NYHQ DSRIP
Finance Committee Kick-Off Meeting
March 2015
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PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Agenda
Welcome & Introductions
PPS Overview & Organizational Structure
DSRIP Updates
• Progress To Date
• Implementation Plan
Committee Purpose
Implementation Plan Draft – Review
• Revision process
Resources
Next Steps
» Implementation Plan – Final Submission (April 1, 2015)
» Next Committee Meetings
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PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
PPS Organizational Structure
NYHQ
Board of Directors
NYHQ
Lead Hospital
PAC
Executive Committee
Audit
Compliance
PMO
High Risk Population
IT &
Performance
Reporting
Clinical
Integration &
Population Health
Mgmt
Finance
*Sub-Committees & Workgroups will be formed as needed.
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Long Term Care
Workforce
Behavioral Health &
Primary Care Integration
Cultural Comp &
Health Literacy
Communications
Practitioner
Engagement
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
PPS Org Structure: Committees
Workgroup Name
Notes
Co-Chair
Primary Care & Behavioral
Health
Maureen Buglino
Maria D'Urso
35 members
High Risk Population
Dr. Somogyi
Dr. Jabbar
Dr. Rubin
Cardio - Margaret Cartmell
Asthma - Naaima Siddiqui
HIV - Keren Francois
31 members
Long Term Care / Care
Transition
Finance
Information Technology &
Performance Reporting
Cultural Competency & Health
Literacy
Communications
Governance
Audit / Compliance
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Chair
Interact - Michael Tretola
Hospital Home Care - Maria D'urso
Palliative - Dr. Cynthia Pan
Caroline Keane
53 members
Frank Hagan
Christopher Caufield
16 members
Dr. Ken Ong
Mark Greaker
14 members
Dianne Ryan
Camela Morrissey
William Wissemann
Adam Weinstein
Rosemarie Liguigli
Kyle Jacobi
Keith Weiner
17 members
13 members
9 members
5 members
Clinical Integration &
Population Health Mgmt
Louisa Low
Caroline Keane
19 members
Workforce
Lorraine Orlando
Mimi Lim
18 members
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
DSRIP Updates
CNA Completed & Projects Selected –
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2.a.ii
Increase Certification of Primary Care Practitioners with PCMH Certification
and/or Advanced Primary Care Models
3.a.i
Integration of Primary Care and Behavioral Health Services
2.b.v
Care Transitions Intervention for Skilled Nursing Facility (SNF) Residents
2.b.vii
Implementing the INTERACT Project (Inpatient Transfer Avoidance Program
for SNF)
2.b.viii
Hospital-Home Care Collaboration Solutions
3.g.ii
Integration of Palliative Care into Nursing Home
3.b.i
Evidence-Based Strategies for Disease Management in High Risk/Affected
Populations (Adults Only) - Cardiovascular
3.d.ii
Expansion of Asthma Home-Based Self-Management Program
4.c.ii
Increase early access to, and retention in, HIV care (Focus Area 1; Goal #2)
Primary Care & Behavioral
Health Committee
Long Term Care & Care
Transitions Committee
High Risk Population Committee
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
DSRIP Updates
Documents Available:
- DSRIP Applications
- Scale & Speed by
Project
- Implementation Plan
Draft
Actualization
of Plans –
Begin April
1, 2015
Current State
Implementation Plan – April 2015
Scale & Speed – January 2015
DSRIP Plan – December 2014
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PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
DSRIP Updates
Distribution Year
Quarter
Reporting Period
Project Plan & Implementation Plan
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Quarterly Report Due
Payment Date
N/A
DY1 - Q2
April 1, 2015 - June 30, 2015
July 31, 2015
DY1 - Q3
July 1, 2015 - September 30, 2015
October 31, 2015
DY1 Q4
October 1, 2015 - December 31, 2015
January 31, 2016
DY2 - Q1
January 1, 2016 - March 31, 2016
DY2 - Q2
April 1, 2016 - June 30, 2016
DY2 - Q3
July 1, 2016 - September 30, 2016
October 31, 2016
DY2 - Q4
October 1, 2016 - December 31, 2016
January 31, 2017
DY3 - Q1
January 1, 2017 - March 31, 2017
DY3 - Q2
April 1, 2017 - June 30, 2017
DY3 - Q3
July 1, 2017 - September 30, 2017
October 31, 2017
DY3 - Q4
October 1, 2017 - December 31, 2017
January 31, 2018
DY4 - Q1
January 1, 2018 - March 31, 2018
DY4 - Q2
April 1, 2018 - June 30, 2018
DY4 - Q3
July 1, 2018 - September 30, 2018
October 31, 2018
DY4 - Q4
October 1, 2018 - December 31, 2018
January 31, 2019
DY5 - Q1
January 1, 2019 - March 31, 2019
DY5 - Q2
April 1, 2019 - June 30, 2019
DY5 - Q3
July 1, 2019 - September 30, 2019
October 31, 2019
DY5 - Q4
October 1, 2019 - December 31, 2019
January 31, 2020
April 20, 2015
October 29, 2015
First Due
Date
April 1, 2016
April 30, 2016
July 31, 2016
October 1, 2016
April 1, 2017
April 30, 2017
July 31, 2017
October 1, 2017
April 1, 2018
April 30, 2018
July 31, 2018
October 1, 2018
April 1, 2019
April 30, 2019
July 31, 2019
October 1, 2019
April 1, 2020
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Committee Purpose
Develop a structure for collaboration to focus on organizational functions
and project implementation and outcomes specific to DSRIP deliverables
according to the need of PPS partners and the community they serve.
Committees will:
Refine & finalize Implementation Plans – Due April 1, 2015
• High level milestones / Risks & Mitigations / Financial Milestone Dates
Develop plans for actualization of functions or projects
• Project Plans
• Budgets
• Partner Expectations
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Engage key-stakeholders specific to project or function need
Provide guidance for best practice standards & evidence based medicine protocols
Recommend strategies or policies to the Executive Committee
Establish monthly reporting expectations & communication channels for progress updates
Partner with PMO to monitor monthly & quarterly deliverables
Create workgroups to continue development or implementation
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Financial Sustainability Implementation Plan:
Strategy Updates
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Financial Sustainability Strategy Updates
Milestone: Finalize PPS finance structure, including
reporting structure
Target Completion Date
Step 1... Confirm Finance Committee membership
Step 2... Draft Committee charter w/ responsibilities &
reporting structure
DY1, Q1
DY1, Q1
Step 3... Obtain PPS Executive Committee approval
Milestone: Perform network financial health current state
assessment and develop financial sustainability strategy to
address key issues.
DY1, Q1
Step 1... Draft process for routine collection of network
partners' financials
Step 2... Ongoing screening of financials to identify fragile
partners
DY1, Q2
Step 3... Draft mitigation strategies/solutions to address
financial issues
DY1, Q3
Step 3... Obtain PPS Executive Committee approval
DY1, Q3
Step 4... CFO's & Finance Committee to implement strategies /
mitigation
DY1, Q1
DY1, Q3
DY1, Q4
DY1, Q2
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Financial Sustainability Implementation Plan:
Strategy Updates
Financial Sustainability Strategy Updates
Target Completion Date
Milestone: Finalize Compliance Plan consistent with New
York State Social Services Law 363-d
DY2, Q1
Step 1... Establish Compliance Committee membership and
charter
Step 2... Draft policies/procedures for a NY363-d PPS
compliance plan
Step 3... Obtain Executive Committee approval of the PPS
compliance plan
DY1, Q1
DY1, Q2
DY1, Q3
Step 4... Confirm that PPS network providers have compliance DY1, Q3
plans
Step 5... Implement compliance plan; submit routine reports
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DY1, Q4
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Financial Sustainability Implementation Plan:
Progress Reports
Progress reports on the PPS effort to transition to valuebased payment systems
Target Completion Date
Milestone: Develop detailed baseline assessment of revenue
linked to value-based payment, preferred compensation
modalities for different provider-types and functions, and
MCO strategy.
DY2, Q1
Step 1... Extend PPS budget to DY6-8 to measure exposure to
FFS loss
Step 2... Create advisory panel of MCO's serving NYHQ's PPS
providers
Step 3... Explore VBP alternatives that align patients, payors
and providers
Milestone: Finalize a plan towards achieving 90% valuebased payments across network by year 5 of the waiver at
the latest
Step 1... Draft transition plan to achieve 90% VBP by DY5
Step 2... Distribute to Network partners; revise to secure PPS
consensus
Step 3... Secure Governing Board authorization to negotiate
with MCOs
Step 4... Negotiate VBP terms and transition plan; initiate
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implementation
DY1, Q2
DY1, Q3
DY1, Q4
DY3, Q1
DY2, Q1
DY2, Q2
DY2, Q3
DY2, Q4
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Financial Sustainability Implementation Plan:
Risks & Mitigations
The path of attempts to convert from the historical FFS system to novel VBP
schemes is littered with false starts and failures as the various players (patients,
payors and providers) seek to perform in unfamiliar roles. Risk- measuring actuaries,
viewing the medical patterns of a million-life pool, cannot diagnose and treat the
maladies of a single individual. Likewise, a skilled obstetrician can deliver a new life
without understanding the expected pmpm health expenses of childbearing women.
Yet, VBP anticipates that patients and payors can measure healthcare value, and that
providers can assume the financial risks of delivering that value, despite a myriad of
factors beyond their control. Thus, the major challenge in implementing the PPS
projects will be developing a mutual understanding by all players that this is not
business as usual. Change is hard, especially in situations complicated by unaligned
incentives. To succeed, PPS governance and management must continually reinforce
the mutual goals of all of the players (including MCOs), ensure that incentives are
aligned, and be fully cognizant that the DSRIP funding expires in only five years.
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PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Financial Sustainability Implementation Plan:
Work Stream Dependencies
The Financial Sustainability is critically linked to all work
streams and projects as the goal of the DSRIP program
is to build a long-term integrated delivery system to
benefit the community we serve.
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PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Financial Sustainability Implementation Plan:
Roles & Responsibilities
Roles and Responsibilities
Please list the key people/organizations responsible for this organizational workstream and describe what their responsibilities involve.
To clarify, the 'Roles & Responsibilities' table is intended to capture those individuals and organizations responsible for driving/managing the
workstream, whereas the 'Key Stakeholders' table is intended to capture the people/organizations with a stake in the project, but who are not directly
responsible for driving it.
Role
[…]
[…]
[…]
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Name of person / Key deliverables /
organization (if responsibilities
known at this
stage)
[…]
[…]
[…]
[…]
[…]
[…]
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Financial Sustainability Implementation Plan:
Stakeholders
The PPS will implement standardized monthly reporting expectations for all workflows utilizing consistent tools
Please identify the key stakeholders involved, both within and outside the PPS.
To clarify, the 'Roles & Responsibilities' table is intended to capture those individuals and organizations responsible for driving/managing the
workstream, whereas the 'Key Stakeholders' table is intended to capture the people/organizations with a stake in the project, but who are not directly
responsible for driving it.
Key stakeholders
Internal stakeholders
Name…
Name…
External stakeholders
Name…
Name…
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Role in relation to Key deliverables /
this
responsibilities
organizational
workstream
[…]
[…]
[…]
[…]
[…]
[…]
[…]
[…]
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Financial Sustainability Implementation Plan:
IT Expectations
Shared infrastructure will allow for cross pollination of
data elements crossing all partners as monthly reporting
will build expectations that will identify and outline
financial sustainability models.
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PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Financial Sustainability Implementation Plan:
Progress Reporting
The PPS will implement standardized monthly reporting
expectations for all workflows utilizing consistent tools
and reports that outline expectations to the project,
milestone, metric, and requirement level. Reporting will
be a bottom-up model that feeds directly from patients,
providers, and staff and will be leveraged as an
accountability tool for the Executive Committee. A
project management tool is under review and will be
purchased based on finalized budget planning.
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PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Funds Flow Implementation Plan:
Design
Designing your funds flow
Milestone: Complete funds flow budget and distribution
plan and communicate with network
Step 1... Refine project-specific scopes of work, provider
roles and budgets
Step 2...Quantify relative contribution levels required by
each provider group
Step 3...Draft/refine the incentive distribution plan to
reflect each provider groups expected contribution
Step 4...Distribute / discuss draft plan with provider
representatives; refine as necessary
Step 5...Finalize and seek Executive Committee approval
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Target Completion Date
DY1, Q4
DY1, Q2
DY1, Q2
DY1, Q3
DY1, Q3
DY1, Q4
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Implementation Plan Milestones
DY0
DY1 Q2
DY1 Q3
DY1 Q4
• Complete Funds
Flow Budget &
Distribution Plan
DY2 Q1
DY2 Q2
DY2 Q3
DY2 Q4
DY3 Q2
DY3 Q3
DY3 Q4
•Finalize
Compliance Plan
•Baseline
Assessment of
Revenue Linked to
VBP
DY 3 Q1
• Finalize plan
for 90% VBP
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PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Resources
NYHQ Project Management Office (PMO) –
• Maria D’Urso – [email protected]
• Louisa Low – [email protected]
• Crystal Cheng – [email protected]
NYHQ PPS Website - http://www.nyhq.org/dsrippps
NYS DSRIP Website https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/
• Applications https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/pps_applicati
ons/
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PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Next Steps
Implementation Plan Revision
• Committee Feedback
• KPMG Feedback
Committee Meetings
• Additional Members
• Implementation Plan Finalization
• Actualization Planning
First Quarter Deliverable – Q2 DY1
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PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.
Questions?
PROPRIETARY & CONFIDENTIAL – © 2014 PREMIER, INC.