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TRANSCRIPT
Practice Transformation Academy
Orientation Webinar
Monday, October 9, 2017
• Introductions
• We will unmute you
when it is your turn to
speak
• If you do not have
audio set up, please
be prepared to type
your response in the
chatbox
• Have a question?
Please enter it in the
chatbox
GoToWebinar Logistics
• Value-based payments overview
• Practice Transformation Academy program structure
• Getting to know each other
– National Council faculty
– Participating organizations and leads
• Program components
– Stretch projects
– Practice transformation lead and VBP steering committee
– Assessment tool
– Kick-off meeting
• Next steps
Agenda
• Three separate contracts,
funded by DOH
• Qualis Health provides Practice
Coaches and Regional
Connectors programs
• Web Resource Portal offered
through partnership with UW
Department of Family Medicine
Primary Care Innovation Lab
The Hub: A Four-year, State
Innovation Model (SIM) Testing
Grant
5
Help Providers to:
– Integrate physical and
behavioral health
– Move from volume-
based to value-based
care
– Improve population
health through clinical
and community linkages
Hub Goals
6
To achieve the ‘Triple Aim’
What Connections Do You Need for
Successful Practice Transformation?
7
What Brings Us Here Today?
Value Is:
Aligning value-based payments across payers, providers, & programs
Emily Transue, MD, MHA, Associate Medical DirectorJ.D. Fischer, Senior Health Policy AnalystSamantha Zimmerman, Senior Health Policy AnalystOctober 9, 2017
201730% VBP
2021: 90% VBP
2019: 80% VBP
HCA Purchasing Goals
12
Medicaid PEBB
By 2021, 90% of state purchased care
and 50% of commercial care will be in
value-based arrangements
Alignment with federal VBP goals APM Framework
2021
90%
state-financed
50%
commercial
13
Defining Value-Based Payments HCP-LAN Alternative Payment Model Framework
14
https://hcp-lan.org/groups/apm-fpt/apm-framework/
Alignment with CMS’ Alternative Payment Models Framework
15
Alignment – driving common elements
Data
Federally-led
transformation (LAN Framework, VBP
goals, & MACRA)
WA Statewide
Common Measure
Set (57 measures)
Care
transformation
based on evidence (Bree Collaborative)
HCA’s Quality
Improvement
Model (rewards improvement &
attainment)
16
Example of VBP in Washington: Medicaid MCOs
17
• HCA withholds 1% of the MCO premium: they can earn this back based on quality performance and on implementing VBP arrangements with providers
• Seven quality measures from Statewide Common Measure Set, including 2 HEDIS measures of antidepressant management (acute and chronic)
• 4 behavioral health quality measures also included in FIMC regions:
– Substance use disorder treatment penetration
– Mental Health treatment penetration
– Substance Use Disorder treatment initiation and engagement
– All Cause Hospital Readmission rate
18
• MCOs are integrating VBP into provider contracts in a variety of ways:
– Incentives for practice changes (collaborative care/behavioral health integration incentive in CHPW)
– Upside incentives for quality (pay for performance)
– Shared savings tied to quality performance
– Upside/downside risk tied to quality performance
– Capitation with quality requirements
VBP in Washington: Medicaid MCO Provider contracts
19
VBP Considerations for Providers
• Potential benefits tend to increase as risk increases
• Which arrangement is best for a given provider depends on their strengths and capabilities, and may change over time
• Certain capabilities (data tracking, registries, outreach) are important to most VBP; gradually building these will help prepare practices for success
Questions?
More Information:
www.hca.wa.gov/about-hca/healthier-washington/paying-value
Emily Transue, MD, MHA, Associate Medical Director
J.D. Fischer, Senior Health Policy Analyst
Samantha Zimmerman, Senior Health Policy Analyst
20
Competencies for Value-based
Payment Contracts
Patient and Family-
Centered Care
Design
1.1 Patient & family engagement
1.2 Team-based relationships
1.3 Population management
1.4 Practice as a community partner
1.5 Coordinated care delivery
1.6 Organized, evidence-based care
1.7 Enhanced access
Continuous, Data-
Driven Quality
Improvement
2.1 Engaged and committed leadership
2.2 QI strategy supporting a culture of quality and safety
2.3 Transparent measurement and monitoring
2.4 Optimal use of HIT
Sustainable
Business
Operations
3.1 Strategic use of practice revenue
3.2 Staff vitality and joy in work
3.3 Capability to analyze and document value
3.4 Efficiency of operation
Program Goals
1. Build readiness for value-based payment
arrangements
2. Cultivate strategic internal champions for
value-based payment arrangements
3. Contribute to meeting the Healthier
Washington VBP target of 90% by 2021
• Duration: October 1, 2017 – January 31, 2018
• Activities
– One in-person workshop
– Four informational webinars
– Two group coaching call
– Stretch project planning
• Tools and Resources
– Practice Transformation Support Hub
– Hub Resource Portal
– Value based planning guide
– Organizational assessment tool
Program Structure
Program Outcomes
By the end of the Academy, participants will:
• Gain understanding of value-based principles and models in
behavioral health consistent with the HCA Value-Based Road Map
and Moving Apple Health to Value
• Cultivate buy-in among internal agency stakeholders
• Establish a VBP steering committee and identify a practice
transformation lead
• Identify a value-based payment initiative aligned with one or more
project metrics found in the Medicaid Transformation Project
Toolkit; and
• Define and collect baseline data for a key “value metric”
Faculty Areas of Expertise
• Value-based payment arrangements and system
drivers
• Developing evaluation and quality improvement
strategies to strengthen large systems
• Integrated health approaches
• Program management
• Clinical design
• Medicaid financing
• Data-informed decision making
• Community behavioral health population and
practice environment
Core Faculty
• Kate Davidson, LCSW –Assistant Vice President, Policy and
Practice Improvement, National Council for Behavioral Health
• Samantha Holcombe, MPH – Director, Policy and Practice
Improvement, National Council for Behavioral Health
• Nina S. Marshall, MSW – Senior Director, Policy and Practice
Improvement, National Council for Behavioral Health
Faculty Coaches:
• Pam Pietruszewski, MA – Integrated Health Consultant,
National Council for Behavioral Health
• Elizabeth Arend, MPH – Quality Improvement Advisor,
National Council for Behavioral Health
Gwen Cox, RNNorth Central
Maria Klemesrud, MEd, LMHCOlympic and
SW WA Regional Health Alliance
Wei-Lin Huang, MSW, LICSWPierce
Sharon Poch, MSWKing
Dawn SayersBetter Health Together
David Stipe, RRTCascade Pacific Alliance
Carolyn Brill, CPHIMS, CHPNorth Sound
Hub Practice Coaches and
Regional Connectors
27
Sam WerdelGreater Columbia
• 20 agencies across Washington
• Agencies representing all 9 ACH regions
• Licensure:
– 18 Dually-Licensed Agencies
– 1 SUD-Only Agency
– 1 Mental Health-Only Agency
Participating Organizations
Participating Organizations & Practice
Transformation Leads
• Catholic Charities, Chris De Villeneuve
• Catholic Community Services, Mary Stone-
Smith & Stephanie Thelen
• Children’s Home Society of Washington,
Mandy Huggard
• Columbia River Mental Health Services,
Craig Pridemore
• Compass Health, Stacey Alles
Introductions Round 1
Participating Organizations & Practice
Transformation Leads
• DESC, Tyreesha Fambrough
• Frontier Behavioral Health, Jan Dobbs &
Kelli Miller
• Grant Integrated Services, Darla Boothman
• Greater Lakes Mental Healthcare, Lorraina
Clayton
• Evergreen Recovery Centers, Natalie Fryar
Introductions Round 1
“Phases of Transformation”
Set AimsUse Data to
Drive Care
Achieve
Progress on
Aims
Benchmark
Status
Thrive as a
Business
Through
Value-Based
Payment
Systems
What is a Stretch Project?
• Purpose
– Operationalize readiness for value-based payment
– Stretch beyond your current knowledge and skills
– Challenge your organization to grow
• Development
– Tailored to your organization
– Well-defined goal
– Can produce tangible outcomes
• Implementation
– Short-term (think PDSA)
– Kick-off meeting and coaching call will help define and refine the stretch
project
– Strategic support from faculty coach
Practice Transformation Lead
• Involved in the day-to-day functions of service
delivery
• Strong relationships with C-suite staff
• Responsible for communicating mechanisms
for change
• Charged with driving change in their
organization
Steering Committee
• Works closely with practice transformation lead
• A strong team is essential to the transformation process
• Comprised of clinical and administrative leadership
• Decision-makers within the organization
• Sets the vision for transformation strategy
• Invited to attend and participate in coaching calls and
webinars
Participating Organizations &
Practice Transformation Leads
• Evergreen Treatment Services, Bill Benham
• Kitsap Mental Health Services, Stacey
Devenney
• Lourdes Health Network, Frank Becker
• Multicare Behavioral Health, Jeffrey
Plancich
• Peninsula Behavioral Health, Dawn Brown
Participant Introductions Round 2
Participating Organizations &
Practice Transformation Leads
• Sea Mar Community Health Centers, Claudia
D'Allegri
• Sound Mental Health, Katrina Egner
• Valley Cities Counseling & Consultation, Lisa
Halvorsen
• Willapa Behavioral Health, Elizabeth Limbocker
• Yakima Valley Farm Workers Behavioral Health
Services, Mary O'Brien
Participant Introductions Round 2
Assessment Tool
• New Tool: Value Transformation Assessment
• Blend of two existing assessment tools
– Practice Assessment Tool (PAT)
– MeHAF
• Used to assess preparedness for VBP arrangements
– Evaluates progression through five phases of
transformation
• Results:
– Can inform your Stretch Project focus and design
– Will be reviewed with your organization’s faculty
coach during the first coaching call
• Practice coaches are available to facilitate the assessment
process
• Deeper dive: VBPs and Washington State context
• Population health management and risk stratification
• Readiness assessment and root cause analysis
• Intervention design and logic framework
• Establishing a VBP steering committee
Important: please bring a laptop computer
Kick-off Workshop Oct. 20th
Participants
• Provide adequate time, energy and enthusiasm to participate in
the program
• Consistently attend all applicable program activities
• Have practice transformation lead and the CEO (or an executive
leadership sponsor) attend kick-off workshop
• Develop a stretch project
• Actively participate in sharing and dissemination of lessons
learned, successes and challenges to other program participants
and to respective practice transformation steering committees
Expectations
Faculty
• Commitment to guiding your organization on the
path to readiness for VBP arrangements
• Commitment to providing tailored support adapted
to the needs of your organizations
• Provide effective tools to developing concrete and
actionable stretch projects
Expectations
Next Steps:
• Monday, October 16 – Submit to Joan Miller,
1. Completed Value Transformation
Assessment (VTA)
2. 1-2 VTA milestones to potentially focus
stretch project
• Friday, October 20 – Kick-off workshop in
Seattle, WA
– Hilton Seattle Airport & Conference Center
www.waportal.org
The Practice Transformation
Support Hub Resource Portal
42
Other Important Dates
Webinar Date Time
Webinar #2Wednesday, November
15, 201711:30-12:30pm
Webinar #3Friday,
December 15, 201711:30-12:30pm
Webinar #4Wednesday,
January 17, 201811:30-12:30pm
Thank you!
The project described was supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.