OKLAHOMA STATE STRATEGIES
Terry Cline, Ph.D. Commissioner of Health Oklahoma Secretary of Health and Human Services October 19, 2015
OKLAHOMA STATE DEPARTMENT OF HEALTH · 2015OHIP2020.com
OHIP 2020 FRAMEWORK
OHIP2020.com PARTNERSHIPS AT WORK
Oklahoma Health Improvement Plan Flagship Issues Obesity Social Tobacco Determinants Child Health Health Systems Oklahoma Works Behavioral Health SIM State HIT Plan Health Workforce Million Hearts Interagency Ini a ves Interagency Ini a ves Public Health/ Health In All Polices Medicaid (Aspen Ins tute) OSDH/TSET HHS Interagency Ini a ves DISCUSS
Individual Agency Initiatives Individual OHIP2020.comAgency Initiatives
POPULATION HEALTH FLAGSHIP ISSUES OHIP Flagship Issues Health Transformation/OSIM Flagship Issues Tobacco Use ¥ Reduce smoking prevalence to 18% by 2020. Tobacco Use ¥ Reduce adolescent smoking prevalence from 15.1% in 2013 to 10% in 2020. Obesity ¥ Reduce adult obesity prevalence from 32.5% in 2013 to Obesity 29.5% in 2020. ¥ Reduce adolescent obesity prevalence from 11.8% in 2013 Diabetes to 10.6% in 2020. Child Health
¥ Reduce infant mortality from 6.8 per 1,000 live births in 2013 Hypertension Behavioral to 6.4 per 1,000 live births by 2020. ¥ Reduce maternal mortality from 29.1 per 100,000 live births to Health 26.2 per 100,000 live births by 2020. Behavioral Health ¥ Reduce the prevalence of untreated mental illness from an 86% treatment gap to 76% in 2020. ¥ Reduce the prevalence of addiction disorders from 8.8 % to 7.8 by 2020. ¥ Reduce suicide deaths 22.8 per 100,000 to 19.4 per 100,000 by 2020.. OHIP2020.com THE “TRIPLE AIM”
The Oklahoma Health Improvement Plan (OHIP), Health Transforma on effort u lizes the “Triple Aim” framework.
Reduce Heath Care Improve Health Outcomes Improve Quality of Care Expenditures
OK State STAT/ OK State STAT/ OHIP 2020 Measure OK State STAT/ OHIP 2020 Measure By 2020, limit annual state- OHIP 2020 Reduce by 20% the rate, per purchased healthcare cost Reduce Heart Disease Deaths 100,000 Oklahomans, or growth, through Medicaid and by 11% by 2020 potentially preventable EGID, to 2% less than the hospitalizations from 1656 in projected national health 2013 to 1324.8 by 2020 expenditures average annual growth rate OHIP2020.com
OSIM STATE HEALTH SYSTEM INNOVATION PLAN Oklahoma is integrating system-wide data to create a new model for health care delivery and value-based payments.
Health care delivery system Payment and/or transformation plan service delivery model
Financial Workforce development Analysis strategy
Components of a
State Health System Successful Model Innovation Plan Design Plan (SHSIP) Health Monitoring Information and Technology (HIT) evaluation plan plan
Quality Stakeholder measure engagement alignment plan
OHIP2020.com CURRENT SIM HEALTH INSURANCE CARRIERS
Primary Carrier Group
¥ Medicaid
¥ Employee Group Insurance Division
¥ Blue Cross/Blue Shield
¥ Community Care
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CHILD HEALTH
Every Week Counts ¥ Multi Organization Quality Improvement Initiative
o Oklahoma Hospital Association o Oklahoma State Department of Health o Oklahoma University Office of Perinatal Quality o Oklahoma Chapter of March of Dimes ¥ 52 Oklahoma Birthing Hospitals ¥ Medicaid supported by introducing payment differential for non- medically indicated C-Sections
OHIP2020.com PREPARING FOR A LIFETIME EVERY WEEK COUNTS COLLABORATIVE
*Comparison is difference between Q1 2011 & Q4 2014 96%*
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Patient with controlled High Blood Pressure
Pharmacist Disease Care Prescrip ons s Management Coordinators Blood Pressure Aspirin Meds Blood Pressure Control Cholesterol Management Blood Pressure Return On Smoking Cessation Measurement Investment Clinicia Policy Analysis n
Care Value Coordina on Based Policy Alloca on Achieved Heartland OK Primary Care/ NQF 18 Public Health Care Coordination Measurement Model Integra on OHIP2020.com MILLION HEARTS
Change in blood pressure between baseline and the Successes last follow up visit for Heartland OK clients
¥ Standardized BP protocol ¥ Community determined pay for performance
¥ Multi-disciplinary, organization team
¥ Use of Medicaid predictive DiastolicBP analytics tools for provider notification
¥ Multi-payer participation Systolic OHIP2020.com BP
MEDICAID/PUBLIC HEALTH PARTNERSHIP MODEL Strategic Level ¥ Joint strategic initiatives built around QI Teams: Strategic Level o Tobacco Goal: Health Outcome Improvement o Rx Drug
Leadership o Hypertension/Diabetes
Business Level o Immunizations for Children Goal: PH Revenue o Childhood Obesity Development Business Officials ¥ Surveillance & Data Collection: Operational Level o Standard data sharing agreement Goal: Day to Day Operations/Billing o Standardization of surveillance tools Staff Level o Tracking health outcome data for the Medicaid population (ex: State of the State’s Health) OHIP2020.com
MEDICAID/PUBLIC HEALTH PARTNERSHIP
¥ Tobacco o Eliminated co-pays for tobacco cessation medication o Removed prior authorization for tobacco cessation medication o NEXT STEP Ð Removal of additional copays for counseling ¥ Immunization o Enforcing provider recall/reminder in pilot county o NEXT STEP Ð Expanding provider recall/reminder enforcement ¥ Rx drug o Pharmacy/Provider lock-in policies o Data analysis and monitoring ¥ Childhood Obesity o Technical assistance grant awarded to OHCA/OSDH OHIP2020.com
HEALTH WORKFORCE
¥ NGA Health Workforce Policy Academy High Quality Coordination ¥ Governor supported multi- Data of Efforts disciplinary team ¥ Integrated into and governed through OHIP Health Workforce
Pipeline, Team Workforce Recruitment Redesign ¥ Key partnerships include economic & Retention development and workforce, academic and health technology
OHIP2020.com PRIMARY CARE SHORTAGE AREAS
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HEALTH WORKFORCE
OHIP2020.com HEALTH HOMES
¥ Person-centered system of care that aims for improved outcomes and better services and value
¥ Oklahoma Department of Mental Health and Substance Abuse Services has partnered with the Oklahoma Health Care Authority to create Behavioral Health Health Homes
¥ Integrates public health with health care
¥ Provides individual and family support services at point of care
¥ Links patient to community and social support services
¥ Utilizes health information to link various services OHIP2020.com
DELIVER INTEROPERABLE SOLUTION COMPONENTS UTILIZING SHARED SERVICES (DISCUSS)
¥ HHS Governance Committee comprised of Deputy Secretary of HHS (Chair) and representatives from the five largest HHS cabinet agencies including the following: o Oklahoma Health Care Authority (Medicaid Agency) o Oklahoma Department of Human Services
o Oklahoma State Department of Health
o Oklahoma Department of Mental Health and Substance Abuse Services
o Oklahoma Department of Rehabilitation Services
¥ Staff support provided by Office of Management and Enterprise Services and HHS shared services staff o Project Coordinator, Project Manager and Business Analyst
OHIP2020.com DISCUSS
Shared Services Successes ¥ Formalized and meeting ¥ Reduce total cost of ownership monthly for two years ¥ Shared staff with cost shared ¥ Increase integration and among all agencies interoperability ¥ Current shared services/ framework include: ¥ Reduce management and o eMPI & interoperability o electronic personnel support overhead o eDiscovery o security framework approved ¥ Create depth of expertise o architecture framework
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DISCUSS SHARED ARCHITECTURE
Citizen Self- Agency/State Agency/State Agency/State Agency/State Agency/State Service Portal Application Application Application Application Application DHS OSDH DMHSAS OHCA DRS
OK-HHS Framework Other Government Systems Presenta on Layer Applica on Interface Layer SOA Messaging SOA Messaging Integra on Integra on Services ESB Services
Technical Services Correspondence Authen ca on Layer Service Service External Systems Invoca on Authoriza on Forms Service MPI Service Service Service Content Mgmt Rules Service Task Service Service Report Service Audit Service Data Service
Business Rules Workflow Forms Engine Repor ng Iden ty & eMPI Engine Document Engine Engine Repository (Std & adhoc) Access Mgmt & Database
¥ Red background or font indicate current potential shared services ¥ Green dotted box indicates future potential shared services OHIP2020.com QUESTIONS
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