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Massachusetts Delivery Model Advisory Committee. February 12, 2013. Agenda. Section 1 . Introduction. Introduction. Today’s discussion corresponds to these tasks from Navigant’s scope of work: Coordinate and lead meetings with various stakeholder groups.
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Massachusetts Delivery Model Advisory Committee February 12, 2013
Section 1 Introduction
Introduction Today’s discussion corresponds to these tasks from Navigant’s scope of work: • Coordinate and lead meetings with various stakeholder groups. Today’s discussion addresses these items from the Committee’s vision statement: • Identifying lessons learned in the MCO program and the PCC plan over the past years and implications for the future. • Describing the desired features of payment and delivery system models going forward including financial analysis of different delivery models. • Describing how this future model will support integrated care to address the physical and behavioral health care needs of patients.
Introduction Completed tasks from Navigant’s scope of work: • Identify individuals or organizations with expertise in Medicaid delivery of care models. • Conduct research on Medicaid delivery of care models, including lessons learned from innovation in the MCO and PCC plans in Massachusetts and implications for the future. Ongoing work • Analyze the experience of other entities and states in initiating and implementing innovative care delivery models. • Model the fiscal impact to the Commonwealth for different delivery of care models, taking into consideration cost drivers and trends, utilization, case mix, and potential for adverse selection;andthe impact of National Health Care Reform implementation • Describe the strengths and weaknesses of the MCO and PCC models to inform the state’s vision for health care payment and delivery moving forward, including the impact on patients and providers and long-term sustainability (updating initial draft based on Committee feedback).
Introduction Ongoing work (continued) • Describe the resources that would be needed to support the desired care delivery system(s), including information technology/data needs, practice supports and financing (updating initial draft based on Committee feedback) • Draft the Advisory Committee’s report of findings and recommendations, including development of an implementation strategy. • Meeting support for the Committee
Section 2 Stakeholder Feedback
Stakeholder Feedback • In October 2012, external stakeholders were solicited to provide feedback related to: • Lessons learned and innovations from the PCC and MCO program • The Commonwealth’s plans for payment reform • Their vision of future MCO and PCC programs in the context of these reforms • Consumer advocates discussed patient experience and future directions supporting more integrated care • Interviewed stakeholders include: • Legislators and/or their staffers • MCOs • Providers (including Associations) • Consumer advocates
Stakeholder Feedback by Key Themes • Stakeholder responses were categorized by 6 major themes: • Theme 1: Different stakeholders and groups had different positions on the role of each delivery model with some seeing greater value with MCO, some seeing greater value with PCC and others appreciating the roles of both programs. • Theme 2: Integrated care requires varying degrees of enhancements to existing care coordination, including more data sharing and physical/behavioral health management. • Theme 3: There is a need for enhanced data analytics, information technology and human capital to evaluate and monitor utilization, cost and care trends. • Theme 4: Stakeholders want increased transparency to measure results and value. • Theme 5: Providers’ readiness for delivery and payment reform varies. • Theme 6: There is consensus that cost and adequate funding arecurrently the biggest short-term problems.
Theme 6: Cost and adequate funding arethe biggest Short-term problems
Summary Next Committee Meeting
