6
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493 TIS (transformational impact summaries) submitted to HHSC, 24 TIS (transformational impact summaries) from Region 12 Of the 493 TIS submitted 41 were selected as most transformational and highlighted at the SLC event. Of the 41 selected 3 were from Region 12 Yoakum County Hospital, Plains Clinic – Telemedicine Amarillo Public Health Dept – ARAD (Amarillo Recovery from Alcohol & Drugs Collingsworth – Coordinate care for patients with chronic disease 250 of the 493 were interested in Poster presentations 56 were selected, 1 from RHP 12 UMC – IP Medication Management for adult diabetic patients 7
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All RHP Plans are subject to potential audits, including review by the independent assessor during the mid-point assessment and ongoing compliance monitoring. The Performing Providers shall have available for review by HHSC and CMS, upon request, all supporting data and back-up documentation evidencing performance as described under an RHP Plan for DSRIP incentive payments. 8
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RHP12 Round 1 20 outcomes from 14 providers selected & reviewed. Round 2 3 projects from 3 providers selected & reviewed After October reporting Myers and Stauffer will be conducting more reviews. If you have not yet had a CAT 3 baseline audit please expect one after October reporting. 10
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RHP12 14 - 3 Year projects included in Mid-Point Assessment Low to Moderate Risk = 78.5% or 11 projects High Risk = 21.4% or 3 projects At Risk projects could be asked to be removed/replaced for Waiver 2.0 11
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In July, providers had the opportunity to submit changes to their 3-Year projects 2 providers submitted change request related to their projects ◦ Both change request were approved recently This was an easy and stress free process by Waiver standards. 12
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Lean Six Sigma- Waste Walk Update Peer to Peer Discussions/ Interactive Discussions Networking Lunch Provider Presentations Panel Discussion: Patient Navigation Panel Next Steps for Waiver 2:0 13
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