RHP 7:
Anchor Entity Presentation
Presented to the Central Health Board of Managers
January 9, 2012
RHP 7 Overview
 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

www.CentralHealth.net
2
UC-Only Hospitals
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
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
www.CentralHealth.net
3
Region 7 RHP Plan DSRIP Totals
 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
www.CentralHealth.net
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Region 7 : No. of DSRIP Projects
Performing Providers
Hospitals – 33
LMHAs – 29
LHD – 6
DSRIP Categories
Cat 1 – Infrastructure Development – 23
Cat 2 – Program Innovation and Redesign - 45
www.CentralHealth.net
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RHP 7 DSRIP
Valuation by
Performing
Provider Type
LMHAs
$167,061,380
26%
Hospitals
$215,062,843
34%
LHD
$18,504,758
3%
CCC
$237,176,362
37%
$637m Total
www.CentralHealth.net
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Travis County Performing
Provider Participation- DY 2-5
Performing Provider
# of DSRIP
Projects
DSRIP Project
Valuation (All Cats)
City of Austin HHSD
6
$18.5m
Dell Childrens
3
$36m
UMC Brackenridge
14
$163m
ATCIC
9
$97m
Community Care Collaborative
14
$237m
46
$551.5m
TOTAL
www.CentralHealth.net
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City of Austin HHSD: 6 projects
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
www.CentralHealth.net
8
Dell Childrens: 3 projects
 Care for Chronically Ill Children
 Family-centered Pediatric Obesity Project
 Counseling on AISD Campuses (AISD funded)
www.CentralHealth.net
9
UMC Brackenridge: 14 projects
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

www.CentralHealth.net
10
ATCIC: 9 projects
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
www.CentralHealth.net
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Community Care Collaborative:
14 projects
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
www.CentralHealth.net
12
Community Care Collaborative:
DSRIP Projects Overview
Presented to the Central Health Board of Managers
January 9, 2012
Community Care Collaborative
DSRIP Projects
Category
Description
No. of Proj
Valuation
1
Infrastructure Development
8
$95m
2
Program Innovation & Redesign
6
$61m
3
Quality Improvements-Outcomes
ALL
$61m
4
Population Focused Improvements
ALL
$30m
TOTAL
$237m
Category
Minimum
Maximum
1-2
$3.4m
$19.5m
www.CentralHealth.net
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Community Care Collaborative
DSRIP Projects
 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
www.CentralHealth.net
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Every DSRIP Project
 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)
www.CentralHealth.net
16
Patient Centered Medical Home
Model
 $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

www.CentralHealth.net
17
Disease Management Registry
 $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
www.CentralHealth.net
18
Chronic Disease Management
Protocols
 $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
www.CentralHealth.net
19
Expanded Hours at Community
Clinics
 $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
www.CentralHealth.net
20
Mobile Clinics to Underserved
Areas
 $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
www.CentralHealth.net
21
Dental Care Expansion
$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





www.CentralHealth.net
22
Musculoskeletal Care in
Community Clinics
 $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
www.CentralHealth.net
23
Gastroenterology Care Expansion
 $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
www.CentralHealth.net
24
Pulmonology in Community
Clinics
 $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
www.CentralHealth.net
25
Integrated Behavioral Health for
Diabetics
 $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
www.CentralHealth.net
26
Telepsychiatry in Community
Clinics
 $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
www.CentralHealth.net
27
STD/HIV Screening & Treatment
 $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
www.CentralHealth.net
28
Adolescent & Young Adult
Pregnancy Prevention
 $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
www.CentralHealth.net
29
Community Paramedic Navigator
Project
 $9,319,427 proposed valuation
 High rates of repeat EMS & ED utilization
 Adds 3 paramedic navigator staff for inhome services & development of patient
care plan
 Serves 900 patients through DY5
 Outcome: Reduced inappropriate ED
utilization
www.CentralHealth.net
30
DY 5
DY 4
DY 3
DY 2
DY 1
DSRIP Project Timeline
Dec 2011 –
Sept 2012
Oct 2012 –
Sept 2013
Oct 2013 –
Sept 2014
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
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Questions or Comments
11/9/2012
www.CentralHealth.net
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Information, Questions, Comments:
www.texasregion7rhp.net
sarah.cook@centralhealth.net
512-978-8195
www.centralhealth.net