New York State DOH
Health Home C-MART
Support Calls-Session #2
February 27,2013
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Technical Specifications Update
Change in 2012 Submission Data Requirement
Q+A Themes from February 13th and 20th
Definitions of Elements 1-18
Questions and Comments
Feedback, Help, and Ongoing Support
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Please submit your questions in writing to the
webinar
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If you would like to ask your questions, raise
your hand (making sure you have entered
your audio pin code) and we will unmute the
call one at a time
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Change for PlanID field on bottom of page 6 and top of page 20.
FFS members field will be filled in with ‘8888888’ not ‘99999999’.
New Specifications are available on Health Home Website
Page 6 changed ‘99999999’ to ‘8888888’
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Page 20 – Changed ‘99999999’ to ‘8888888’
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We have received a lot of feedback about the first file
submission and have decided to reduce the amount of data for
the first reporting period.
The first report will only require data collected by the FACT-GP
and Health Home Functional Assessment
This data will NOT be entered into the HH-CMART tool. This data
will be entered into an excel document and submitted via the
HCS system. A template will be introduced next week.
The date for submission of this data has NOT changed. Data
from Calendar year 2012 is still due Monday, May 13, 2013
All other reports are due no later than the first Monday of the
second month following the end of the reporting period
(see updated deadlines on table in next slide)
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Reporting Period
Report Date
Element
HH-CMART File Submission
Date
FACT-GP and Health Home
Functional Initial Assessment
all enrollees (Jan-Dec 2012)
Excel template Monday, May 13, 2013
First Two Quarters 2013 (JanJune 2013)
2/2013
Monday, Aug 5, 2013
Third Quarter 2013
(July-Sep 2013)
3/2013
Monday, November 4, 2013
Fourth Quarter 2013
(Oct-Dec 2013)
4/2013
Monday, February 3, 2014
For each file submission, use a copy of the original version of the HH-CMART
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FACT-GP - For a member entering a Health Home, a
FACT-GP and Health Home Functional Assessment must
be completed at 1) enrollment, 2) annually and 3) at
disenrollment.
◦ The results of these assessments are used to adjust the risk
scoring for members and applicable rates.
◦ These tools do not take the place of the comprehensive
assessment needed to develop a care management plan for
the member.
◦ The care manager should use all resources available for each
member to ensure an appropriate care management plan is
formulated.
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Field#1, PlanID and Members switching plans – If a member
switches plans in the middle of a reporting period, the HH-CMART
data should report where that person is at the end of that
reporting period.
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Switching Health Home within a Reporting Period- Each Health
Home should have HH-CMART data to report
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Data Vs. Billing - The HH-CMART tool is for data submission
purposes only and is not to be intended to be used for billing
purposes.
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Phase 3 Health Homes-CMART Submission – Phase 3 Health
Homes that have not started providing Health Home services
should be reporting data starting from when they received the
first assignment file and started active outreach and engagement.
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How to submit data/who submits data - Data reporting
process should be determined between the Health Home
and the downstream providers. The Health Home is
responsible to collect all the data and submit to NYS DOH
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Resources – Lead Health Homes should have passed all HHCMART files and documents to their downstream providers.
If this has not occurred, contact your lead Health Home and
the Department of Health.
◦ Previous Webinars are located under the February 2013 tab here:
http://www.health.ny.gov/health_care/medicaid/program/medicaid_
health_homes/meetings_webinars.htm
◦ Updated Specifications Manual and User’s Guide can be found here:
http://www.health.ny.gov/health_care/medicaid/program/medicaid_
health_homes/assessment_quality_measures/process_measures.htm
◦ Today’s power point slides and webinar audio file will be on the Health
Home website by early next week.
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Q: AIRS system and HH-CMART – Conduct a Gap Analysis/Mapping
◦ What is the element definition?
◦ Do I have it in my system?
◦ If I do, where is it? And how do I extract it to the HH-CMART?
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EXAMPLE: Is there something currently being captured or
documented that provides that element’s information?
◦ Yes, data is captured. Is there any reformatting or mapping that
needs to be done from it’s current form to the formats specified for
collection?
◦ No, there is a gap. If the information is not currently captured, how
could systems change and staff trained to capture for future?
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Each element is color coded by data collection needs for each
element by reporting period
◦ Green = changes each reporting period
◦ Red = Once in, remains the same always
◦ Orange = Needs to be reviewed for new information
each report
◦ Blue = DOH will fill in
* Color Coding See slides from Feb. 20, 2013 Webinar
power point:
http://www.health.ny.gov/health_care/medicaid/progra
m/medicaid_health_homes/meetings_webinars.htm
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1 – PlanID: The organization’s OMC Plan ID. FFS members should be filled in with
‘8888888’ If a member changes health plans during a reporting period, use
the PlanID for the member at the end of the reporting period. HH-CMART
User Manual Appendix has a list of PlanIDs.
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2 – HHID: This is the MMIS number and will be the same for all members in the
Health Home’s file.
◦ More than one Care Management Provider - If a member changes care management
providers during the reporting period, the Health Home will need to combine the data
for the member for the reporting period. For example, if the member is with agency A
for one month and Agency B for the next two months, the data will be combined by the
Health Home to one row for the member for the reporting period.
◦ More than one Health Home - If the member changes Health Homes, report the data
connected with each Health Home for the partial period. Member may be in more
than one Health Home file for a CM provider. HH-CMART has HHIDs in drop down on
the main menu screen. * see below.
HHID
ReportDate CIN
DOB ProgramType
AbleContact ContactDate OutreachEffort
2202501 2/2013 AB12345C 1/18/1978 HH Behavioral Health Yes
12/14/2012
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4208471 2/2013 AB12345C 1/18/1978 HH Behavioral Health Yes
2/21/2013
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3 – Report Date: Should reflect the quarter for the end reporting period, Q/YYYY
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4 – CIN: Medicaid Client ID Number. Valid CIN must be provided
for every record and should be the CIN from the reporting period.
5/6 – Last/First Name of member
7 – Date of Birth of member
8 – TriggerDate: Imported as MM/DD/YYYY. This is the same thing
as the “Begin Date” on the Health Home Patient Tracking System
for the first record submission for the member.
◦ It is the first day of the month when outreach and engagement began.
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9 – ProgramType: Members should be placed in a category based
on the primary issue for care management. Members may have
conditions for more than one category; select the category based
on the member’s primary focus for care management.
◦ Categories are – HH Behavioral health, HH Chronic Adult, HH Children,
HH Developmentally Disabled, HH LTC, and Missing
◦ We use Program Type in analyses to subset populations when analyzing
outcomes. This allows more focused evaluation of impact for people
with similar conditions.
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10 – AbleContact: Indicates if Health Home was able to contact member regarding
participation in care management.
◦ Contact is defined as a verbal interchange (phone or in-person) between member/ legal
representative/ family and Health Home staff. Contact does not include mailings or attempts to
contact (voice message or unsuccessful in-person attempt to locate member).
◦ Hiatus Period – A hiatus period is a three month span during which the Health Home cannot bill
for outreach efforts for any member who has not be able to be engaged in the Health Home in the
previous three months. Ongoing outreach efforts can be undertaken during the hiatus period;
hiatus period signifies the billing status for the member.
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11- ContactDate: Completed for those who were contacted (AbleContact = ‘YES) and
left blank for those not contacted. This is the date of initial contact or verbal interchange
between member/legal representative/family and Health Home staff.
◦ ‘Missing’ should be used for members who were contacted but the date is not known
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12 – OutreachEffort: Count of in-person or phone contacts or attempts to locate and
interact with the member during the reporting period.
◦ The count includes interactions or attempts prior to the member’s agreement to participate in the
Health Home. The interaction where the member agrees to participate in the Health Home is not
counted.
◦ Outreach contacts are reported for all members even if the member did not agree to participate in
the Health Home. Efforts made during hiatus period should be included in counts even if not
billing for outreach.
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13 – AppropriateCM: Indicates if the member met criteria for
participation in the Health Home.
◦ Appropriateness may be determined through a review of data or an
assessment of member needs.
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14 – AssessedCM: Indicates if the member received an initial
comprehensive assessment for needs with an initial care plan. An
initial review of a priority problem is not a comprehensive
assessment.
◦ A comprehensive assessment includes: physical/functional, psychosocial,
environmental/residential, care-giver capability, medication lists and/or
compliance).
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15 – AssessDate: Date when the initial comprehensive assessment
with care plan is completed. If the member is not assessed or not
able to be contacted, the AssessDate will be blank.
◦ The completion of the comprehensive assessment and care plan may occur
over more than one interchange. In these cases the date of the interchange
when the initial assessment and care plan is completed should be used as the
date.
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16 – OptOut: Indicates if member/legal representative/family
refused to participate in the Health Home.
◦ Foe members offered participate, the response should be either
‘OPTED OUT’ or ‘DID NOT OPT OUT’.
◦ For members who were not offered participation because the member
was not able to be contacted or was not appropriate for participation,
the response should be ‘NOT APPROPRIATE HH’.
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17- EngagedCM: Indicates if the member agreed to participate
in the Health Home.
◦ Engagement is the agreement of the member/ legal rep/ family and
care manager that there is a need for care management and the
member is willing to participate .
18 –EngagedCMDate: This is the date when the member agrees to
participate in the Health Home.
◦ It is the ‘Begin Date’ in the PTS for the first record submission for the
member with the Outreach/Engagement code = ‘E’.
◦ If the member does not engage in CM (EngagedCM = ‘NO’), this
element through #34 will be blank.
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We encourage your feedback
◦ Case Scenario development
◦ Clarify fields so that the thinking behind how a question is answered in
the HH-CMART is the same across the board
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Email the Health Home Team at
[email protected]
with the Subject : HH CMART
Or Call the Health Home provider line – 518.473.5569
Health
Home website, Assessment and Quality Metrics menu, Process
Measures section:
http://www.health.ny.gov/health_care/medicaid/program/medicaid
_health_homes/assessment_quality_measures/process_measures.ht
m
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Weekly call every Wednesday from 10 a.m. to 11 a.m.
◦ The next call will be March 6th
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Slides from all webinars be accessed by visiting the
Health Home website at:
http://www.health.ny.gov/health_care/medicaid/program/me
dicaid_health_homes/meetings_webinars.htm
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