HCH Advisory Committee
January 5, 2016
*Please do not put phone on hold
Health Care Homes Program/State Innovation Model Grant
Cally Vinz
Chair
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Welcome
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Introductions
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Review of Agenda
Health Care Homes Program/State Innovation Model Grant
Bonnie LaPlante
HCH Director
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Announcements
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Updates
Health Care Homes Program/State Innovation Model Grant
Diane Rydrych
Health Policy Director
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Legislative Primer
Health Care Homes Program/State Innovation Model Grant
HCF TF Recommendations
(preliminary)
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Prospective payment for care coordination
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Reduce administrative burden/payment lag
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Modify tiering to ensure it is sufficient, and to incorporate nonmedical/social complexity as well as clinical
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Encourage/incent care coordination with a wider variety of
community/social services organizations
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HIE recommendations to ease data sharing
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Voting in January; Report to Legislature
Health Care Homes Program/State Innovation Model Grant
Statute vs Rule –
General
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Statute tells us what to do (implement a program, write a report, etc)
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Rule spells out how (program details)
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MDH has general rulemaking authority
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Don’t always need it – sometimes statute is sufficiently clear/detailed
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Sometimes explicit rulemaking authority is given – or we are directed
to adopt rules
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Used more often with complex, new programs
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HCH Rule developed using expedited process in 2009
Health Care Homes Program/State Innovation Model Grant
HCH Statute vs Rule
HCH Statute
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General principles for certification
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Requirement to recertify annually
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HCH Rule
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Detailed definitions (care coordination,
care plan, family, etc)
Require all clinicians in a HCH to
participate

Detailed requirements, by domain, for
initial certification and recertification
State establishes learning
collaborative

Processes and application requirements
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Benchmarking process/timeline
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Variance processes and criteria
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Appeals and revocation
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Requirement to meet
process/outcome/quality standards

Advisory committee

Tiered payments based on pt
complexity
Health Care Homes Program/State Innovation Model Grant
HCH Statute vs Rule
Example – Certification Standards
HCH Statute

Ensure that HCH develop
and maintain appropriate
comprehensive care
plans for their patients
with complex or chronic
conditions, including an
assessment of health
risks and chronic
conditions;
Health Care Homes Program/State Innovation Model Grant
HCH Rule

One or more members of care team
meets with patient to set goals and
identify resources to meet them
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Team and pt determine how/how
often to meet, community resources
to involve
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Care plan documents referrals and
follow up, tests and results,
admissions, post-discharge plans, etc
Administrative changes

Some changes can be made administratively, without
change in Rule or statute
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Process for assigning patients to tiers
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Level of PMPM payment for patients in different tiers
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Billing process for care coordination payments;
prospective vs retrospective payment
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Topics/method of participation for learning
collaborative
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Benchmark rates and selected measures
Health Care Homes Program/State Innovation Model Grant
Statute vs Rule –
Timeline and Process
HCH Statute: 2017 session
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General plan/proposals: summer 2016
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Stakeholder/community discussions
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Approval by:
HCH Rule
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18-24 month process

First step: Public comment period on
part/all of Rule
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Multiple public input windows
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MDH/DHS
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Proposed and final Rule
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Governor’s office


Legislature
Multiple layers of review/approval by:

Agency program/legal staff
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Governor’s office

Office of Administrative Hearings
Health Care Homes Program/State Innovation Model Grant
Rulemaking Progress Chart

Health Care Homes Program/State
Innovation Model Grant
Next (first?) Steps

Identify – and educate stakeholders on - components
of statute, Rule that MDH may be interested in
updating

Identify changes that could be made administratively
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Ensure robust opportunities for public participation

Advisory committee, public comments,
presentations/meetings, other
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Think through budgetary implications and timelines
Health Care Homes Program/State Innovation Model Grant
Learning Collaborative Updates

Charter Revised but still needs final approval

Deliverable 1:

Learning Days offer Beginners & Advanced Sessions
by 4/27/16
Deliverable 2:

Disseminate resources to foster clinics linking to
community organizations that can aid in care
coordination by 6/30/16
Deliverable 3:

Design learning activities to improve workforce
capabilities that support Health Equity by 12/31/16


Financial Sustainability Update

Charter Approved with Modifications

Deliverable 1:

Conduct analysis on various payment models
used in MN and nationwide by 3/30/16

Deliverable 2:

Develop an integration “on ramp” for HCH to
move towards an integrated value based model
by 12/31/17

Deliverable 3:

Partner with key stakeholders to maintain and
improve capacity of HCHs to link data to
performance and payment by 12/31/16
Communication & Evaluation Updates

Charter Approved with Modifications

Collaboration with MDH Communication Office

Deliverable 1:

Develop strategically focused marketing and communication
plans for health care homes advancement engaging digital,
print, social media and other strategies to build awareness and
strengthen relationships with key stakeholders by 12/30/16.

Deliverable 2:

Evaluate measures that assess population health impact to
advance health equity and the correlation to care coordination
activities by 6/30/17.

Deliverable 3:

Review program evaluation measures and assess whether to
add community impact, health capacity and/or practice
transformation measures by 6/30/16.
Practice Transformation Updates
Charter Revised but still needs final approval
Deliverable #1:
Define alignment.
Describe how HCH supports and links with other services, models and
initiatives (MACRA, BHH, IHP’s/ACO’s, ACHs, etc) by 6/30/16
Deliverable #2:
Refine HCH certification and recertification process
Deliverable #3:
Partner with MDH Office of Health Information Technology to provide
technical assistance to clinics to identify processes that use patient name
and primary care provider data fields that will be used for interoperability
with other medical providers.
Deliverable #4:
Improve population health and care coordination technical assistance to
clinics by 12/31/16.
Health Care Homes Program/State Innovation Model Grant
Next Steps





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Approve Timeline
Finalize Strategic Plan
Review Work Plan Drafts
Begin To Think About Potential Legislation
and/or Rule Changes
Learning Days April 26 & 27, 2016
Next Meeting 4/12/16
Health Care Homes Program/State Innovation Model Grant
Health Care Homes Contact Information
HCH mailbox:
[email protected]
HCH Website:
http://www.health.state.mn.us/healthreform/homes/
index.html
HCH telephone number: 651-201-5421