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Craig Jones , M.D. Blueprint Executive Director Burlington, VT craig.jones@ahs.state.vt PowerPoint Presentation
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Craig Jones , M.D. Blueprint Executive Director Burlington, VT craig.jones@ahs.state.vt

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Craig Jones , M.D. Blueprint Executive Director Burlington, VT craig.jones@ahs.state.vt

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  1. Vermont Blueprint for Health Craig Jones, M.D. Blueprint Executive Director Burlington, VT craig.jones@ahs.state.vt.us 9/25/2014

  2. Vermont Blueprint Context Dedicated leadership Guiding Legislation History of working together Improve quality & control of costs Focus on prevention & wellness 13 Hospitals & Service Areas 3 major commercial insurers, Medicaid, Medicare

  3. Hospitals • A foundation of medical homes and community health teams that can support coordinated care and linkages with a broad range of services • Multi Insurer Payment Reform that supports a foundation of medical homes and community health teams • A health information infrastructure that includes EMRs, hospital data sources, a health information exchange network, and a centralized registry • An evaluation infrastructure that uses routinely collected data to support services, guide quality improvement, and determine program impact Advanced Primary Care Specialty Care & Disease Management Programs Community Health Team Nurse Coordinator Social Workers Nutrition Specialists Community Health Workers MCAID Care Coordinators Public Health Specialist Advanced Primary Care Social, Economic, & Community Services Advanced Primary Care Mental Health & Substance Abuse Programs Advanced Primary Care Healthier Living Workshops Public Health Programs & Services Health IT Framework Evaluation Framework 9/25/2014

  4. Multi-insurer Payment Reforms • Medicaid • Commercial Insurers • Medicare? Insurers • Fee for Service • Unchanged • Allows competition • Promotes volume • Patient Centered Medical Home • Payment to practices • Consistent across insurers • Promotes quality • Community Health Teams • Shared costs as core resource • Consistent across insurers • Minimizes barriers + + • Based on NCQA PPC-PCMH Score • $1.20 - $2.49 PPPM • Based on active case load • 5 FTE / 20,000 people • $ 350,000 per 5 FTE • Scaled based on population

  5. Building a Learning Health System • State • Policy & leadership • Strategic planning • Coordination • IT Infrastructure • Central Registry • Multi-payer database • University of Vermont • NCQA scoring • Chart review • Analytics • Reporting • Informatics platform • Multi-disciplinary expertise Web based reporting platforms Multi-disciplinary study teams Comparative effectiveness & evaluation Coaching & Facilitation Team (Blueprint & University of Vermont) Practices Community Health Teams Hospitals Other Services & Providers