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Ohio’s Vision for Sustainability. ANCOR Fall Leadership Summit October 24, 2011. Increased Pressure for Resources. Increased demand for services 27,000 on waiting list Direct support professional crisis Wages Benefits Turnover Decreased Resources $ 8B deficit Inflation. Tools.

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ohio s vision for sustainability

Ohio’s Vision for Sustainability

ANCOR Fall Leadership Summit

October 24, 2011

increased pressure for resources
Increased Pressure for Resources
  • Increased demand for services
    • 27,000 on waiting list
  • Direct support professional crisis
    • Wages
    • Benefits
    • Turnover
  • Decreased Resources
    • $8B deficit
    • Inflation
tools
Tools
  • No HCBS DD waiver provider rate cut
  • 1.5% reduction in per member per month (pmpm)
  • 3% voluntary reduction in service utilization
  • Managed care
    • Role in our system
  • Patient-Centered Medical Home - ACO
  • Waiver reimbursement pilot
  • Leverage
patient centered medical home aco
Patient-Centered Medical Home - ACO
  • Patient-Centered Medical Home
    • Geography or diagnosis
    • IADD-specific
    • Current coordination
    • Partnerships
  • Possible role of IADD providers
    • Primary medical care and health home services
    • Health home services
    • Subject Matter Expert (SME)
    • Memorandum of Understanding (MOU)
  • Affordable care organization
waiver reimbursement pilot
Waiver Reimbursement Pilot
  • 15 minute rate
  • Misaligned incentives
  • Realignment of incentives by state, county boards and providers
  • Same or improved outcomes – shift focus from inputs to outcomes
  • Better manage expense
  • Decrease administrative expense
possible pilot model
Possible Pilot Model
  • Weekly rate
  • Acuity based case rate
  • Utilization adjusted
  • Efficiency dividends for state, counties, people on waiting lists and providers
  • Service planning
  • Oversight role
    • Quality
    • Access
    • Cost
why a pilot
Why a Pilot?
  • “If we knew it would work, we wouldn't need a pilot.”
  • Dynamic
  • Collaborative
  • Longer view
leverage
Leverage
  • Shared service models
  • Acquisitions and mergers
  • Collaboratives
  • Member services
  • Strange bedfellows
thank you
Thank You!

Mark Davis

Ohio Provider Resource Association

1152 Goodale Boulevard

Columbus, Ohio 43212

614.224.6772

mdavis@opra.org