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Rhode Island State Health Improvement Plan

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Rhode Island State Health Improvement Plan Rhode Island State Innovation Model (SIM) Test Grant Better Health, Better Care, and Lower Cost Operational Plan Version 3 April 25, 2018 Table of Contents A. SIM Project Summary ............................................................... 4 Overview of Changes and Updates ......................................................................... 4 Summary of Model Test ................................................................. 6 Overview ................................................................................................................. 6 End State Vision of Transformation ......................................................................10 Background: SIM Operational Plan ....................................................................... 11 Core Metrics and Accountability Targets ..................................... 20 Core Metric Set ..................................................................................................... 20 Updated Master Timeline ............................................................ 21 Budget Summary Table ............................................................... 22 B. Detailed SIM Operational Plan ................................................ 26 Narrative Summary of SIM Components ..................................... 27 Rhode Island SIM Components ............................................................................ 27 Investing in Rhode Island's Healthcare Workforce and Practice Transformation29 Data Capability and Expertise .............................................................................. 45 Other System Transformation Components ......................................................... 49 SIM Sustainability Strategies and Workplan ............................... 55 Risk and Mitigation Strategy ....................................................... 61 Risk Register ......................................................................................................... 63 C. General SIM Operational and Policy Areas .............................. 70 SIM Governance ...........................................................................71 Governance and Management Structure .......... Error! Bookmark not defined. Stakeholder Engagement ............................................................. 76 Rhode Island’s Approach ...................................................................................... 76 Description of Stakeholders .................................................................................. 76 SIM Outreach and Engagement ........................................................................... 79 Strategies for Maintaining Stakeholder Commitment ......................................... 82 Rhode Island State Improvement Plan ........................................ 84 Overview ............................................................................................................... 84 Future Directions .................................................................................................. 88 Healthcare Delivery System and Payment Transformation Plan with Detailed SIM Work Plans ............................................................ 90 Baseline and Vision ............................................................................................... 90 The Rhode Island Approach to Transformation.................................................... 91 Leveraging Regulatory Authority ................................................ 119 Quality Measure Alignment ....................................................... 123 Quality Measure Alignment Process .................................................................... 123 Aligned Measure Sets ........................................................................................... 125 SIM Alignment with State and Federal Initiatives ...................... 126 Current CMMI Projects and Awards .................................................................. 126 Federal Initiatives ................................................................................................ 128 Rhode Island Department of Health ................................................................... 132 Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals138 OHIC ................................................................................................................... 140 Governor’s Office Initiatives ................................................................................ 141 Other State Departments for SIM Alignment ...................................................... 142 Healthcare Workforce Transformation ..................................... 144 2 Grant Number 1G1CMS331405; April 25, 2018 Healthcare Workforce Transformation Report ................................................... 144 EOHHS/SIM Healthcare Workforce Transformation Priorities and Strategies to Support Health System Transformation Goals ................................................................. 147 Emerging Healthcare Workforce Transformation activities ............................... 150 Health Information Technology Plan ......................................... 156 HIT Adoption and Use ......................................................................................... 156 State HIT Governance.......................................................................................... 158 HIT Policy Levers ................................................................................................ 160 Existing State HIT Systems ................................................................................. 163 SIM Test Grant HIT Components........................................................................ 166 SIM HIT Modular Functions ............................................................................... 191 D. Program Evaluation, Monitoring, and Reporting ..................200 State-Based Evaluation Overview ....................................................................... 200 Current Evaluation Efforts Summary ................................................................. 201 Data Collection and Sharing ...................................................... 209 Fraud and Abuse Prevention, Detection, and Correction ........... 213 Conclusion ................................................................................ 214 Acronym and Abbreviation List ................................................. 215 3 Grant Number 1G1CMS331405; April 25, 2018 A. SIM Project Summary This section updates the outline of Rhode Island’s SIM Test Grant. It provides a narrative for the overall goals and project approach, and contains the following five areas: project narrative, driver diagram, core progress metrics and accountability targets, master timeline, and budget summary table. Overview of Changes and Updates Version 4 of the Rhode Island SIM Operational Plan lays out our roadmap for the final year of our Test Grant, including our sustainability planning. This document now includes updates on our progress in Award Year 3 and modifications to our plan for Award Years 4, with more specificity than before. Our focus for Year 4 will be to ensure that the work that we have done to institute health system transformation in Rhode Island can be sustained with the state administration and in the partnerships we have built throughout the community. Our workplan for Year 4 includes tasks that will allow us to sustain and institutionalize the changes we have achieved so far. We have also integrated the newly-funded initiatives decided upon by our Steering Committee in November 2017 throughout the Operational Plan. These include the Preceptor Project, additional End of Life trainings, and the Social Service Database project described in our latest Annual Report. Additional notable updates from Version 3 to Version 4 of our SIM Operational Plan include: General Themes • Throughout the document, we highlight ways that our fourth-year planning is part of our planning for the future of our health system integration and our overall SIM sustainability thinking. • We provide updates on our Integration and Alignment initiative and other components of our work on social determinants of health (SDoH). Project Summary • Added information on our new initiatives, funded with savings from Year 2, updating our Driver Diagram and other sections with new information; • Changed the Driver Diagram to reflect additional alignment; • Pulled out our Metrics to an appendix, for easier review; and • Updated the Budget Summary Table. Detailed SIM Operational Plan • Updated the summary of all SIM components, where applicable; • Updated our SIM Sustainability strategies; and • Revised our Risk Matrix to include changing mitigations and new risks, where applicable. • Updated our Healthcare Delivery System and Payment Transformation Plan to reflect accomplishments in Award Year 3 and provide detail on Award Year 4 plans; 4 • Provided updates on Leveraging Regulatory Authority, Quality Measure Alignment, and SIM Alignment with State and Federal Initiatives; and • Revised the Health Information Technology Plan. 5 Summary of Model Test Overview Rhode Island’s history of health reform is impressive. We have been innovators, with expansion of Medicaid for children and their parents in the 1990’s; steadfast, in our commitment to build on the market reforms and coverage expansions of the Affordable Care Act; and bold, as we embrace
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