Adirondack Health Institute News

Project Design Grant Awards Pending

DOH anticipates making DSRIP Project Design Grant Awards on August 6th.   In the interim, AHI leaders and members have been in dialogue with legal experts on DSRIP governance options, and RFPs for consultant services are in development.  No formal commitments can be entered into until after an award is made.  The Adirondack Rural Health Network has begun the required community health needs assessment; community and partner involvement will be solicited in the coming weeks.  Partners can expect meeting invitations and updates to commence in early August.

 

NOTE:  AHI employees have new e-mail addresses, following the convention “firstinitialastname@adkhi.org ”.  For example, Colleen Florio’s new e-mail is  cflorio@adkhi.org.  The DSRIP mailbox is now DSRIPahi@adkhi.org

Emerging Performing Provider Systems Request $76.2 million in Planning Funds; Capital Needs Estimated at $4.2 billion

New York State DOH received 50 DSRIP project design grant applications with budgets totaling $76.2 million and capital estimates reaching a total of $4.2 billion.  Budget requests for the one year planning period (the “project design grants”) range from $340,000 (Health Alliance of the Hudson Valley serving Delaware & Ulster Counties) to $5.6 million (American Dental Offices, PLLC serving Nassau & Suffolk Counties).  AHI’s budget of $891,000 is at the 41st percentile in the budget distribution.  Projected capital needs ranged from 0 to 1.18 billion (SUNY Downstate Medical Center), with an average of 94.9 million.  AHI’s capital estimate of $122,973,200 falls at the 73rd percentile in the distribution of capital needs. The source for proposal budget information is the summary posted by DOH here.

DSRIP Project Design Grant Applications POSTED

Applications for DSRIP planning funds were due on Thursday, June 26, 2014.  The DOH received 50 applications. These applications will be reviewed by the state team, and awards for accepted applications will be made on August 1, 2014.  To view the received applications, please refer to the following web page: http://www.health.ny.gov/health_care/medicaid/redesign/dsrip_award_letters/ .  A summary is available here.

Simonik Promoted to AHI Accountant

Diane Simonik has been promoted to the position of AHI Accountant. Diane joined AHI in December 2013 as an Accounting Specialist.  “Diane quickly displayed a strong understanding of administering fiscal policies and procedures and has been instrumental in improving efficiencies,” stated Ann Pepe, Director of Finance.  “She will continue to play a significant role supporting the finance department with the general ledger, financial reporting, and reconciliation of audit schedules.”

 

Capital Needs and DSRIP

The DSRIP Project Design Grant application included projections of capital needed by PPS partners to implement DSRIP programs.  Cost-effective health system redesign will require repurposing existing infrastructure.  In some areas, there is a need to expand primary care to ensure ready access for Medicaid beneficiaries.  Capital investments may be needed to support other DSRIP programs as well.  The PPS partners were surveyed to provide estimates of their capital needs under DSRIP.  Two summaries of the survey responses are available here. These numbers are projections.  A formal capital request will be part of the final DSRIP Project Plan that is due in December.  In the interim, the PPS governance will be established and will need to make determinations about what capital investments are vital to the ability of the PPS to achieve DSRIP goals.

DSRIP Capital Needs Estimates pdf
Capital Estimates pdf

DSRIP: An Opportunity to Implement Recommendations of the North Country Health Systems Redesign Commission

The emerging Performing Provider System’s (PPS) vision is to realize the primary recommendation of the North Country Health Systems Redesign Commission (NCHSRC), “to ensure that New Yorkers in the North Country achieve high quality care, better health outcomes, and lower costs, both now and into the future”. When New York State DOH Commissioner, Nirav R. Shah, M.D., M.P.H., announced the formation of the NCHSRC, he charged the Commission with a goal “to create an effective, integrated health care delivery system for preventative, medical, behavioral, and long term care services to all communities throughout New York’s North Country.” This is the same overarching goal of the emerging PPS.

The Commission points to an integrated approach that “emphasizes prevention, increases primary care, builds more community-based options, strengthens coordination and communication, supports critical safety net providers, monitors and rewards quality, and builds affiliations and partnerships that achieve these goals in a cost efficient and fiscally sound way”. The PPS proposes a set of DSRIP projects that will make real the integrated approach to delivery system redesign that the Commission recommends.

The main objective of DSRIP is to reduce avoidable hospital use by 25%. To get there, the emerging PPS will create the appropriate infrastructure and care processes needed to promote efficiency and to support prevention and early intervention.  Goals include: (1) expand primary care, (2) integrate care through the cooperation of inpatient, outpatient, institutional, and community-based providers, (3) improve communication and coordination across settings of care, and (4) expand community-based options, and (5) educate providers, patients, and communities about palliative care and hospice options.

To date, over 100partners are involved in the planning; AHI cast a wide net and invited all public and private health care organizations to the planning table. The breadth and depth of partners at the planning table lends itself to formation of a sustainable new network.

The PPS will work to leverage, and reconfigure where needed, existing infrastructure to support the DSRIP plan. This includes hospital and nursing home infrastructure, as well as health information technology. HIT readiness for performance based contracting will be assessed, and the PPS will seek to build on existing HIT infrastructure as part of a long-range regional HIT plan. Similarly, the PPS will work closely with the Hudson-Mohawk Area Health Education Center to ensure a long view of workforce development is paired with short-term needs for training.  The PPS will be sustainable in part because it will be grounded in long-range strategic planning for facilities, HIT, and workforce. Another key facet of sustainability will be the ability of the PPS to negotiate contracts with Managed Care Plans.

July 2014 AHInsider Newsletter Published

AHI has published the latest edition of our newsletter, AHInsider — July 2014.  This issue spotlights a number of initiatives, including a planning grant to reduce avoidable emergency room visits and potentially preventable inpatient stays, and a grant to train or retrain health industry workers.