Session 16– May 7, 2013 Program Updates 1

 Working on timing for next list release-new lists for Phases 1 and 2 and first list for Phase 3.  Still need designated Health Home for Southern Tier counties.  CMART - Ongoing technical assistance calls; first submissions are due May 13, 2013 for 2012 FACT-GP data, full submissions for first two quarters of 2013 are due August 5,

 Ongoing refinements to Member Tracking System  Health Home team will be using SurveyMonkey more extensively to better implement the program and take in feedback on various subjects  Health Home and Managed Care Workgroup has been reconvened, six subgroups identified to work on key issues 3

 Next Learning Collaborative scheduled May 30 in NYC; agenda is being developed.  Center for Health Care Strategies (CHCS) has launched an online community for New York Health Homes who are a part of the Learning Collaborative funded by the New York State Health Foundation and facilitated by CHCS.  The online community will allow Health Homes to participate in online conversations with other Health Homes. The goal is to provide a safe space for Health Home staff in all phases to share best practices, resources and ask questions about implementation.  You are invited to join the community if you are a staff member of a health home agency or network partner: To join, please contact: Anjana Pandey,

 Network partners and MCOs continue to develop operational policies and procedures.  Contracts are being executed.  Governance models continue to evolve.  Subcontracts and agreements continue to be formalized with network partners.  Active billing for Health Home services (Outreach and Engagement and Active Care Management). 5

Statewide Health Home Enrollment Statistics (Based on Jan 2012 to April 2013 Claims) Total Number Health Homes50 Converting Members# of HH Recipients Engaged in Outreach608 New Members# of HH Recipients Engaged in Outreach10,102 Converting Members# of HH Recipients Engaged in Active Care Management21,962 New Members# of HH Recipients Engaged in Active Care Management6,749 Total # HH Recipients (Distinct count) 34,022 Total Health Home Eligible Individuals (MHSA and others)805,000 # of Higher Risk Members Higher risk members are identified based on predictive risk model and ambulatory connectivity measure; e.g.,those with lower ambulatory connectivity and those more likely to die or have an inpatient or nursing home admission) 224,000 % of Higher Risk Members28% % of Higher Risk Members Enrolled15.2% 6

Total HH Billings from January 2012 – February 2013 as of April 25, 2013 Claim Type Amount PaidClaim CountRecipientsAmount Paid Per Claim Converting Legacy Claims $94,372,022158,88822,286$594 New Health Home Claims $6,998,23438,34815,302$182 Total$101,370,256197,23634,022$514 7

8 Amount Paid Members

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10 Questions?

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