What is the VIP?
Behavioral and medical health care is transforming at a rapid pace. We are experiencing a much needed and welcomed paradigm shift in healthcare as it moves from a volume-based care system to a value-based care system. Regulators and organizations across the nation are seeking ways to measure care that focuses on individuals’ outcomes.
Partners is dedicated to being a leader in North Carolina’s public behavioral health system. We are collaborating with our network of providers to develop the Value, Innovation & Performance Program, also referred to as VIP, a value based system that promotes and measures the impact of high-quality healthcare with improved outcomes.
We welcome you to review the information and resources below to learn more. If you have questions or feedback, please email email@example.com.
The Development of VIP
Partners kicked off a collaborative project earlier this year to begin planning and developing a formalized value-based program. In early 2017, Partners held two consortiums to solicit input and involvement in this transformation. Members of Partners’ network of providers, along with the Consumer and Family Advisory Committee (CFAC) shared recommendations and offered valuable input and assistance toward measuring performance and outcomes, along with assisting in the development of the overall program.
This program is a work in progress, and, through the collaboration between providers and Partners, we plan to implement a measurement and outcomes-based program that illustrates our joint value to our community and demonstrates how we improve the lives of those we serve.
Partners has developed a resource list of various healthcare outcomes and performance measures. We hope this listing will help you, the provider, in individual efforts to support value-based measurement and outcomes.
|Hospital Compare||https://www.medicare.gov/hospitalcompare/search.html||Compare Hospitals based on their Medicare Star Rating|
|Quality Net||https://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetHomepage&cid=1120143435383||Established by CMS – provides QI resources, tools and information|
|Health Resources Services Administration (HRSA) Quality Toolkit||https://www.hrsa.gov/quality/toolbox/index.html|
|Substance Abuse Mental Health Services Administration (SAMHSA) – National BH Quality Framework (NBHQF)||https://www.samhsa.gov/data/national-behavioral-health-quality-framework|
|CMS Quality Strategy||https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/CMS-Quality-Strategy.html|
|Institute for Healthcare Improvement (IHI)||http://www.ihi.org/resources/Pages/default.aspx|
|National Quality Forum (NQF)||http://www.qualityforum.org/Qps/||National Measures Search tool and resources|
|The Joint Commission||https://www.jointcommission.org/core_measure_sets.aspx||Link to TJC Core Measures|
|NC Treatment Outcomes and Program Performance System (NCTOPPS) at a Glance||https://nctopps.ncdmh.net/ProviderQuery/Index.aspx||LME/MCO and Provider performance and outcomes comparison tool|
|NC State Center for Health Statistics (SCHS)||http://www.schs.state.nc.us/data/keyindicators/||State and County key indicator tools|
|Council on Quality & Leadership (CQL)||https://www.c-q-l.org/resource-library/toolkit-for-states||State toolkits|
|NCQA – HEDIS||http://www.ncqa.org/HEDISQualityMeasurement/HEDISMeasures.aspx\||NCQA establishes and manages national HEDIS measures.|
|Medicare Access & CHIP Re-Authorization (MACRA)||https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html||CMS link to MACRA related information. Includes various elements, including the Quality Payment Program & related information|
|MIPS||https://qpp.cms.gov/measures/quality||Direct link to the CMS Medicare MIPS measures (Note: PQRS is now part of MIPS)|
Questions & Answers
Below are the questions and answers presented at the Provider Consortiums.
Stay tuned for opportunities to further discuss this topic. We will inform you of future conversations via email and in Partners’ Provider Communications (Provider Communication Bulletin and Provider Alerts).
If you would like to be involved in further discussion and opportunities, you may contact your Provider Network Account Specialist.
What about the other discussion points in the groups that did not make the list of top three? Will Partners look at those other discussion points, as some of those points were a common theme?
Partners Response: Yes, we are reviewing all the information shared in the breakout groups. We will share the information with the Provider Council. We will engage with the Provider Council to obtain more stakeholder involvement as well as direction from the Provider Council and our internal Quality Improvement Committee on the best way to move forward.
What is the procedure for submitting individual agency’s process for collecting and reporting outcomes prior to Partners finalized plan as Rhett Melton referred to?
Partners Response: Please send to your assigned Partners Provider Network Account Specialist.
How to best support the MH/IDD consumers in IDD services during MH episodes (i.e. psychosis/mania)?
Partners Response: Having effective, objective outcome data should help drive knowledge of service and transition gaps, therefore improving services to all disabilities and those who overlap disability groups.
Medical fields (Hospitals, MH, SU) can measure more easily and already have tools
IDD (very diverse) more difficult to measure
IDD must measure agency attributes
Utilize the Peer Review Concept
Partners Response: We agree that coming up with appropriate outcomes for IDD is a difficult process, which is why we wish to continue engaging with stakeholders to find an effective set of tools. We must remain focused on individual and group outcomes, not simply attributes or outputs.
For both IDD groups, during the group reports: maintenance of the client skills was discussed in both groups but did not make any of the list. Will that be addressed?
Partners Response: Yes, maintenance of skills is potentially a valid outcome for several subsets of those we serve: the elderly, traumatic brain injury, and some individuals with IDD immediately come to mind.
Child services need to have or be measured by a yardstick that also considers that the client outcomes are often based or heavily influenced by outside forces – guardians, parents, courts, caretakers – and the decisions made those involved.
Partners Response: All disability groups are impacted dramatically by outside forces, from parents, courts, the weather, the economy, the availability and affordability of medical services, etc. The challenge is universal, and outcomes remain important.
I provided Rachel Jerzak specific feedback there wasn’t time to address. If possible, I would appreciate some follow up. Kathryn Hinkle, Clinical Director, MHA, CCHS – 704-984-0329; firstname.lastname@example.org
Partners Response: This has been requested from Rachel.
What would you as a family member want to know? How will we pay for it?
Partners Response: We believe what family members want to know is a good, and even foundational question. As for paying for outcomes, it is our sincere belief that we will pay much more in funding support and community support if we do not have outcomes to show what our providers are accomplishing with the support that is now being provided by taxpayers and others.
We will be getting with consumer representatives to gather their input on this topic too. We suggest providers do the same (Cleveland Strong Analogy)
Partners Response: Thank you, and we are incorporating our CFAC (Consumer Family Advisory Committee) in the process.
Today is just a start, shared responsibility, going to move quickly, the “so what” questions, we want proposals.
Partners Response: We will continue to work with providers and other stakeholders in a collaborative fashion to reach this goal. Partners Quality Management department will become more involved as we move forward.
Thank you for this opportunity to collaborate! I was impressed by the sophistication of Partners and providers from where we were 4 years ago having similar conversations. We are heavily invested in sharing our thoughts/experiences and working with Partners to shape this process.–Eric Baumgardner, New Hope
Partners Response: Thank you.
General Umbrellas – Provider can choose at least one from each umbrella to focus on for that fiscal year
Partners Response: This is a good idea and will be sent to the IDD Sub group of Provider Council.
Consider individual application of the Bible. Same words but people individualized to apply, same for this.
Partners Response: Thank you for this comment.
May 23, Hospitals will be in Raleigh for legislative advocacy. Hospitals can discuss at their quarterly meeting in Hickory run by Dr. Salazar.
Partners Response: This is a good idea and we will send to Dr. Salazar.
May 23 is also hospital advocacy day with legislatures sponsored by NCHA – Just FYI – Also I believe PQRS is changing to MIPs (Merit Based Incentive Payment System)
Partners Response: Thank you for that information.
Can a copy of the State/MCO Outcome Measures be emailed out to providers?
Partners Response: The measure specifications have not been made available to MCOs yet.
Once DMA and DMH have finalized and shared the details of outcomes measures specifications, Partners will provide both the contracted measures and specifications to the Provider Council.
Questions 2 and 3:
We would like copies of the notebooks?/ Could we attain copies of the notebooks?
Partners Response: Partners has uploaded this information for you to view/print. A PDF is available here.
What Partner’s data could be electronically available to providers (HIE) linked?
Partners Response: Partners has recently gained access to NC HealthConnex (i.e., HIE). This has facilitated Partners assessing the data and utility of this data connection. As this becomes more clear, Partners will share the information with the providers.
Are there plans to pilot implementation of outcomes based contracting prior to roll-out?
Partners Response: Partners anticipates piloting most, if not all, measures when feasible. However, we do recognize critical measures tied to significant penalties in the FY 19 contracts for LMEs/MCOs may impact the extent we are able to feasibly pilot these specific measures
- Pilot measures with small, medium and large providers to identify barriers/resource needs.
- Give providers choice of social determinants of health to track outcomes – have a “menu” of items that providers select to measure.