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RHP 7: Anchor Entity Presentation
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  1. RHP 7:Anchor Entity Presentation Presented to the Central Health Board of Managers January 9, 2012

  2. RHP 7 Overview www.CentralHealth.net • Texas – 20 RHPs • $11.4 billion in DSRIP funds available • $17.5 billion in UC funds available • RHP 7 • Six counties including Bastrop, Caldwell, Fayette, Hays, Lee, and Travis • RHP 7 Plan consists of both UC and DSRIP

  3. UC-Only Hospitals www.CentralHealth.net • Austin State Hospital • St David’s Medical Center • St David’s North Austin • St David’s South Austin • Seton Edgar B Davis • Seton Medical Center Austin • Seton Medical Center Hays • Seton Southwest • Seton Northwest • Seton Shoal Creek • Smithville Regional Hospital

  4. Region 7 RHP Plan DSRIP Totals www.CentralHealth.net • Available • $689 million in total DSRIP valuation available • DY 1 = $30 million – Preliminary Funding • DY2-5 = $659 million – Performance Based • Actual • 68 projects • $637 million valuation • 9 Performing providers • 5 Hospitals (including CCC) • 3 LMHAs • 1 LHD

  5. Region 7 : No. of DSRIP Projects www.CentralHealth.net Performing Providers Hospitals – 33 LMHAs – 29 LHD – 6 DSRIP Categories Cat 1 – Infrastructure Development – 23 Cat 2 – Program Innovation and Redesign - 45

  6. RHP 7 DSRIP Valuation by Performing Provider Type $637m Total www.CentralHealth.net

  7. Travis County Performing Provider Participation- DY 2-5 www.CentralHealth.net

  8. City of Austin HHSD: 6 projects www.CentralHealth.net • Behavioral Health • ACT for Residents of PSH • Prenatal Care & Family Health • Pre & Post Natal Program • Healthy Families Expansion • Prevention & Education • Community Diabetes Project • Tobacco Program for 18-25 Year Olds • Immunization to high risk adult populations

  9. Dell Childrens: 3 projects www.CentralHealth.net • Care for Chronically Ill Children • Family-centered Pediatric Obesity Project • Counseling on AISD Campuses (AISD funded)

  10. UMC Brackenridge: 14 projects www.CentralHealth.net • Behavioral Health • Psychiatric Emergency Department • Post-Graduate Training for Psychiatric Specialties • Psychiatric Telemedicine for Emergency Service • Substance Abuse Care Connection & Navigation • Behavioral Health Care Connection & Navigation • Cancer Care • Women's Oncology Care Screening • Women’s Oncology Care Navigation • Chronic Disease Care • Adult Diabetes Care • Chronic Care Management: Adults • Care Transitions • Patient Experience • Language Access & Resource Center • Culturally Competent Care Training • Palliative Care • Palliative Care Expansion • Prenatal Care • OB Navigator Project

  11. ATCIC: 9 projects www.CentralHealth.net • Crisis Services • MCOT Expansion • MCOT Telepsychiatry Services • Crisis Residential program • Community Behavior Support Team • Outpatient Community Based Services • Integrated Medical & Behavioral Health Center in Dove Springs • Chronic Disease Self Management • Whole Health Peer Support • Workforce Development • Prescriber Expansion • Mental Health First Aid & Suicide Prevention Training

  12. Community Care Collaborative: 14 projects www.CentralHealth.net • Infrastructure • Disease Management Registry • Patient Centered Medical Home Model • Chronic Disease Management Model • Care Expansion: Primary, Specialty, Dental • Expanded Hours at Community Clinics • Mobile Care Vans • Gastroenterology at Community Clinics • Musculoskeletal Care at Community Clinics • Pulmonology at Community Clinics • Expanded Dental Services • Behavioral Health • Integrated Behavioral Health for Diabetes • Telepsychiatry at Community Clinics • Sexual Health • Pregnancy Reduction Program • STD/HIV Screening & Treatment • Patient Navigation • Community Paramedic Navigation

  13. Community Care Collaborative:DSRIP Projects Overview Presented to the Central Health Board of Managers January 9, 2012

  14. Community Care CollaborativeDSRIP Projects www.CentralHealth.net

  15. Community Care CollaborativeDSRIP Projects www.CentralHealth.net • 14 total projects • 3 “infrastructure” projects • Connection and standardization among safety net providers • 11 care delivery projects • Expand access to primary, specialty and dental services • Access to appropriate care & treatment for chronic conditions • Sexual health

  16. Every DSRIP Project www.CentralHealth.net • Will impact all patients in Safety Net System – CCC, Medicaid, Uninsured, Others • Has process measures & improvement measures, and outcome measures • Payment based on performance; outcomes must be achieved • Contains some element of Continuous Quality Improvement (CQI)

  17. Patient Centered Medical Home Model www.CentralHealth.net • $25,001,546 proposed valuation • Intended to enhance shared care & data exchange between providers • Outcomes: • All safety net providers will share certain PCMH standards • FQHCs get PCMH recognition/ certification

  18. Disease Management Registry www.CentralHealth.net • $27,126,462 proposed valuation • Intended to enhance Health Information Exchange analytic capabilities • 90% of CCC providers use DMR through DY5 • Outcome: better blood pressure control for enrolled hypertensives

  19. Chronic Disease Management Protocols www.CentralHealth.net • $25,982,686 proposed valuation • Will create treatment standards across CCC • 12,000 patients enrolled in Multiple Chronic Condition treatment protocol through DY5 • Outcomes: • better cholesterol control for patients with cardiovascular disease; • better blood pressure control for diabetics; • improved self-assessed functional status for patients with Multiple Chronic Conditions

  20. Expanded Hours at Community Clinics www.CentralHealth.net • $21,106,982 proposed valuation • Patients currently use ED for conditions that could be treated at clinics • Expands hours at 3 centers to 8pm, including SE Hub; pilot one site to 11pm • 49,000 additional visits serving 16,000 patients by DY5 • Outcome: fewer ED visits for those using services

  21. Mobile Clinics to Underserved Areas www.CentralHealth.net • $6,025,279 proposed valuation • Brings care to underserved areas of Travis County • Three vans; 4800 annual appointments slots and 1600 patients served by DY5 • Outcome: improved patient satisfaction scores for those using vans

  22. Dental Care Expansion www.CentralHealth.net • $17,912,179 proposed valuation • To increase access to dental services • Expands hours & capacity at clinics • 12,000 annual visits for 4500 patients • Focus on pregnant women (450 by DY5) & those with chronic conditions (3050) • Outcome: More pregnant women get recommended preventive dental care

  23. Musculoskeletal Care in Community Clinics www.CentralHealth.net • $17,864,274 proposed valuation • To address ortho wait times and provide appropriate level of care • 2 rotating specialists, including SE Hub • Serves 1800 patients by DY5 • Outcome: patients report improved quality of life

  24. Gastroenterology Care Expansion www.CentralHealth.net • $15,781,027 proposed valuation • Reduce wait time for GI visits & offer preventive colorectal cancer screenings • Adds 1 specialist at North Central; 1 rotating specialist, including SE Hub • Serves 1800 patients through DY5 • Outcomes: • Reduced time to 3rd next available appointment • Ensures adherence to HCV regimen, including depression medication • Increases colorectal cancer screening rate

  25. Pulmonology in Community Clinics www.CentralHealth.net • $14,260,001 proposed valuation • Wait time currently 4 months, with a 2 month lacuna in services • 2 rotating specialists, including SE hub • Serves 2400 patients through DY5 • Outcome: reduces COPD admissions rate for population receiving services

  26. Integrated Behavioral Health for Diabetics www.CentralHealth.net • $13,509,644 proposed valuation • Depression co-occurs with diabetes & affects ability to self-manage condition • Offers care team management of diabetics with depression • 1500 enrolled through DY5 • Outcomes: depression remission at 12 months & good A1c control

  27. Telepsychiatry in Community Clinics www.CentralHealth.net • $11,110,177 proposed valuation • Smaller sites currently lack psychiatric services & health counselors • Offers consultation for PCPs & direct treatment for patients via “telemental” service • 3500 patients served through DY5 • Outcomes: Depression &/or anxiety remission at 12 months

  28. STD/HIV Screening & Treatment www.CentralHealth.net • $4,698,966 proposed valuation • Climbing rates of infection, particularly among young adults • Total of 7500 patient visits and 750 treatment courses/referrals through DY5 • Outcomes: increased rates of gonorrhea, chlamydia, and HIV testing & treatment

  29. Adolescent & Young Adult Pregnancy Prevention www.CentralHealth.net • $6,511,842 proposed valuation • High birth rate for women under 20 in Travis County • 1550 patient visits through DY5 • Provides contraception education and counseling, including long acting reversible contraception (LARC) counseling • Outcome: lowers pregnancy rate of those under 25 who receive services

  30. Community Paramedic Navigator Project www.CentralHealth.net • $9,319,427 proposed valuation • High rates of repeat EMS & ED utilization • Adds 3 paramedic navigator staff for in-home services & development of patient care plan • Serves 900 patients through DY5 • Outcome: Reduced inappropriate ED utilization

  31. DSRIP Project Timeline • Dec 2011 – Sept 2012 • Oct 2012 – Sept 2013 • Oct 2013 – Sept 2014 • DY 1 • DY 2 • DY 3 • DY 4 • DY 5 Oct 2014 – Sept 2015 Oct 2015 – Sept 2016 Preliminary Planning Implement Outcomes Outcomes • HHSC/CMS Timelines • RHP Plan Submittal to HHSC – December 31, 2012 • RHP Plan Submittal to CMS – February 2013 • CMS Approval of RHP Plan – May 2013 www.CentralHealth.net

  32. Questions or Comments www.CentralHealth.net

  33. Information, Questions, Comments:www.texasregion7rhp.netsarah.cook@centralhealth.net512-978-8195www.centralhealth.net