Health Care Homes Community Meeting - December 12, 2008
Transcript
“Next Steps, Health Care Homes Process”
Marie Maes-Voreis RN, MA, Program Manager, Health Care Homes
Minnesota Department of Health
Good morning everybody. I am the newest member of the health care home team at the Minnesota Department of Health. I believe this is the third week that I have worked on the project. And I am very, very excited to be a part of this project. Early in my years as a nurse and as a health care leader, I really became committed to working with patients to prevent some of the care coordination problems that we have talked about today, and a commitment to working as a team, and over the past several years as I have watched my father who has a number of chronic diseases try to maneuver on his own all of the specialties and the care coordination of having new disabilities, I’ve become even more committed to the aspects of care coordination and the work that we are going to do to make better health care for Minnesotans.
So my job today is to tell you a little bit more about the nuts and bolts of how we are going to move forward. As Carolyn shared with you the wonderful work that the collaborative teams have done around the first phase, we are moving into our second phase, and as the Commissioner said, we are going to be doing that in a really rapid way.
We’ve started some foundational work as you can see, looking with starting with the end in mind. We’ve started some outcomes work. We are going to do a very exciting capacity assessment, which I am going to talk more about, and we now have an established consumer and family council. Now, as the Commissioner alluded to, we have some very aggressive timelines.
And this is basically a picture of all of the things we have going on right now, that will continue through, into 2010, and you’ll see at the very top there where it says outcomes, many of you have probably participated in the work that ICSI has been doing, around
developing our first stab at our outcomes. The next part there is related to input, and one of the things that I am really excited about is the opportunity to work with all of you, and to work in establishing our standards for certification. And that’s a process that we are going to start imminently, beginning next week.
You’ll also see that later on in the year we are going to be looking at some grants around how do we establish health care homes, what are the nuts and bolts that we need to put into place, and some opportunities to do some more learning. We have our consumer family council, which we had our first meeting in November, and we are looking at collaborative care models for the future. So let’s dive into some of these details.
First of all, related to outcomes, the first RFP was issued in October to develop broad recommendations for outcomes. That contract was awarded to ICSI, and probably how many of you have had a chance really to participate and get your feedback in. I hope all of you are actively doing that; we really appreciate your feedback. And the work is really exciting, and we are looking forward to see that next final draft.
The next thing here is another RFP that we issued, and that contract was for a capacity assessment, and that was awarded to a professional consortium of state association providers, primary care providers, the association of pediatrics, internal medicine and family medicine, and Stratis Health. We are really looking forward to working with *Kathy Cairns* and her team on looking at the readiness of primary health care delivery systems to implement health care homes. This is really an opportunity to go out, to visit with many of you across the state, and see, well, are we really ready, and what things do we need to put in place.
The next part of that is really the understanding of our consumers. As I sat down and I was talking with my mother about this great project that I was going to be involved in, and she said, “What is a health care home again?” And so I think that she is an example of where some of our consumers may be at, and we want to find out where our consumers are really at.
And the last part of that is to make recommendations about what kinds of building blocks do we need to put in place across the state to be really successful. So we had our first meeting this past week, and this work is just starting and moving ahead quickly.
The next group that I’d like to speak to is the input that we feel very committed to by the public and by our consumers, and we have gone through a process and Carolyn has been leading this project related to seeking out our professional organizations to look for consumers that might like to be participating in our consumer council. So we now have consumers from groups such as the American Heart Association, or the Courage Center, United Cerebral Palsy Association, people that are really living the health care system in our state, and who really want to be involved in giving us input. We will not only have a consumer council, but these people will also be involved in our criteria-setting workgroups as we move forward, and many of you will get an opportunity to meet and work with them, and we really thank our consumers for their time and their commitment to our health care home project.
OK, well this is sort of a big picture. It’s kind of busy, but this is really the model around the community engagement process, and the reason I wanted to show this to you is that every single one of those boxes and circles and triangles up there really are an opportunity for input. And that’s really one of the things that’s critical about the success of our project is a wide amount of engagement.
Now, as we start our criteria process, we’ve established some work groups, and I’ll get into the detail in that in just a bit. But one of the questions that we’ve heard a lot of is, “Who is going to participate in the work groups?” …Because there’s a lot of excitement around this as well. So I mentioned our consumers, as well as we have government agencies and other agencies across the state that represent certain areas of health care. We have our payers. We also have our primary care providers, and we have a good mix of primary care providers on our group that are from the rural sector from greater Minnesota as well as our clinics that serve our minority patients and a variety of different communities. And the last is our professional organizations, which include our clinicians, our nurses, our home care staff, and a broad range of professional primary care provider organizations
OK so this is the first meeting that’s coming up, and the first meeting of the work group is going to be on December 18th with the end in mind. Our outcomes are driving our work during our meeting. We are actually dividing the work into five different care domain groups. At this point and again we are evolving every day related to how we are going to do this, and so we are looking at care partnership and support, delivery system design, community, decision support, clinical information systems, and quality improvement is really a part of each one of these care domains.
The groups will plan to review existing standards that are out there, and quite a lot of work has already been done for us to use as resources across the national scene and across the state as well.
We’ll be looking at identifying some draft standards for each of the care domains and we will begin the process for design of measures and functions within those care domains. So that we can continue to look at the how: How are we going to develop our criteria?
Now, the second phase to that which is built in all along the way is a process of community response, and this is where I hope everyone in this room will provide us your input related to the work that our first work group session has produced. We will be establishing an
Internet survey tool. We are going to be distributing that broadly, and that will be set up with some measurable criteria that have been developed around our triple aim criteria goals in order for us to hear your feedback in a way that we can measure it and see your opinion.
Statewide feedback and public feedback is going to be critical really to the success of how we move forward to the next group, and that’s really our affinity groups or our stakeholder work groups That meeting is now scheduled for January 9th, so what we’ve done is we are taking all of the people that participated in our first groups where we were looking at care domains, and now we put them into their natural groups where they work and they have the most expertise, and we are going to ask those groups to take a look at the community’s response, and the stakeholders work, and really review the standards, prioritize those, help us to continue to define and refine. As the commissioner said we are on a journey here, and so this will take many reiterations of us thinking about what is the best way to lay this out. We are going to then prioritize our work, identify any barriers that are out there related to our success related to our measures, and we are going to be developing a set of recommendations.
Now this certainly won’t be the final work that we do, but related to this part of the process we are looking at two events. Dr. Schiff mentioned that we are going to have an event on January 13th, we hope that you will all come – it should be a great event with our national experts – and we will be asking them to provide us with some feedback and some information regarding their experience. And then on January 14th we plan to reconvene our work group, and this is our opportunity really to look at the fruits of our labors. How does it look? Are we getting to where we want to be? It’s good to have that implementation discussion just around those criteria and develop those recommendations for the Commissioners of Health and Human Services, and we really need to do this by the middle January on our timeline.
OK, so we have a number of other things in development besides our criteria process. First of all, towards the end of January, we’ll begin the expedited rulemaking process. There’ll be a variety of other opportunities in that process for public input. We need to begin the verification process, where we really start to look at the certification registry and all of the components around the certification process.
Next one is really looking at, on the timeline, you saw collaborative learning models, development and testing, what kinds of RFPs will we be putting together for that work? So that we can continue our learning and our testing opportunities, and as Dr. Schiff said, we need to take a look at payment system development. And we’ll be starting that as you saw in the timeline again, early in 2009. And the last, but certainly the most important along our way to measuring our outcomes is to look at how are we going to evaluate our successes so that we really do know that we are making a difference.
Lots of you have questions, and so we wanted to make sure that you have our contact information. You can certainly contact any of us. Pat Adams is in Florida right now but she will be back next week and will be also available, and in addition, you can contact the Web site. … The health care reform Web site. We’ve provided that information. There is general information also about the health care home project. And coming soon, very soon we are going to be adding a spot on the health care reform Web site that will give you specific information about the work groups and the work that is proceeding. You can also subscribe for updates. So if you haven’t done that, it’s very easy. Go in and you can e-subscribe and updates will come out on a regular basis.
So that’s it from our formal presentation today. Lots of things going on and as the Commissioner said, we are evolving and changing, and I think we’ll go ahead and take your questions.
