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Advancing Outcomes June 3, 2014 Jackey Matson Director, Bureau of Performance Improvement and Patient Safety.

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Presentation on theme: "Advancing Outcomes June 3, 2014 Jackey Matson Director, Bureau of Performance Improvement and Patient Safety."— Presentation transcript:

1 Advancing Outcomes June 3, 2014 Jackey Matson Director, Bureau of Performance Improvement and Patient Safety

2 Managed Long-Term Care – Assessment and Quality Semi Annual Assessment of Members in 2005 Based on OASAS Used to determine eligbility First report in 2011 Not publicly reported Feedback loop and buy-in from the MLTC plans Publicly reported in 2012 and 2013 http://www.health.ny.gov/health_care/managed_care/mltc/reports.htm

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4 Managed Long-Term Care – Consumer Surveys “In House” survey developed 2007 Two more in 2011 and 2013 Satisfaction Access Timlieness Ratings of care managers, nurses, personal care, home care, Etc. Advanced Directives - 2011 “Quality of Life” – 2013 http://www.health.ny.gov/health_care/managed_care/mltc/reports.ht m

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7 OPWDD Population Measurement Quality Assurance Reporting Requirements (QARR)/HEDIS Quality performance data collected from MMC plans since 1994 Women’s Health, Children’s Health, Chronic Illness Numerators/Denominators Medicaid: MEMBER level Allows for matching to Medicaid data Voluntarily enrolled OPWDD members Compared OPWDD performance to non-OPWDD

8 Table 1. Demographic information on individuals eligible for developmental disabilities services regulated by the Office for People with Developmental Disabilities, who were voluntarily enrolled in Medicaid managed care for 12 consecutive months during 2012. N% Gender Male 8,34658.9 Female 5,82041.1 Race White 6,28044.3 Black 3,26423.0 Hispanic 2,75619.5 Asian/Pacific Island 4263.0 Native American 430.3 Other 5243.7 Unknown 8736.2 Age Age 0 to 4 Years 9266.5 Age 5 to 17 Years 5,82341.1 Age 18 to 49 Years 6,87748.6 Age 50 to 64 Years 4913.5 Age 65+ Years 490.4 Region Western 3,91927.7 Central 1,93213.6 Northeast 1,41110.0 Hudson Valley 1,1298.0 New York City 4,86634.4 Long Island 9066.4

9 OPWDD Population Measurement – Results, 2012 Compared to rest of MMC, mostly no statistically significant differences Lower performance in some cancer screenings Higher performance in some well child visits and asthma management Will publish and repeat the process for 2013 data

10 Cross Agency Work Group to Implement Olmstead Outcome Measures

11 Background  Determine applicability of each of 64 measures for each agency and population served – M. DeMasi  Determine availability of data sources  Identify need for additional measures  Develop a set of common measures  Determine whether development may need 2015-2016 budget request  5 Agencies. 4 Responses.  OMH/OASA combined response

12 Populations  D OH  MLTC, ALP, Personal Care, CDPAP, LTHHCP, TBI, Adult Day Health, Care at Home and NH Transition and Diversion waivers  OMH  BHOs, HARPs  OPWDD  All eligible individuals  OASAS  HARPs, BHOs  SOFA

13 Instruments  DOH  Uniform Assessment System (UAS)  OPWDD  Coordinated Assessment System (CAS)  OMH  In development (core set comprised of UAS and CAS)  OASAS  In development (UAS and CAS)  SOFA  Comprehensive Assessment for Aging Network Community Based Long Term Care Services (COMPASS)

14 Issues and Decisions  What is long term care? – 120 days of care – NA to SOFA clients  Medicaid only? – no, i.e., SOFA included  Children and Adult? - Adult initially  Institutions as well as community based – Ideally yes  Employment measures’ applicability to older populations (SOFA and MLTC)

15 Results: Summary Olmstead Focus Sum of Choice of support options Sum of Access to and use of self directed support models Sum of Employmen t Sum of Meaningful day activities Sum of Appropriate Living setting in Community –“ most integrated setting” Sum of Access to transportatio n Grand Total16372223160

16 Results: Summary of Data Sources for Measure “Domains” DOHOPWDDOMHSOFAOASAS Row Labels Sum of Data Source Exists CROSS AGENCY TOTALS Choice52101027 Community Integration021014 Employment01441423 Employment-choice020002 Housing0324211 Housing-choice030003 Self-determination000000 Service access101013 Supports100001 Transition of care000000 Grand Total745868

17 Results: Measure Summary  Applicable Populations  Data Exist  If not should it be collected?  Data sources  UAS  Administrative  Interview  Satisfaction Survey

18 Going Forward  Choose set of measures with data that touch many agencies to begin “dashboard.”  Discuss data collection needs for “gaps.”  Other measures necessary?  Transportation  Self-directed data

19 Jacqueline Matson Jacqueline.Matson@health.ny.gov 518-486-9012


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