Adirondack Regional Healthcare Workforce Planning Meeting€¦ · Adirondack Regional Healthcare...
68
Adirondack Regional Healthcare Workforce Planning Meeting March 26, 2014
Transcript of Adirondack Regional Healthcare Workforce Planning Meeting€¦ · Adirondack Regional Healthcare...
Adirondack Regional Healthcare Workforce
Planning Meeting March 26, 2014
Presenter
Presentation Notes
Welcome the Adirondack Healthcare Workforce Planning Meeting. This is the third meeting of a group comprised of representatives from healthcare education and practice in the Northern New York region. This region has been delineated as including Clinton, Essex, ___ counties. I would like to thank Lottie Jameson and Kelly Owens from Hudson Mohawk AHEC for bringing us all together today, and for choosing to hold this meeting at SUNY Plattsburgh with satellite sites at SUNY Adirondack and North Country Community College. Isn’t technology wonderful?!
SUNY Plattsburgh
Presenter
Presentation Notes
Just to set the stage for those of you who are not here in Plattsburgh, we are here in Ausable Hall, the newest building on campus. I took this picture this morning so you would feel like you were here. We are just having the nicest weather here today!
Health-Related Programs: SUNY Plattsburgh
• Biological Science Program – 3+4 Optometry option – Biochemistry – Cytotechnology – Medical Technology
• Chemistry • Communication
Disorders and Sciences – Speech-Language
Pathology, MA
• Clinical Mental Health Counseling, MS
• Nursing Program • Nutrition Program • Pre-med, pre-dental,
pre-veterinary, pre-optometry
• Psychology • Social Work Program
Presenter
Presentation Notes
Here at SUNY Plattsburgh, we have a number of programs that prepare students for health-related careers. Some programs move graduates directly into an entry level position in the workforce, while others prepare them for advanced education. Some do both. Biology and chemistry play a role in pre-professional education (those listed, pharmacy, PT, others). We also have comm disorders, counseling, social work, psychology. Nutrition, and nursing, which I will talk about in more detail later.
Presenter
Presentation Notes
Plattsburgh is part of the SUNY System. I include this map just to remind us all how sparse things can get up here in the North Country. There is much down here, but not much up here. It shows the importance of these meetings to help us work together regionally to meet the healthcare needs of our communities.
Significant Needs • Low number of primary care providers • Low number of psychiatric providers • High number of emergency room visits • Low number of BS prepared nurses
Presenter
Presentation Notes
And we have significant needs. According to data compiled by the Center for Workforce Studies and provided to us in the first meeting held in Lake Placid, we are lacking in numerous health indicators. Compared to elsewhere in the state, we have a low number of primary providers, including primary care physicians and nurse practitioners (I know we will be hearing about physician assistants later, but I have not seen data about that). We have low numbers of psychiatric care providers and high rates of emergency room visits, both for physical and mental health problems. While we have a decent total number of registered nurses, there are too few who are prepared at the bachelor degree level, which creates a whole other set of trickle down problems, including poorer outcomes for hospitalized patients, lack of adequate preparation to work in community based programs, and a hindered ability to go to graduate school to become nurse practitioners or nursing faculty.
RP2
Right Professionals in the Right Places
Presenter
Presentation Notes
This brings us back to our purpose today, to talk about “The right professionals in the right places” (RP2, or is it rp3 – I think Lottie added “with the right preparation”). RP2 was coined by SUNY – I thought it was new, but I think the idea may have been around for a couple of years. I first heard the phrase at our meeting in Lake Placid, where representatives from SUNY System took the lead on helping us think about what this means for our region. At that meeting, we took steps to assess our needs and develop action plans. At our meeting in Queensbury, we explored what the future of healthcare looks like and how new initiatives can help us be ready. As we continue today, we are going to hear about some plans in the works for interesting and innovative programs here in the Adirondack region that move us toward the goal of RP2. Beneath any information I have gathered at these meetings, I think what I have gotten most out them is a focus on collaboration, and I’d like to set that as the backdrop for today. People are talking and asking, How can we partner? How would this work better if we did it together? I feel the spirit of collaboration and breakdown of barriers as I meet with people from community colleges, hospitals and other entities to talk about working together. Our nursing program at SUNY Plattsburgh is involved in partnering Clinton Community College and SUNY Adirondack in developing accessible avenues for RNs to continue to the bachelor degree. We are having that conversation with hospitals as well. We are talking with CVPH about how our planned nurse practitioner program can have some synergy with their family medicine residency program. Collaboration is not easy; it is hard work and it creates an intertwined web that flexes in many directions. But by working together, we can be greater than a sum of our parts and that will be better for everyone. Thank you and enjoy this meeting.
Healthcare Workforce Education and Employer Resource Directory www.gohealthcareer.org
Education/Training info: Information on health related degrees and certificates offered by community colleges, four year colleges and BOCES programs. Also includes information on employer provided training related to HHA and PCA. Funding Resources: Provides information related to scholarships and loan repayment programs for health related fields. Healthcare Employer Resources: Provides contact information for healthcare employers in an 8-county Adirondack region. County specific information provides employer information sorted by: • Acute care • Primary care • Home care • Skilled nursing care • Behavioral Health • Public Health • One Stop contact information
Washington Hall, 640 Bay Road, Queensbury, NY 12804
Phone: (518) 743-2238 * Email: [email protected] * www.sunyacc.edu/ContinuingEd
• Medical Coding ICD-10 Certification Program • Pharmacy Technician • Phlebotomy Technician • Other In-Demand Certifications • Customized Contract Training
Workforce Priority Setting Survey Results
1. Educate guidance counselors on local healthcare jobs and academic preparation
2. Promote healthcare jobs to students/parents/job seekers 3. Provide worksite training in the Business of Healthcare
[supervisions, data analysis, finance skills] 4. Develop nurse educators/other clinical preceptors 5. Create a rural track for Primary Care students/residents 6. Develop career ladders in healthcare management/leadership 7. Promote telehealth/telemedicine 8. Provide worksite training in Team Approach to Care
[communication, teamwork, conflict resolution] 9. Locate healthcare career advisors on college campuses 10.Develop career ladders in care coordination
89%
86%
75%
High or Somewhat High Priority
Champlain Valley Family Medicine Residency
North Country AHEC March 26, 2014
Plan Overview
The Champlain Valley Family Medicine Residency will be a community hospital administered, university affiliated program. FAHC and UVM support is essential.
Mission: To train family medicine physicians that excel in the leadership of high quality and value, patient and family centered care teams for people of all ages in their communities.
Goal: To provide high quality primary care to the region by addressing the short term needs of patients who do not have access to physicians in Clinton County and addressing long term projected primary care physician shortages in Clinton, Essex, Franklin, and St. Lawrence Counties.
Northern New York Core Physician Snapshot
Net Physician Need: 2018 County Fam Prac Int Med Pediatrics OB/GYN Surgery Clinton 4.92 5.4 4.89 (2.51) (0.33) Essex 0.22 13.58 7.22 4.69 3.72 Franklin 6.25 8.13 3.16 2.47 (2.75) St. Lawrence 8.13 16.63 18.37 5.21 (0.43)
TOTAL 19.52 43.74 33.64 9.86 0.21
Age Range 2010 2020 Change
24-44 20% 21% +1% 45-64 66% 62% -4% 65plus 14% 17% +3%
Physician Age & Projected Changes
Future Physician Needs
Source: Center for Health Workforce Studies and HANYS Market Expert
Family Medicine physicians can address the need in the highlighted boxes.
Strengths and Concerns – Residency Program Solutions©
Strengths Fits with mission, vision, & needs of
the hospital & system Significant need in community for
PCPs – aging population and PCP supply Linkage with FAHC & UVM – faculty
develop, scholarly endeavors, student clerkships, potential faculty CVPH Health Center’s new location Strong leadership and physician
support Significant funding opportunities
Concerns Recruitment of Program Director will
be a challenge – Program Director will need training Current Health Center does not
provide family medical care Volumes may require residents to go
elsewhere for pediatric rotation Due to hospital specific Medicare
rate, CVPH is excluded from IME funding
Costs & Funding: 4-4-4 Program
Funding: CVPH will look to alternate sources of funding to offset these costs including the following:
FAP Commitment Funding from NYS Philanthropic support from the CVPH Foundation Grants (NYS Health Foundation, Josiah Macy Foundation, Hearst Foundation, The
Commonwealth, Regional Development Council, etc.) Investments from other organizations for time residents spend onsite
Timeline and Next Steps Fall 2013: Seek approval from CPI & FAP Boards Winter 2013: Petition NYS for funding support Spring 2014: Establish UVM/FAHC affiliation agreements Summer 2014:
Hire Program Director* Identify and hire primary faculty and adjunct faculty* Formal curriculum development Develop MOU for program components Affiliation agreement for away rotations
September 2014: New application form complete Schedule RRC visits
Spring 2015: RCC accreditation Summer 2015: Marketing of program Fall/Winter 2015: First interview season March 2016: Match day July 2016: First residents start
*Contingent on securing funding
MS in Nursing: Adult / Gerontological
Nurse Practitioner
Nursing Programs • Major in Nursing
(BS, pre-licensure) • RN-to-BS Program
– Online – Classes at CVPH – Classes at SUNY
Adirondack
Presenter
Presentation Notes
Well established nursing program BS 200 students RN-to-BS 150 students, 2 cohorts at CVPH 20-30 each, starting at SUNY Adirondack this fall, now recruiting.
Planting the seed • “When are you going to have a
Masters program?” • “How about a DNP program?”
Presenter
Presentation Notes
Every good idea starts somewhere (can you tell I’m anxious to get outside?). It all starts with a seed. For many years, we have had graduates and other nurses in the area ask us about starting a masters program. I will admit we have started the journey in the past, but the timing was never quite right to move forward. Currently there is increased interest in advancing nursing education, including raising the number of advanced practice nurses who can provide primary care to meet the healthcare needs of communities that I mentioned previously. And since our region has the needs already identified, we were asked by SUNY System to think about what we could do to contribute. During an e-mail exchange to discuss SUNY Adirondack program, it was suggested that we consider a offering a doctor of Nursing practice degree, a DNP. SUNY noted we had a strong BS program, had a successful accreditation visit, and a dearth of options in this region for graduate nursing education.
MS in Nursing • Does not require master plan
amendment • Provides earlier graduates who can
meet healthcare needs • Phases in transition to DNP
Presenter
Presentation Notes
Then we had to decide exactly which seed to plant. We wanted to make sure we could handle what we planted, and there were some considerations related to a DNP that made it less attractive as a starting point for us new gardeners. Also, further discussion with SUNY and the nursing representative at the State Education Department led us to pursue a nurse practitioner program at the MS level. Let me just explain a bit about nursing degrees for a second. Nursing currently requires that nurse practitioners obtain a MS degree, but we are transitioning to a requirement for the doctor of nursing practice. Although this is suggested to happen by 2020, it is likely that the deadline will be later than that. Anyway, with the strong suggestion from SUNY and the State Education Department following our very successful accreditation visit, we got to work.
Adult / Gerontological Primary Care
• Clinical availability • Faculty expertise • Meets community needs
Sprouting • Letter of Intent approved • Curriculum and program
approved by department • Submitted to division • On to Faculty Senate, SUNY, State
Education Department • Fall 2015 start (Hopefully!)
What it will look like… • Primarily online, low residency • Synchronous seminars, possibly with
Family Medicine Residents • Curriculum (14 courses)
– Graduate nursing core – Direct care core – Adult-gerontological core – 500 hours of clinical
Room for growth • DNP • Other tracks
Clarkson Physician Assistant Program
Physician Assistants
• Origins • Physician / PA Team • Interdisciplinary team approach • Services: Conducting physical exams Obtaining medical histories Diagnosing and treating illnesses Ordering and interpreting tests Counseling on preventive health care Assisting in surgery Prescribing medications
PA Education
• Average 27 months • Medical model • Total Immersion • Clinical Areas
– Ambulatory Med - Behavioral Health – Internal Med - Women’s Health – Peds - General Surgery – ED - 2 Electives
Clarkson’s Master of Science Degree
• 28 months – 7 consecutive semesters • 3 phases
– Didactic (12 months) • Modular format
– Clinical (15 months) – Summative (1 month)
• 700 applicants for 20 seats • 6 full time faculty – 2 adjuncts – 2 staff and
part-time Medical Director
History
• Discussed initially in 2008 • Chair hired February 2010 • Directors hired September 2010 • NYSED application November 2010 • ARC-PA application January 2011 • ARC-PA site visit April 2011 • ARC-PA and NYSED approvals September
2011
History
• Applicant interviews • Clinical site exploration ongoing • Charter class January 2012
Students
• Total 56 in 3 classes – Majority from NY State • Class of 2014 - graduates in May • Class of 2015 – in Clinical Phase • Class of 2016 – in Didactic phase 1st semester • Class of 2017 – interviews in progress • Avg GPA 3.4 (current students) • 172 Pre-PA undergrad applicants for Fall
Clinical Sites
• St. Lawrence • Jefferson • Franklin • Clinton • NYC
Challenges
• Clinical Sites – Administration – Preceptors – Promises vs. Reality – Expectations of stakeholders
• Faculty – Recruitment – Retention
• Student recruitment – More NNY applicants – More diversity
Health Professions Moving Forward
• DPT program > 30 students this year • PA program > 30 students in 2-3 years • OT program under construction
Questions?
Service Area – Clinton, Franklin, and Essex Counties Funding – NYSDOH, Charles D. Cook Office of Rural Health Health Workforce Initiative: Improve health system capacity by
advancing workforce training/education within the region. Research based training programs to ensure a dementia-capable frontline
workforce. Institute for Health Care Improvement’s Triple AIM Initiative – Sponsor
training for current and future health care providers through IHI Open School.
Support the development of Graduate Certificate Programs.
Occupational assessment of aging related workforce training needs and
resources that can be shared among providers.
2014 Survey Results
Sponsored by the Eastern Adirondack Healthcare Network with funding from the New York State Department of Health and the Charles D. Cook Office of Rural Health
Eastern Adirondack Health Care Network Northern Area Health Education Center, Inc.
(NAHEC) Adirondack Rural Health Network Hudson Mohawk AHEC
Survey the training needs of incumbent healthcare workers and existing community resources
To link providers with existing resources 75 Healthcare facilities in 7 counties 61% response rate
0.0% 5.0%
10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0%
Nursing Home Hospital Public Health Mental Health
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0%
0.00 0.50 1.00 1.50 2.00 2.50 3.00
Entry level nursing (CNA; …
Business Office/Billing Staff
Nursing (RN/BSN)
Management (Department …
Physician Extenders (NP’s, PA’s)
Physician (Category I CME)
Geriatric Mental Health … Changing Models of Care
Billing & Coding Teamwork/Communication in …
DSM V Assessment Customer Service
Leadership & Management Training Soft Skills for Entry Level Employees
0.00 1.00 2.00 3.00
33%
67%
Respondents Willing to Share Existing Training
Yes No 90% of Yes Respondents willing to share /conduct at no charge and were willing to provide contact information regarding same.
Dementia/Behavior Modification Medication Management Wound Care Home Health Aide; Certified Nurse Aide;
Personnel Care Aide Training; CNA to HHA Infection Control Diabetes Education Elder Abuse/Neglect Team Building Open seating at various sessions
Yes 65%
No 35%
Respondents Currently Using LMS
57% of those not currently using an LMS were interested in doing so.
Mandatory trainings
(i.e. fire safety, etc.) 41%
Continuing Education programs
39%
Other 20%
LMS Uses
Team building and communication 24/7 interactive, engaging modules End of Life transitions Coding/documentation (2) Outcomes/performance measures (2) Nursing skills competency Cultural competency Patient education Project management
Leadership Series New Nurse Residency Program General/Clinical Orientations Hospice Expertise/Bereavement Life Safety Programs Vendors Technology (3) (Equipment/LMS/Internet) Home Health/Personnel Care Aide Training Membership services
CE is important; take every opportunity Need for low/no cost alternatives Online resources that are reliable and
affordable
Complete data base of workforce training resources (topics/contacts) to be shared among regional providers at low or no cost.
Follow up with respondents who are interested in Learning Management Systems
Opportunities for Telemedicine in NNY March 26, 2014
Organizational Mission Statement ◦ Our mission is to lead North Country
healthcare organizations in transforming our regional healthcare systems…through collaboration, engagement, planning, and development.
Member Hospitals ◦ Alice Hyde Medical Center ◦ Canton-Potsdam Hospital ◦ Claxton-Hepburn Medical Center ◦ Massena Memorial Hospital ◦ Samaritan Medical Center ◦ Community Providers, Inc. (Champlain Valley
Physician Hospital & Elizabethtown Community Hospital)
Presenter
Presentation Notes
This mission statement was updated in May 2012. Former Members Clifton Fine Hospital EJ Noble Hospital North Country Healthcare Providers, LLC NCHP was formed in 1998 Membership organization North Country Healthcare Providers Educational & Research Fund, Inc. NCHPERF was formed in 2003 NCHP is the sole Member of NCHPERF Oversight by Board of Managers and Executive Committee
Rural Health Network funded project The study will identify our current state and
gaps, assess opportunities and their associated costs, and provide a return on investment analysis for three focus areas including: ◦ Telemedicine ◦ Professional development ◦ Voice Over Internet Protocol (VoIP) services
Presenter
Presentation Notes
Within the last five years, our North Country region was enhanced by the creation of two regional fiber optic telecommunications/telemedicine networks that were made possible through federal grant funding. The first network was completed in 2010 and is named the North Country Telemedicine Project (NCTP). The second network will be completed by April 2013 and is named the Adirondack-Champlain Telemedicine Information Network (ACTION). An interconnection between NCTP and ACTION is expected to be complete by the end of January 2013 which will connect all of the participating entities on NCTP and ACTION into a single logical network. Please see Attachment 7 (pages 1-2) for a listing of hospitals on the network and supplemental material related to the networks and completion of this objective. This project intends to leverage the federal resources that our region has received to build these networks by developing a consolidated study of the meaningful utilization of the two aforementioned fiber networks that cover our service area. The study will identify our current state and gaps, assess opportunities and their associated costs, and provide a return on investment (ROI) analysis for three focus areas including the movement toward VoIP services; telemedicine; and professional development with appropriate next steps. The focus of the study will be on the 14 rural hospitals located on the networks. Given that NCHPERF is the only organization that bridges the gap between the NCTP and ACTION fiber networks and our member hospitals are connected to either network, NCHPERF is the appropriate entity to successfully carry out this project. NCHPERF will partner with FDRHPO who will provide the technical consultation required to successfully conduct this study. FDRHPO partnered with the Development Authority of the North Country to build the NCTP network and currently manages the network and has the technical expertise on staff to conduct the necessary analyses required to summarize the current state of the network, which will be an important aspect of the utilization study. As part of FDRHPO’s consulting partnership with NCHPERF, FDRHPO will hire a Fiber Network Coordinator who will coordinate all project activities, engage stakeholders, and record all project milestones. The consulting team at FDRHPO will lead the utilization study and will be responsible for creating the final utilization plan and return on investment analysis. In addition, NCHPERF will partner with FDRHPO to convene a joint working group that is representative of members from both networks for the purpose of analyzing the results of the study, assessing progress, and making recommendations to each partner on how they can meaningfully utilize the networks. NCHPERF understands the importance of combining efforts with like-minded organizations to ensure its organizational asset are complemented to ensure project success. As a result, NCHPERF will collaborate with the AHI/ARHN and FDRHPO throughout the project. All three organizations will convene at least quarterly to strategize how best to focus attention, build momentum, and ensure the success of the meaningful utilization study with the five year goal of developing a rural, regional center of excellence for the meaningful utilization of fiber networks. The North Country Initiative or NCI is a joint initiative between seven hospitals located in Jefferson, Lewis, and Sothern St. Lawrence Counties funded under a NYS HEAL grant. The initiative focuses on six areas one of which telemedical capacity and capability. The goal of this telemedical capacity and capability focus area is to improve the distribution of, and expand access to, community-based and specialty services through connectivity, deployment of mobile telemedical capability within each hospital in the region, select primary care clinics, and home telehealth. Progress to date: 1) Connecting additional hospital practices to the fiber network 2) Clinical Advisory Workgroup meeting regularly to look at potential telemedical opportunities for the area 3) home telehealth devices purchased and deployed 4) telemedical equipment for hospitals, emergency departments, and primary care clinics purchased and deployed.
Presenter
Presentation Notes
Regional fiber optic networks North Country Telemedicine Project (NCTP) Adirondack Champlain Telemedicine Information Network (ACTION) – Managed by NCHP. FDRHPO Telemedicine/Fiber Network Program North Country Initiative – HEAL 21 grant to purchase telemedicine equipment
Lack of regional/statewide investment ◦ Recommendation: Coordinated Statewide
investment is required. Become a statewide leader in telemedicine.
Lack of a centralized coordination to make it happen ◦ Recommendation: Develop a rural New York State
Telemedicine Resource Center. Policy development ◦ Recommendation: Ensure licensing and
credentialing policies do not hinder growth. License held in the state in which the provider is located not the state in which the patient is located.
Presenter
Presentation Notes
Reimbursement from Medicare Jefferson County is no longer an eligible patient location given MSA Proposed 2014 changes may reverse this The Centers for Medicare & Medicaid Services (CMS) recently released its telehealth program reimbursement changes for Calendar Year (CY) 2014. In summary, the changes will allow Medicare telemedicine reimbursement in Jefferson County as all of the zip codes in Jefferson County are within a rural census tract of the County’s MSA as determined by the Office of Rural Health Policy (ORHP) of HRSA. However, the current scale used to measure this is a 2006 version which was last updated on 11/13/2007. Unfortunately, the codes are expected to be revised in late 2013 and therefore, we may again lose Medicare reimbursement depending upon how they revise the codes. We will just have to wait and see what happens and continue to keep an eye on this moving forward. Text from the proposed changes: CMS clearly expands the potential geographic area for a facility to be considered an “Originating Site”. The Proposed Rule, in addition to retaining the non-MSA county eligibility for telehealth reimbursement, proposes that an Originating Site can also be: Located in a HPSA (any type) that is either: o Outside of a MSA; or o Within a rural census tract of an MSA as determined by the Office of Rural Health Policy (ORHP) of HRSA. E.g., utilizing rural-urban commuting area (RUCA) codes (http://www.ers.usda.gov/data-products/rural-urban-commutingarea-codes.aspx#.UdxUEUHVDw9), with a “rural census tract” being defined as having a value of 4-10 on the 10 point RUCA scale, or having a 2 or 3 RUCA value that is also at least 400 square miles and has a population density of less than 35 people per square mile. The Proposed Rule would also expand Medicare reimbursable telehealth services to include “transitional care management services”. CPT Code 99495 o Transitional care management services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge medical decision making of at least moderate complexity during the service period face-to-face visit, within 14 calendar days of discharge; and CPT Code 99496 o Transitional care management services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge medical decision making of high complexity during the service period face-to-face visit, within 7 calendar days of discharge. These services are for a patient whose medical and/or psychosocial problems require moderate or high complexity medical decision making during transitions in care from an inpatient hospital setting (including acute hospital, rehabilitation hospital, longterm acute care hospital), partial hospitalization, observation status in a hospital, or skilled nursing facility/nursing facility, to the patient’s community setting (home, domiciliary, rest home, or assisted living). Transitional care management is comprised of one face-to-face visit within the specified time frames following a discharge, in combination with non-face-to-face services that may be performed by the physician or other qualified health care professional and/or licensed clinical staff under his or her direction. CMS’s Proposed Rule would allow the face-to-face visit component of 99496 and 99495 to be delivered via telehealth (and, of course, the other service components of the CPT code can be made via non-telehealth communication. The Proposed Rule also makes technical corrections to 42 C.F.R. § 414.65 (Payment for Telehealth Services) to more closely align it to the similar list of permissible telehealth services at 42 C.F.R. § 410.78 and current telehealth reimbursement policies as reflected in CMS manuals. Source: http://www.americanbar.org/content/dam/aba/administrative/healthlaw/ehealth_telehealth_proposed_rule.authcheckdam.pdf
Current Medicaid reimbursement is limiting Recommendations: ◦ Expand eligible spoke and hub sites to include: Article 31 clinics (i.e Behavioral Health) Skilled Nursing Facilities (SNF) Private practices Federally Qualified Health Centers (FQHC) regardless of
opting in or out of Ambulatory Patient Groups (APGs) ◦ Expand eligible providers to include: Psychologists Social workers Psychiatric nurse practitioners Physician extenders (NPs & PAs)
◦ Coverage for telemedicine should be required in Medicaid Managed Care (MMC) plans
Presenter
Presentation Notes
Changes that should be included in the Medicaid reimbursement policy: Expand eligible sites to include primary care practices, Article 31 clinics, and those that haven’t opted into APGs What about schools? (non-SBHCs) Expand providers to include psychologists and social workers Ensure facility fee is maintained Telemedicine reimbursement should be required. Remove “coverage for telemedicine services by Medicaid Managed Care (MMC) is optional.”
Private payer reimbursement is minimal ◦ Recommend an all-payer mandate: Reimbursement
should be available for those services that would ordinarily be covered if delivered in person
Presenter
Presentation Notes
We are very supportive of: NY Pending Legislation SB 4337: This bill would require that every policy (including group or blanket policies and the state’s medical assistance program) provide coverage for services delivered via telemedicine, if those services would ordinarily be covered if delivered in person. As of August 2013, there are 20 states plus the District of Columbia that have an all payer mandate. NYS Telehealth Resource Center – to share best practices, to learn about processes and next steps, a resource to connect locations who want to participate in telemedicine. A NY specific center would be better than the North East Telehealth Resource Center which serves New England and New York given that the state issues are so different. Finding providers who accept insurances that cover telemedicine is challenging Behavioral healthcare providers in particular Finding specialty providers willing to provide care via telemedicine Reimbursement must be similar to an in-person visit
Tracy Leonard Network Director [email protected] David Storandt Telemedicine Project Coordinator [email protected] Corey Zeigler Director, North Country Health Information Partnership [email protected]
Main Office: (315) 755-2020
Objectives: April 2014 – March 2015
1: Develop, implement, and support strategic regional health planning.
• Continue to convene public health, hospital, and community-partners. • Expand involvement of behavioral health providers in the planning process. • Ensure planning is evidence-based and data-driven.
2: Establish and facilitate an all-inclusive regional process for review of funding opportunities, prioritization, and subsequent joint planning of programs and/or applications.
3: Increase access to high-quality chronic disease preventive care and management in clinical and community settings. • Provide health care organizations and clinicians with training related to quality improvement and the use of
health information technology to increase the use of clinical preventive services and disease management. • Highlight community needs and communicate disease burden to engage consumers, communities, and
relevant stakeholders • Promote awareness of, and demand for, community preventive services. 4: Ensure the Adirondack Rural Health Network is well-positioned to become part of a Regional Health Improvement Collaborative. 5: Coordinate and collaborate with Northern NY Rural Health Networks.
What’s New With…
DSRIP and SHIP Delivery Systems Reform Incentive Payment Program State Health Improvement Plan North Country Health Systems Redesign Commission Funding Applications
- Stephanie Fargnoli, SUNY
- Cathy Homkey, CEO Adirondack Health Institute
- Heather Eichin, SUNY
Key Components of DSRIP
Open to public and safety net providers
Payments are performance-based
REDUCE AVOIDABLE
HOSPITALIZATIONS STATEWIDE BY
25%
Requires regional collaboration
Pre-approved menu of projects to choose from
Transform the healthcare delivery system by working together to improve quality and health outcomes while lowering cost
Develop programs and investments that address those needs, with measurable metrics and milestones
Identify community needs, healthcare challenges and quality objectives
Partners should include: Hospitals
Nursing Homes
Clinics & FQHCs
Behavioral Health Providers
Home Care Agencies
Other Key Stakeholders
Regional Collaboration
SUNY High Needs Program for Health Care
Over $18 million dedicated to increasing nursing and medical technology students from 2006-2011. Enrollment in Nursing programs has increased by over 2,700 in Bachelor programs, 950 in Masters, and 185 in Doctoral programs from 2007-2012 In 2013-14 Competitive RFP, 9 awards were made in Healthcare for a total of over $2.7 million. RFP to be issued in April for 2014-15 cycle, grant proposals in areas of high levels of nursing, occupational therapists, physical therapists, physical therapy assistants, radiologic technologists/technicians, diagnostic medical sonographers, pharmacists, and medical health service managers
What’s Next…
• Communication Strategy/Format/Frequency
• DSRIP Planning Forums • April 7 – Plattsburgh Holiday Inn • April 8 – High Peaks Resort, Lake Placid • April 10 – Queensbury Hotel
Two or more with an intersection of a common objective Join forces – share ideas, experiences, resources Win/win – let go of control Intentional structure Ongoing facilitation Critical reflection Common goal achieved
Collaboration
