by Brett Kinsler | Aug 13, 2017 | Conferences, DSRIP, HIT Strategy, innovation, Interoperability, Quality Care, Transitions of Care
Chicago, August 2017 — Al Kinel discussing care transition IT strategy at Allscripts Population Health University
As part of the Allscripts Population Health University held August 8 – 10, 2017 at Chicago’s McCormick Center, Strategic Interests president, Al Kinel, led a presentation explaining the improvement of care transitions using information technology. As seasoned implementation agents for Allscripts dbMotion product, SI understands first hand how the timely exchange of pertinent information positively impacts transitions of care from clinical, technical and strategic angles.
Kinel was joined by two SI clients who discussed their experience with interoperability and transitions of care: Erik Jacob, Manager of IT Interoperability at Rochester Regional Health, discussed the projects in Rochester from the Community Diabetes Collaborative through the merger of multiple hospitals and practices. Brian Henderson, Director of Physician IT Services at Sarasota Memorial Hospital presented the project connecting ambulatory community providers to the hospital’s health information exchange, SMHxchange. Finishing the talk, Strategic Interest’s Director of Clinical Services, Brett Kinsler, DC presented the methodology used to identify gaps and prioritize data elements to be exchanged to facilitate a Medicaid DSRIP program.
Chicago, August 2017 — Erik Jacob presented Rochester Regional Health’s interoperability process
Overall, the team defined the value of Health Information Exchange (HIE) with specific use case examples and described how innovative solutions can impact organizations and practices, increase care quality, decrease duplication of services, prevent unnecessary readmissions, and enable innovative payment models while attaining strategic objectives and enhancing partnerships among hospitals, LTPACs and community providers.
We appreciate being invited by Allscripts to present a topic we are so passionate about and are grateful to our client partners from RRH and SMH for bringing real life examples and experience to the discussion.
by Brett Kinsler | Sep 18, 2015 | DSRIP
We’ve had several meetings with clients who have asked us about DSRIP. For the well-informed, you can skip this blog post, but for everyone else, we offer this brief DSRIP 101 primer:
Q. What is DSRIP?
The Delivery System Reform Incentive Payment Program is a Medicaid restructuring plan that reinvests money into the health care system in an effort to transform how hospitals and providers deliver care to Medicaid recipients.
Q. Why does Medicaid need restructuring?
Really?
Q. Yes, really. What is wrong with Medicaid?
Soaring costs for the government coupled with huge cuts to providers has led to difficulty in access for the patients with Medicaid. Plus, Obamacare requires states to add an additional 20 million people to the system — mostly pregnant women, children and the elderly. Just having a Medicaid card in your wallet is far from a guarantee of care. Many physicians decline to participate citing low reimbursement and mountains of paperwork to complete. There is also evidence that Medicaid enrollees receive a lower quality of care. A study from the University of Virginia found that Medicaid patients have worse surgical outcomes than individuals without insurance, even controlling for numerous confounding factors. As Federal spending for Medicaid has gotten out of control, there have been three bailouts to the system.
Q. How much is spent on Medicaid in New York?
New York’s Medicaid program is the single largest health care payer, serving more than 6 million (one in three) residents. Total spending on Medicaid in New York is expected to reach $62 billion this year alone.
Q. What are the main DSRIP focuses in New York?
Reduce avoidable hospitalizations by 25% through a series of transformative investments in community based care, including expanded care coordination, facilitated access to care, integrated health and behavioral health, and others, and to better manage chronic health conditions.
Q. How much money is available in New York for DSRIP?
$6.42 Billion over the next 5 years.
Q. What is a PPS?
Performing Provider Systems are the groups that submit DSRIP applications. They comprise eligible public hospitals and safety net providers in each pre-existing or newly formed networks. Included are health and behavioral health care providers, social service providers and community-based organizations. Safety net partners can include an array of providers: hospitals, health homes, skilled nursing facilities, clinics & FQHCs, behavioral health providers, community based organizations and others.
Q. Is membership in a PPS is enough to receive payment from DSRIP?
To receive payment, the PPS must coordinate in order to meet predetermined benchmarks and achieve outcomes related to each project. Goals are set by each PPS in accordance with their community needs. Incentive payments are not guaranteed, but can be utilized at the discretion of the network.
Q. How many PPSs are in New York State?
There are 25 in New York. Our region is part of the the Finger Lakes PPS (FLPPS).
Q. Which states have DSRIP programs?
The program was originally introduced in California and followed by Texas, Massachusetts, New Jersey, Kansas and New York. Other states are expected to establish DSRIP programs soon as well.
Q. Is the program the same from state to state?
DSRIP differs somewhat across state borders but there are some common themes that are universal: DSRIP initiatives promote collaboration, support innovation, and bring renewed attention to social services.
Q. So DSRIP is the same as Managed Medicaid?
Not quite. While DSRIP waivers often share many of the same goals as Medicaid managed care programs – slowing the rate of growth in spending, improving care and offering greater accountability, DSRIP offers providers – rather than health plans – the opportunity to change the way that they provide care. Keeping that in mind, the relative roles of DSRIP-funded provider networks and managed care plans has not been fully defined in all situations.
Q. What does Strategic Interests have to do with DSRIP?
SI has strong relationships with several PPSs, their founding partners and members. We’ve collaborated to define vision, write grants, provide strategic planning and formulate vendor selection in alignment with DSRIP initiatives. We understand the DSRIP big picture for individual organizations up to nationwide commercial ventures and everything in between.
by Strategic Interests News | Sep 15, 2015 | DSRIP
On October 8, 2015, Strategic Interests president Al Kinel is scheduled to speak at a Digital Rochester/HIMSS partnered educational event. Per the NYS Department of Health, DSRIP´s purpose is to fundamentally restructure the health care delivery system by reinvesting in the Medicaid program, with the primary goal of reducing avoidable hospital use by 25% over 5 years. Up to $6.42 billion dollars are allocated to this program with payouts based upon achieving predefined results in system transformation, clinical management and population health. Many of the projects in the DSRIP program require subtantial technology initiatives around analytics/reporting, interoperability, and infrastructure.
Join us and learn about the IT initiatives required to support this transformation and what is being done in the Rochester and Western NY area to facilities the technological requirements.
Speakers include:
Chris Bell, Sr. Project Manager, Finger Lakes Performing Provider System
Al Kinel, President, Strategic Interests
Denise DiNoto, Director of Community Services, Rochester RHIO
Jose Rosario, Director of IT & Analytics, Finger Lakes Performing Provider System
When: Thursday, October 8, 2015
Time: 7:30 AM
Where: Locust Hill Country Club
2000 Jefferson Rd, Pittsford, NY 14534
Admission: $20 for DR Members, $35 for Non Members.
Promo Codes: Not-for-Profit Attendees, use promo code NFP2015
Register or get more information here
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