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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:

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Presentation on theme: "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:"— Presentation transcript:

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2 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

3 OUR DSRIP: ACP / AW MEDICAL

4 NYCPPNorth Shore - LIJ MEDISYS SYSTEM LEAD: AW MEDICAL

5 NEW YORK COMMUNITY PREFERRED PROVIDER COMMUNITY PREFFERED NETWORK RENAISSANCE COLLABORATIVE

6 Asian American ACO Chinese American IPA Chinese Community ACO Eastern Chinese American Physicians IPA Korean American Physicians IPA CBW Community Health Center Community Provider Network (CPN)

7 Balance Medical ACO Balance Medical IPA Breukelen Community Network IPA Corinthian Medical IPA Excelsior Medical IPA Queens County IPA Renaissance Collaborative (RC)

8 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 NYCPP Leadership Team

9 WHAT IT MEANS FOR COMMUNITY PROVIDERS LIKE US?

10 我們是一家人 Somos uno We have brought over 2,000 physicians together as ONE

11 Non-physician partners AW Medical PPS is not just made up of Physicians Behavior Health and other important providers Physicians Hospitals

12 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 Bronx

13 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 Brooklyn

14 181 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

15 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 HOSP- ST 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 Manhattan (continued)

16 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 Queens

17 THE PHYSICIAN AND DSRIP:

18 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.

19 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

20 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.iiIncrease Access to High Quality Chronic Disease Preventive Care and Management in Both Clinical and Community Settings Projects Selection

21 PATIENT ENGAGEMENT:

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23 PCMH (2014 Version) Level 3 by 2017 201420153/31/201520163/31/201620173/31/2017 ActionAttestDataActionAttestDataActionAttestData EHR Adopt, Implement, Upgrade (AIU) to 2014 Certified EHR AIU to Certified EHR AIU any 90-day period from 2014 Use Certified EHR MU Stage 1-Y1 any 90-day period from 2015 Use Certified EHR MU Stage1-Y2 & meet MU Stage 2 criteria full yr. 2016 MU Stage 1-Y1 any 90-day period from 2014 MU Stage 1-Y2full yr. 2015 MU Stage 2-Y1full yr. 2016 MU Stage 1-Y2 any 90-day period from 2014 MU Stage 2-Y1full yr. 2015 MU Stage 2-Y2full yr. 2016 MU Stage 2-Y1 any 90-day period from 2014 MU Stage 2-Y2full yr. 2015 MU Stage 3-Y1full yr. 2016 PCMH Upgrade to PCMH 2014 version Prepare PCMH Level 3Submit PCMH Level 3Achieve PCMH Level 3 by 6/2017

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33 Support Team Lidia Virgil212-567-4918 lvirgil@rapidcaresolution.com lvirgil@rapidcaresolution.com John Dionisio212-740-8294 jbdionisio@gmail.com jbdionisio@gmail.com Susan Lau212-965-9888 adm.aaaco@gmail.com adm.aaaco@gmail.com Liz Webb212-740-8294 webbliz@cm-ipa.com

34 Q & A


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