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INNOVATIVE PRACTICESFOR CLINICALLY INTEGRATED NETWORKS
Presented by:
Health Center Partners of Southern CaliforniaHenry Tuttle - President & CEOSparkle Barnes - Chief Strategy Officer
W W W. H C P S O C A L . O R G
© Health Center Partners | 2
A Family of Companies….
THE MISSION IS RIGHTEOUS. THE WORK IMPERATIVE. THE IMPACT PROFOUND.
© Health Center Partners | 3
Be the thought leader and innovative influencerof change in the primary care marketplace,informing and inspiring our members and partnersto enrich the patient experience and improvethe human condition.
Serve as the nexus for our members and partnersto transform primary care through the power ofinnovation and collaborations.
Mission
Vision
© Health Center Partners | 4
IT’S WHO WE ARE. IT’S WHAT WE DO.
We leverage synergies across our $50M enterprise.
Consortium of 17 primary care organizations
Voice & advocate for its members
Technical training & assistance
Serving the health needs of communities in
southern California San Diego, Riverside & Imperial Counties
© Health Center Partners | 6
San Diego County = 3,337,685
Riverside County = 2,423,266
Imperial County = 182,830
5,943,781Total Population of Service Area
3 County Region
www.census.gov
© Health Center Partners | 7
OUR MEMBERS…
806,158 Unduplicated Patients
3.25M Unduplicated Patient Visits
135 Sites Of Care In 5 Counties
© Health Center Partners | 8
Patient Demographics - 2017
Source: OSHPD Annual Utilization of Primary Care Clinics, 2017 Final Data
Gender
Age
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
Hispanic Non-Hispanic Unknown
Ethnicity
Federal Poverty Level
Below 100%
100-138%
139-200%
Unknown
Race White
Black
Native American
Asian/PacificIslander
Unknown
© Health Center Partners | 9
Patient Demographics - 2017
Source: OSHPD Annual Utilization of Primary Care Clinics, 2017 Final Data
617,538
200,356
41815
582241316
11,258
Patients
Underinsured - 617,538
Uninsured - 200,356
Medicare - 41,815
Other Payor Source - 5,822
Private Insurance - 41,316
Covered California - 11,258
Medicaid – 617, 538
© Health Center Partners | 10
Economic Impact: HCP Members
Source, 2017 UDS and IMPLAN via Capital Link
Every link stronger
Industry-leading Group Purchasing
Organization (GPO)
40 years of experience
Headquartered in San Diego with nationwide
representation
An affiliate and certified sponsor of Premier,
one of the nation’s largest GPOs
OURDIVERSIFIEDMEMBERSINCLUDE:
SURGERY CENTERS
PRIMARY CARE PHYSICIANS OFFICES
COMMUNITY HEALTH
BUSINESS & INDUSTRY
PRISONS & CORRECTIONAL FACILTIES
VETERINARIANS
LABS / IMAGING CENTERS
COLLEGES & UNIVERSITIES
K-12 EDUCATION
AND MORE…
Our Member Footprint7,835 MEMBERS (and growing daily)
25,000+ LOCATIONS
$631,309,346CY18
Total Sales
Our Total Volume
2,700,000
2,257
$50B
25,000+
30ContractedProducts
SupplierContracts
In Collective Purchasing
Power
Member Sites
Service Driven Staff Members
CNECT By The Numbers
© 2018 CNECT | 16
CONTRACTING OPERATIONSSALES MARKETING
Supports community health centers and other safety net providers in taking the best possible care of their patients.
Develop & implement a broad portfolio of innovative grant funded programs and research projects.
Improve efficient and effective access to care, patient engagement, quality of care and clinical outcomes.
© Health Quality Partners | 18
11 staff developing and implementing a broad portfolio of innovative, collaborative, grant-funded programs for our members and strategic partners:
– Behavioral health integration– Medical-dental integration– Quality improvement activities with member CMOs– Coverage initiatives– Support for PCMH recognition– SBIRT– Social determinants of health– Data aggregation and analysis to support population health management
In 2017/2018 we expended $5.42 million in grant revenue and passed through $2.7 million to health centers. An additional $300K paid to specialists on behalf of patients.
Current Work
INNOVATIONHUB
© Health Quality Partners | 20
• An Outcome Evaluation of the IMPACT Program• Safety Net Integration• Advancing Value-Based Care through Patient Engagement: An
initiative of the Blue Shield Foundation• Advancing Value-Based Care through Patient Engagement• Connecting Kids to Coverage Outreach and Enrollment
Cooperative Agreements Program• Effective Strategies and Best Practices for Increasing Medi-Cal
Enrollment among Uninsured ChildrenClick Here to Read Reports
Evaluated and Disseminated Results
© 2016 Health Quality Partners | 21
Behavioral Health Services at Health Center Partners of Southern California
w w w .HCPSOCAL.o r g
2018
2008 2017Therapists: 29.7 103.7 249%Visits: 28,267 126,143 346%
2008 2017 Psychiatrists: 6.7 19.7 194%Visits: 12,099 39,646 227%
Source: 2008/2017 UDS
Expansion
www.SanDiegoIntegration.org
Region’s leading clinically integrated primary
care network.
Brings together 10 community health center
members representing 632,000+ low
income and underinsured Medi-Cal patients
in San Diego & Riverside Counties.
Launched in March 2016.
© Integrated Health Partners | 23
IHP is a powerful advocate for primary health care service providers and their patients, striving to create a stronger health care safety net by:
• Delivering higher quality of care and achieving new levels of performance and accountability.
• Developing stronger relationships with payers while improving the network’s ability to perform at optimal efficiency in managed care contracts.
• Helping FQHCs respond to the changing environment for payment reform.
Why Integrated Health Partners?
© Integrated Health Partners | 24
IHP’s Value Proposition
*Source: Premier, Population Health Informatics & Technology Overview
Population Health Management
© Integrated Health Partners | 25
IHP Membership Profile
Health CenterIHP Enrolled
Members(Eligibility as of
10/31/18)
Total Members
(OSHPD, CY 2017)
Borrego Community Health Foundation 10,136 205,297
Community Health Systems, Inc. 4,114 29,178
Imperial Beach Community Clinic 6,036 10,420
Neighborhood Healthcare 28,391 76,111
North County Health Services 28,105 79,272
San Diego American Indian Health Center 832 4,281
San Diego Family Care 15,905 28,600
San Ysidro Health Center 24,342 113,319
St. Vincent de Paul Village 725 2,336
Vista Community Clinic 19,366 82,050
Total (including 421 unassigned IHP members) 138,277 632,682
10 Health Center Members:
Molina
Care 1st
IEHP
© Integrated Health Partners | 26
Core Elements of IHP’s CIN
Clinical Quality Improvement
•Clinical practice protocols
•Practice guidelines
•Risk-based coding with payers
•Clinical Committee
Clinical Information
Systems
•Analytics strategy for clinical technology including the population health data aggregation tool
•Informatics & Technology Committee
Participation Criteria
•Network performance standards
•HEDIS measure thresholds
Utilization Control
Mechanisms
•Utilization management by MSO
•Data validation
•Operational Committee
Centralized Network
Staff
•Population health leadership
•Finance•Contracting•Quality•Billing•Revenue Cycle
•Informatics
Patient Experience
•Surveys administered to assess patient experience
Financial Incentives
•Value-based distribution model for P4P incentive payments
•Finance Committee
Payor Relations
•Expansion of existing network through joint risk-based contracting
•Marketing to become network of choice by payers
Demonstrating Efficiencies
•Tracking costs by payer
•Quantification of overall efficiency benefits of network to MCOs
The IHP Experience
Network Governance by the IHP Board of Managers
© Integrated Health Partners | 27
Population Health Informatics
*Source: Premier, Population Health Informatics & Technology Overview.
Members required Arcadia population health solution to drivenetworked health centers to achieve the quadruple aim by:
Improve Health of
Population
Improve Clinician
Experience
Improve Patient
Experience
Eliminate Waste &
Lower Cost
Quadruple Aim
• Establishing a collaborative system for reporting, analytics, and performance improvement.
• Demonstrating value of the CIN to payers and other customers.
• Moving to greater data acquisition, processing, and automated reporting.
• Provides a master patient index and longitudinal health record with a real time EHR pop-up.
© Integrated Health Partners | 28
IHP Population Health Goals
• Provide a centralized data asset for IHP to use for quality reporting, research functions and grant initiatives.
• Develop an electronic infrastructure for performance and utilization management at the network level.
• Create a common set of population health management capabilities to share and integrate best practice workflows across the network.
• Produce a platform to enhance care management and performance management capabilities at the health center level.
• Utilize reporting and analytic capabilities of the platform to support value-based contracting and total cost of care initiatives in the future state.
© Integrated Health Partners | 29
HEDIS Measures
© Integrated Health Partners | 30
IHP Member Performance: Quality OutcomesThe IHP clinical committee, health center members, and participating health plan partners have
worked to improve quality outcomes and reported measures.
FROM 2016 TO 2017, FOR OUR LONGEST ESTABLISHED HEALTH PLAN PARTNERSHIP:
• IHP sites demonstrated marked improvement on most HEDIS measures.
• For that plan, IHP sites became their highest scoring measure set in California.
• In our MSO’s million+ patient base, IHP member patients score the highest.
• IHP sites increased P4P revenue, after joining IHP.
© Health Center Partners | 31
H E N R Y T U T T L EP r e s i d e n t & C h i e f E x e c u t i v e O f f i c e r
h t u t t l e @ h c p s o c a l . o r g
S PA R K L E B A R N E SC h i e f S t r a t e g y O f f i c e r
s b a r n e s @ c n e c t g p o . c o m
www.HCPSOCAL.org
