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Session 16– May 7, 2013 Program Updates 1
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Working on timing for next list release-new lists for Phases 1 and 2 and first list for Phase 3. Still need designated Health Home for Southern Tier counties. CMART - Ongoing technical assistance calls; first submissions are due May 13, 2013 for 2012 FACT-GP data, full submissions for first two quarters of 2013 are due August 5, 2013 2
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Ongoing refinements to Member Tracking System Health Home team will be using SurveyMonkey more extensively to better implement the program and take in feedback on various subjects Health Home and Managed Care Workgroup has been reconvened, six subgroups identified to work on key issues 3
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Next Learning Collaborative scheduled May 30 in NYC; agenda is being developed. Center for Health Care Strategies (CHCS) has launched an online community for New York Health Homes who are a part of the Learning Collaborative funded by the New York State Health Foundation and facilitated by CHCS. The online community will allow Health Homes to participate in online conversations with other Health Homes. The goal is to provide a safe space for Health Home staff in all phases to share best practices, resources and ask questions about implementation. You are invited to join the community if you are a staff member of a health home agency or network partner: To join, please contact: Anjana Pandey, apandey@chcs.orgapandey@chcs.org
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Network partners and MCOs continue to develop operational policies and procedures. Contracts are being executed. Governance models continue to evolve. Subcontracts and agreements continue to be formalized with network partners. Active billing for Health Home services (Outreach and Engagement and Active Care Management). 5
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Statewide Health Home Enrollment Statistics (Based on Jan 2012 to April 2013 Claims) Total Number Health Homes50 Converting Members# of HH Recipients Engaged in Outreach608 New Members# of HH Recipients Engaged in Outreach10,102 Converting Members# of HH Recipients Engaged in Active Care Management21,962 New Members# of HH Recipients Engaged in Active Care Management6,749 Total # HH Recipients (Distinct count) 34,022 Total Health Home Eligible Individuals (MHSA and others)805,000 # of Higher Risk Members Higher risk members are identified based on predictive risk model and ambulatory connectivity measure; e.g.,those with lower ambulatory connectivity and those more likely to die or have an inpatient or nursing home admission) 224,000 % of Higher Risk Members28% % of Higher Risk Members Enrolled15.2% 6
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Total HH Billings from January 2012 – February 2013 as of April 25, 2013 Claim Type Amount PaidClaim CountRecipientsAmount Paid Per Claim Converting Legacy Claims $94,372,022158,88822,286$594 New Health Home Claims $6,998,23438,34815,302$182 Total$101,370,256197,23634,022$514 7
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8 Amount Paid Members
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10 Questions?
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Visit the Health Home website: http://www.health.ny.gov/health_care/medicaid/program /medicaid_health_homes/ http://www.health.ny.gov/health_care/medicaid/program /medicaid_health_homes/ Get updates from the Health Homes listserv. To subscribe send an email to: listserv@listserv.health.state.ny.us (In the body of the message, type SUBSCRIBE HHOMES-L YourFirstName YourLastName)listserv@listserv.health.state.ny.us Email questions or comments: hh2011@health.state.ny.ushh2011@health.state.ny.us Call the Health Home Provider Support Line: 518-473-5569 11
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