AGENDA I. Our DSRIP: ACP / AW Medical What it means for community providers like us? II. The Physician and DSRIP: Pay for performance III. Patient engagement: Simple steps to higher payment OUR DSRIP: ACP / AW MEDICAL LEAD: AW MEDICAL NYCPP MEDISYS SYSTEM North Shore - LIJ NEW YORK COMMUNITY PREFERRED PROVIDER COMMUNITY PREFFERED NETWORK RENAISSANCE COLLABORATIVE Community Provider Network (CPN) • • • • • • Asian American ACO Chinese American IPA Chinese Community ACO Eastern Chinese American Physicians IPA Korean American Physicians IPA CBW Community Health Center Renaissance Collaborative (RC) • • • • • • Balance Medical ACO Balance Medical IPA Breukelen Community Network IPA Corinthian Medical IPA Excelsior Medical IPA Queens County IPA NYCPP Leadership Team • • • • • • • • • • • • Dr. George Liu, Co-Chairman Dr. Ramon Tallaj, Co-Chairman Dr. Henry Chen, Treasurer Dr. Emilio Villegas - Secretary Dr. Bing Lu, Board of Manager Dr. Hanbin Zheng, Board of Manager Dr. Jonathan Chang, Board of Manager Dr. Michael Li, Board of Manager Dr. Sunhoo Foo, Board of Manager Dr. Vincent Wang, Board of Manager Dr. Hal Sadowy, Co-Chief Operating Officer Ms. Peggy Sheng, Co-Chief Operating Officer WHAT IT MEANS FOR COMMUNITY PROVIDERS LIKE US? We have brought over 2,000 physicians together as ONE 我們是一家人 Somos uno AW Medical PPS is not just made up of Physicians Hospitals Physicians Behavior Health and other important providers Non-physician partners Bronx • • • • • • • • • • • • • • • ACMH, Inc. Affinity Health Plan Alpine Home Health Care Amazing Home Care Amber Court At Home Amber Court Of Pelham Gardens Arms Acres, Inc Best Choice Home Health Care, Inc. Beth Abraham Health Services Boris Dubrovsky, Phd Bronx Center For Rehabilitation & Health Care Bronx Lebanon Hospital Center Bronx Park Rehab & Nursing Center Bronx Supported Housing Bronx-Lebanon Hospital Center • • • • • • • • • • • • Center for Urban • Community Services • Centerlight Healthcare Inc. Centerlight Healthc • are Diagnostic & Tr eatment Center CL Healthcare Inc • Community Access Inc • Daughters Of Jacob Nursing • Home Company Inc. Doshi Diagnostic • Imaging Services, P.C. Eli Leiter, Phd • Friends And Family Hebrew Home At • Riverdale Jewish Association For Services For • The Aged (Jasa) Jewish Board Of • Family And Children'S Services • Kings Harbor Multicare Ctr. • Kingsbridge Hieghts Rehab And • Care Center Mvp Housing • Development Fund Company Inc. • Narco Freedom, Inc • New York Dialysis Services, Inc. New York Psychotherapy And • Counseling Center Palisade Nursing Home Company, • Inc. • Park Housing Development Fund • Company Inc. Phoenix Houses Of • New York, Inc. Postgraduate Center For Mental • Health Project Renewal • Rain (Regional Aid For Interim Needs) Riverdale Mental • Health Association Rosselle Estrella, • Pt Scheuer Gardens • Limited Partnership • Scheuer Plaza Limited Partnership • Schnurmacher Center For Rehabilitation And Nursing Seniorcare • Emergency Medical Services • Seniorride Sheryll Garcia, Pt • St Barnabas Hospital Health • System St Joseph's Hospital • Steinway Child And Family Services, Inc Success Counseling Services, Inc Sus-Mental Health Programs, Inc. Terrace Health Care Center, Inc The Bridge The Pac Program Of The Bronx, Inc University Consultation & Treatment Center For Mental Hygiene, Inc. University Nursing Home VIP Community Services Westchester Family Health Center Weston United Community Renewal, Inc. Williamsbridge Man or Nursing Home Brooklyn • • • • • • • • • • • • • • • • • • MJHS License Home Care Service Agency AlphaCare Amber Court at Home Amber Court of Brooklyn Americare Certified Specialty Services, Inc. Anna Sidorkina, LAC Best Choice Home Health Care, Inc. BETH ISRAEL MEDICAL CTR BGR Services, Inc. Boro Park Center for Rehabilitation & Health Care Breukelen Community Network IPA Bridge Back to Life Center, Inc. Bridger BRIDGING ACCESS TO CARE Brooklyn Center for Rehabilitation and Residential Health Care Brooklyn Community Services Bushwick Brooklyn ACT Bushwick Center for • • • • • • • • • • • • • • • • • • • Rehabilitation and Health Care • CAIPA Social Day Care • Center Catholic Charities • Center for Nursing and • Rehabilitation • Center for Urban Community Services • CenterLight Certified Home Health Agency • Central Brooklyn ACT CL Healthcare Inc • Cobble Hill Health Center, Inc. • Community Access Inc./ • Warren Street Community Radiology of NY • Doshi Diagnostic Imaging • Services, P.C. East Brooklyn ACT Team Elderplan • Emerson TAP • Empire City Laboratories Federation of Organizations • for NYS Mentally Disabled • Fresenius God's Love We Deliver, Inc • Guidance Center of Brooklyn Health Homes Homecrest Community Services, Inc ICL ICM Brooklyn Jewish Board of Family and Children's Services John J. Pershing Intermediate School 220 Lawton Street Community Residence Linden House Community Residence Livonia Avenue LUTHERAN MEDICAL CENTER Marizza Dulfo, PT Menorah Center for Rehabilitation and Nursing Care MJHS Long Term Care New York Congregational Nursing Center New York Psychotherapy and Counseling Center NEW YORK THERAPEUTIC COMMUNITIES, INC Ohel Childrens Home and • • • • • • • • • • • • • • • • Family Services Phoenix House Foundation, Inc. Phoenix Houses of New York, Inc. Postgraduate Center for Mental Health Preventive Diagnostics Rockaway Park Center Shiel Medical Laboratory St. Joseph's Hospital St. Mark's MICA Supported Housing St. Mark's Scattersite Supported Housing Steinway Child and Family Services, Inc. Steppingstone Congregate Treatment Summit Home Health Care Supported Housing for Women with HIV/AIDS SUS Tillary Street Women's Shelter Williamsburg Physical Therapy Manhattan • • • • • • • • • • • • • • • • • • • 181 Street Medical PC • 3rd Street Men's Shelter • ACMH, Inc • Alberto De Castro, PT • Aleksey Kleyman, LAC Americhoice • Amerigroup MLTC • Amerigroup/Healthplus Asian American Accountable Care • Organization, LLC • Balance Medical ACO • Balance Medical IPA, Inc Beacon of Hope House • BETH ISRAEL MEDICAL CTR • Bridge Back to Life Center, Inc. • CareNext • Center for Alternative Sentencing • and Employment Services • Center for Urban Community Servcies • Charles B. Wang Community Health Center • Chinese American IPA, Inc. Chinese Community Accountable • Care Organization • CL Healthcare Inc • Community Access Inc. • Community Association of • Progressive Dominicans (ACDP) Comunilife Inc • Coordinated Behavioral Care, Inc • Pathways to Wellness HH • Corinthian Medical IPA, Inc Diana Badillo • Doshi Diagnostic Imaging • Services, P.C. • Elizabeth Uzor • Elmont Open MRI • Empire State Dental • Geffner House • Good Sheperd Services • Gouverneur Healthcare Services - • Skilled Nursing Facility Gramercy Park Digestive Disease • Center, LLC Greenwich House, Inc. Harlem East life Plan Healthfirst Heritage Health Home Network Heritage Healthcare Network ICL Broadway Community Residence Isabella Nursing Home Jason Waterman Jewish Board of Family and Children's Services Kenneth Ged Kenton Hall Men's Shelter L&L Orthotics, LLC Manhattan Supportive Housing Mary Claire Arbilo, PT MARY MANNING WALSH Melida Knibbs Metroplus Health Plan Metropolitan Center for Mental Health Metropolitan Jewish Home Care Inc. d/b/a MJHS Home Care Manhattan (continued) • • • • • • • • • • • • • • • • • MIH Experience LTD • Mitzy Baldovino, PT • MJHS Hospice and Palliative Care • National Association on Drug Abuse Problems, Inc. • New York Dialysis Services, Inc. • New York eHealth Collaborative • (NYeC) NEW YORK EYE & EAR • INFIRMARY Ninel Platsman, PT • Palladia, Inc. • Phoenix House Foundation, Inc. Postgraduate Center for Mental • Health • Project Renewal • Rapid Care Solutions • Rowell Arguelles, PT Salcare Home Health Services, Inc SCAN New York Senior Health Partners • • Senior Whole Health • Seong Chul Ha, LAC Service Program for Older People, • Inc. • Shiel Holdings, LLC • Shiel Medical Laboratory ST LUKES ROOSEVELT HOSP- • ROOSEVELT HOSP • ST LUKES ROOSEVELT HOSPST LUKES HOSP • St. Nicholas House • SUS- Mental Health Programs, • Inc. • TERENCE CARDINAL COOKE The Bridge • The Fifth Avenue Counseling • Center, Inc. • The First Chinese Presbyterian • Community Affairs Home Attendant Corp. • THE MOUNT SINAI HOSPITAL The National Alliance for the Mentally Ill of New York City, Inc. The PAC Program of The Bronx, Inc United Rx Buying Group LLC University Settlement Early Intervention Program Vidyasagar Pamulapati, PT Vijayalakshmi P. Davuluri, PT Visiting Nurse Service of New York Home Care VNS Choice VNSNY VNSNY Behavioral Health VNSNY Hospice and Palliative Care Washington Heights Imaging WellCare Health Plan WellCare MLTC Weston United Community Renewal, Inc. Women In Need Queens • • • • • • • • • • • • • • • • • • ACMH, Inc. • Alvin Orodio, Pt • Amber Court Of Westbury • Arms Acres, Inc • Bleuler Psychotherapy Center, • Inc. • Bridge Back To Life Center, Inc. Catholic Charities • Center For Urban Community Services/Rikers Island Single Stop • CL Healthcare Inc • Conifer Park, Inc Cornerstone Medical Arts Center • Hospital • Cuatro Llc Dba Access Medicare Ny • Doshi Diagnostic Imaging • Services, P.C. • Dr. William O. Benenson Rehab • Pavilion Eastern Chinese American • Physicians Ipa Excelsior Medical IPA • Fed Of Org For Nys Mentally Disabled • Fidelis Care • Fishman Center Total Eye Care • Flushing Manor Care Center Flushing Manor Dialysis Center • • Flushing Manor Nursing Home Goodwill Industries • Holliswood Center For • Rehabilitation And Healthcare Jewish Board Of Family And • Children'S Services • Liberty Physical Medicine & Rehab • Long Island Care Center • Long Island Consultation Center • Margaret Tietz Nursing And • Rehabilitation Center Michael K.T. Mangubat, Pt • Milestone Supportive Housing New Horizon Counseling Center • • New York Psychotherapy And Counseling Center Ohel Childrens Home And Family • Services • Parker Jewish Institute For Healthcare & Rehabilitation • Phoenix House Foundation, Inc. Phoenix Houses Of New York, Inc. Postgraduate Center For Mental Health Qsa Services, Inc. Queens Center For Rehabilitation & Residential Health Care Queens County Ipa Queens Treatment Apartment Program Samaritan Village Samuel Field YM/YWCA Shiel Medical Laboratory South Shore Physician Group St Joseph's Hospital Steinway Child And Family Services, Inc. Supportive Services For Veteran Families Sus- Mental Health Programs, Inc. The Mount Sinai Hospital Of Queens Union Plaza Nursing Home Dba Union Plaza Care Center Venture House Xeron Labs THE PHYSICIAN AND DSRIP: ABOUT DSRIP • Delivery System Reform Incentive Payment • Incentive payments are performance based • Patient engagement is KEY for incentive payment calculation which starts 01/01/2015 • Goals are to achieve transformation of the health care safety net provider system, improving healthcare quality, improving population health, reducing avoidable hospital and ED use, and lowering healthcare cost. ACHIEVING THE GOAL • Implementing collaborative models of patient care • Enhanced care coordination and care management models • Monitoring specific performance measures • Adherence to evidence-based protocols • Adherence to standardized processes across the PPS • EDI and PCMH level 3 certification Projects Selection 2.a.i Integrated Delivery System 2.a.iii Health Home At-Risk Intervention Program 2.b.iii ED care triage for at-risk populations 2.b.iv Care Transition 3.a.1 Integration of Primary Care & Behavioral Health 3.b.1 Cardiovascular Disease Management 3.c.1 Diabetes Disease Management 3.d.iii Asthma Management 4.b.i Tobacco Use Cessation 4.b.ii Increase Access to High Quality Chronic Disease Preventive Care and Management in Both Clinical and Community Settings PATIENT ENGAGEMENT: PCMH (2014 Version) Level 3 by 2017 2014 2015 3/31/2015 Action Attest Adopt, Implement, AIU to Upgrade Certified AIU (AIU) to 2014 EHR Certified EHR 2016 Data Action 3/31/2016 Attest 2017 Data Action 3/31/2017 Attest Data Use any 90-day Use MU Stage1-Y2 & any 90-day period Certified MU Stage 1-Y1 period from Certified meet MU Stage 2 full yr. 2016 from 2014 EHR 2015 EHR criteria EHR PCMH Upgrade to PCMH 2014 version MU Stage 1-Y1 any 90-day period from 2014 MU Stage 1-Y2 full yr. 2015 MU Stage 2-Y1 full yr. 2016 MU Stage 1-Y2 any 90-day period from 2014 MU Stage 2-Y1 full yr. 2015 MU Stage 2-Y2 full yr. 2016 MU Stage 2-Y1 any 90-day period from 2014 MU Stage 2-Y2 full yr. 2015 MU Stage 3-Y1 full yr. 2016 Prepare PCMH Level 3 Submit PCMH Level 3 Achieve PCMH Level 3 by 6/2017 Support Team • Lidia Virgil 212-567-4918 lvirgil@rapidcaresolution.com • John Dionisio 212-740-8294 jbdionisio@gmail.com • Susan Lau 212-965-9888 adm.aaaco@gmail.com • Liz Webb 212-740-8294 webbliz@cm-ipa.com Q&A