Maine SIM Evaluation Subcommittee May 2015 May 27, 2015

lewin.com | 1 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment

lewin.com | 2 Welcome, Introductions, and Goals for Today’s Meeting Provide a status update on SIM Self-Evaluation provider, key stakeholder, and consumer interviews Present the latest iteration of the SIM dashboard and provide an update regarding target setting Inform the committee regarding evaluations for the Community Health Worker (CHW) pilot & the National Diabetes Prevention Program (NDPP).

lewin.com | 3 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment

lewin.com | 4 Meeting Minutes Please see meeting minute handouts for April 22nd Suggested edits from Committee members? Additional questions or clarifications? Motion to approve as written or amended

lewin.com | 5 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment

lewin.com | 6 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment

lewin.com | 7 SIM Self-Evaluation: Provider/Stakeholder interview update Maine SIM Provider / Key Informant Interviews Update as of May 21, 2015 Provider interviews Calls made:378 Interviews scheduled:91 Interviews completed**:71 Declined to participate:1 Voice mails left:199 Messages (live) left:39 Spoke with target:27 Calls - no message left:29 Other call responses:0 *Types of Completed Interviews Medicaid Health Homes including PCMHs 50 Behavioral Health Homes 13 Community Care Teams 5 Key Informants 3 Interviews completed:71 Cumulative Progress Medicaid Health Homes including PCMHs (57 total goal)107% Behavioral Health Homes (20 total goal)85% Community Care Teams (7 total goal)86% Key Informants (16 total goal)44% Interviews completed: 91%

lewin.com | 8 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment

lewin.com | 9 SIM Self-Evaluation: Consumer interview /survey update Target to complete = 1500 consumer interviews/surveys Mail Survey next steps Early impressions Timeline for completion of interviews / survey Next steps /timeline for analysis & reporting of results Consumer Interview Outreach and Completion Data as of HH- Adult HH-Adult Control HH- Child HH-Child Control BHH - Adult BHH-Adult Control BHH - Child BHH-Child Control Total Sample Records No Phone Number % Invalid Phone Number % Refusals % Completes % Total Final Disposition % Remaining Sample % Outreach Attempts

lewin.com | 10 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment

lewin.com | 11 Maine SIM Core Metrics – Setting Benchmarks and Targets- recap Once measures are vetted, identify appropriate benchmarks: –“Benchmarks” are usually defined as how the top 90 th percentile performs. Example: For the top 10% of providers, XX% of their patients received the correct procedure. –Benchmarks are guideposts to what the system can aspire to. –For overall ME SIM performance, we identify national benchmarks, such as NCQA, CMS, NQF. If a relevant national example isn’t available, we won’t display a national benchmark. –For HHs and BHHs, we calculate the 90% benchmark based on the ME Care data and the providers participating in those programs using the “Achievable Benchmarks of Care” (ABC) Methodology. This is the 90% measure that is statistically adjusted Stakeholders can then use the benchmarks to help select “Targets” Targets are achievable goals that promote accountability and can be readily monitored

lewin.com | 12 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment

lewin.com | 13 Maine SIM Research Collaborative- next steps Goal: To establish an ongoing research and evaluation collaborative to build upon the evaluative research occurring under the SIM grant. –The collaborative will: Facilitate ongoing research studies Test innovative health care delivery and reform approaches Implement targeted quality improvement initiatives Develop focused strategies for translating research Next steps- The draft description will be shared with the other SIM subcommittees for review and feedback. Any suggestions collected will be vetted by the Evaluation Subcommittee Final product will be presented to the Steering Committee for acceptance of the concept Recruiting will begin by late summer

lewin.com | 14 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment

lewin.com | 15 Evaluation Process- CHW & NDPP Evaluation components being conducted by John Snow Inc. (JSI) CHWI Evaluation objectives: –Evaluation of four CHW Pilot Projects: project steps, tasks, barriers, solutions, and successes. –Capacity-Building Evaluation of CHW Initiative: assess sustainable capacity to support CHWs in Maine (CHW and supervisor training, certification, hiring, and reimbursement.) NDPP Evaluation objectives –Process evaluation that captures projects steps, tasks, barriers, solutions, and successes through the project period (October 2013 – September 2016). –Formative evaluation to document and support learning and information from the partners/organizations engaged throughout the project period. The formative evaluation will guide strategy development for payment test for SIM Years 2 & 3. Stakeholder workgroup is defining evaluation questions Using RE-AIM Framework –Reach, Efficacy, Adoption, Implementation, Maintenance Timeline for evaluation

lewin.com | 16 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment

lewin.com | 17 Risk Identification and Discussion Risks previously identified –Delays in access to Medicare data –Lack of access to clinical data for evaluation analysis purposes Any new risks from the committee? Discussion Follow-Up & Next Steps

lewin.com | 18 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment

lewin.com | 19 Next Steps Next Meeting –June 24, 2015, 3-5 pm Conference room A 35 Anthony Avenue, Augusta Future Discussion Topics –Sustainable Research Collaborative –Status Update of the Self-Evaluation Provider, Stakeholder, & Consumer interview process & early findings when available –Presentation of preliminary data analysis –Follow up on identified risks as necessary

lewin.com | 20 Today’s Agenda Welcome and IntroductionsReview & Approve the April 22nd Meeting MinutesSteering Committee Meeting updateStatus Update: Provider, Key Stakeholder InterviewsStatus Update: Consumer InterviewsDashboard & Target Setting UpdateResearch Collaborative- next stepsEvaluation Process- CHW & NDPPRisk Identification & DiscussionNext StepsPublic Comment