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Building the Capacity of Indigent Care Networks by Standardizing and Collecting Data

More Efficiently

Kellan Chapin, MPH

Executive Director, Care Share

Shelisa Howard-Martinez, MPA

Collaborative Network Specialist, Care Share

Linda Kinney, MHA

Dial: 1-866-740-1260 Passcode: 8618359 Deputy Director, Care Share Health Alliance

Webinar Logistics

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Webinar Overview

Introduction and Webinar Purpose – Kellan Chapin (10 minutes)

Background of Standard Outcomes and Measures Work- Shelisa Howard-Martinez (20 minutes)

• Work by Care Share Evaluation Committee• Standard Outcomes and Measures Pilot Project• Key Learnings from Pilot • Nine Standard Measures

Available Technical Assistance and Tools – Linda Kinney (10 minutes)

Questions & Answers – moderated by Adrian Russell (30 minutes)

Care Share Health Alliance

Care Share is a statewide nonprofit that helps communities coordinate care for low-income uninsured and underserved individuals.

We help communities by:

• Bringing people together to create a shared plan for serving those in need;

• Sharing knowledge and resources within communities;

• Sharing best practices and guidance among communities and across the state.

Care Share Health Alliance

 

Care Share is funded by: the Blue Cross and Blue Shield of North Carolina Foundation; The Duke Endowment; Kate B. Reynolds Charitable Trust; the North Carolina Health and Wellness Trust Fund; and the North Carolina Office of Rural Health and Community Care.

Thanks to their support, Care Share’s technical assistance is available to communities throughout the state at no charge.

Visit www.CareShareHealth.org or call 919-861-8353 for more information.

Care Share TA Service Map

Western NC – Julie Lawhornjlawhorn@caresharehealth.org919-861-8360

Central NC - Linda Kinneylkinney@caresharehealth.org919-861-8356

Eastern NC – Shelisa Howard-Martinezshoward-martinez@caresharehealth.org919-861-8359

Collaborative Networks

Bring together all of the local (most commonly defined as county) stakeholders who provide health services and other resources that promote and improve the health of low-income, uninsured North Carolinians

Are developed when its members decide they want to form one and then create a formalized structure

Have a shared vision, their priorities are determined by one strategic plan, they provide integrated systems of care to local communities and work to achieve common outcomes/system that improves access, quality, health and reduces unnecessary or escalating costs

Webinar Outcomes

1. Learn about nine standard measures and common definitions that have been tested by local indigent care networks.

2. Learn how Care Share’s technical assistance can help build your networks’ capacity to collect and report standard data.

3. Learn how your network can implement standard measures and common definitions.

Vision for Standard Outcomes and Measures for Networks

From its inception, Care Share's vision included developing standard outcomes, measures, and common definitions for networks and providers participating in networks

No other organization in the state has this role

Standard measures are needed so Networks can:

• Improve performance and quality of work

• Report to funders and document outcomes for grant writing

• Demonstrate and communicate their value

• Compare and share best practices with other Networks who serve low-income, uninsured people

Important for this work to be community-driven so that measures are useful and meaningful to Networks.

Standard Outcomes and Measures – Evaluation Committee Work

June 2009 – Care Share Evaluation Committee membership formalized and charged with developing standard outcomes, measures, and definitions for Collaborative Networks and providers participating in local Networks

Evaluation Committee membership composed of professional evaluators from state-level healthcare policy and research centers and representatives from local indigent care networks and statewide funders

Standard Outcomes and Measures – Evaluation Committee

Evaluation Committee developed:

• 7 domains: Access to Care, Utilization/ Appropriate Use of Care, Efficiencies and Cost Savings, Improved Health, Quality of Care, Patient Experience, and Provider Experience

• 46 standard measures covering all 7 domains

• A glossary of standard definitions to help networks apply measures to data collection

Work was developed with feedback of Collaborative Network Committee and Care Share Board of Directors

January 2010Standard Outcomes and Measures Survey to Safety Net

Purpose of Survey –

1. To gather recommendations for core measures that would be used in a Pilot Project

2. To assess the current data collection capacity of indigent care networks and providers

3. Identify potential participants for Pilot Project

84 surveys completed

Survey noted wide variability in:• Types of data being collected by networks and providers who serve low-income, uninsured

people,• Capacity to collect and report data between types of organizations• Capacity of respondents to collect and report data for specific domains and measures

Standard Outcomes and Measures – Pilot Project

Evaluation Committee recommended developing Pilot Project to test and refine 14 measures within 5 domains:

1. Access to Care

2. Cost Savings/Efficiencies

3. Utilization/ Appropriate Use of Care

4. Quality of Care

5. Improved Health Status

Standard Outcomes and Measures Pilot ProjectPurpose

Work with a group of 6-10 Pilot Sites to:• Finalize a list of “core” Standard Outcomes &

Measures • Test and refine online data collection tool - Standard

Measures Web Portal• Identify needed TA services• Identify challenges and best practices in data

collection and reporting • Facilitate shared learning

Standard Outcomes and Measures (SOM) Pilot Project Sites

Name of Network Counties Served

CapitalCare Collaborative Wake

Durham Project Access Durham

First Health of the Carolinas/ Moore Health/ Moore and Montgomery Counties HealthNet

Moore and Montgomery

Franklin Health Care Collaborative Franklin

Healthcare Access/ Forsyth Healthcare, Inc. Forsyth, Davie, Stokes, Yadkin, Davidson

HealthNet Gaston Gaston

HealthNet Expansion Albemarle Region

Measures Collected during SOM Pilot Project

1.Total # of unduplicated, low-income, uninsured individuals who are enrolled in the Network

2. Total # of active unduplicated, low-income, uninsured patients in the Network

3. Number of visits by Network enrollees

4. Number of enabling health services provided to Network enrollees

5. Total number of unduplicated, low-income, uninsured individuals enrolled in the Network with access to primary care/ medical home

Measures Collected during SOM Pilot Project

6. Number of prescriptions filled for Network enrollees

7. Number of individuals screened for Network eligibility

8. Number of providers participating in the Network

9. Estimated cost of donated care

SOM Pilot Project Lessons Learned - Data Collection and Reporting

• Networks have a wide range of data collection and reporting capacity, dependent upon:– Stage of development (including collaboration among

partners)– Number and type of partners– Resources

• Data collection challenges: – Most Networks do NOT have centralized/ linked system of

data collection or reporting – Partners use different electronic and manual data collection

systems • Challenge to merge this data into one system

– Duplicate patients – hard to “de-duplicate”

SOM Pilot ProjectLessons Learned - Data Collection and Reporting

• Data collection challenges (continued): – Partnership challenges

• Time-intensive to collect data from all partners• Need to build relationships/ trust• Data sharing agreements need to be in place

Lessons Learned Standard Measures

• Overall, Network partners feel that collecting/ reporting Standard Measures is at least “somewhat useful” (among those surveyed)

• Networks feel that Standard Measures are important for reasons including:– To report to funders, document outcomes for grant writing,

demonstrate value, compare with other Networks, improve Networks

• Networks current data collection/ reporting systems are not able to track/ capture all measures with current definitions

Standard Outcomes and Measures – Moving Forward in 2011

Collaborative Network Committee will continue to refine current standard measures and definitions with assistance of Best Practices and Innovation (Evaluation) Committee

Collaborative Network Committee will also begin identifying additional measures, definitions, and reporting templates for networks to use

Standard measures will be developed to support local networks capacity to:• Improve and maintain the health of people they serve • Improve network performance and outcomes by sharing best practices and

facilitating shared learning• Identify data to prepare community/ network for Health Reform implementation

Health EducationPatient engagementWellness/Prevention

Health/Care Navigation

Medical/Primary Care HomeSpecialtyHospital

Urgent CareDental

Behavioral HealthMedications

Labs & DiagnosticsDurable Medical Equipment

Chronic Disease Management

Community Support Services

Department of Social Services

Homeless SheltersFood Banks/PantriesInterpreter/translation

servicesTransportation

Churches, civic clubs

Economic DevelopmentConsumer Credit

CounselingAffordable Care

Education

Collaborative Network

Access to CareSafety Net

Improved health

Individual behavior

Community

Economic

Care Share’s TA Values & Principles

Collaboration is fundamentalInclusive of all stakeholders

Collaborative and working relationships are at the core of improving systems

 

Responsiveness to all communities Focus on those communities that invite us to work with them

Connecting with communities to create opportunities for improving health

 

Understanding that each community is uniqueEach community has its own assets and challenges

Considering the context is key to successful efforts

 

 

 

SustainabilityValuing and drawing upon diverse local assets and

resources

Recognizing the long term value 

 

Applying useful tools and resources

Innovative and creative practices

Learning from peers and other places

 

Outcomes focusedA practical focus on reaching outcomes

Forward looking to accomplish goals

 

Supporting local capacity Community driven and defined

Everyone is an expert in one’s own experience

Tools to implement SOM in Your Network

Contact TA person in your region

On-site TA available to:

1. Facilitate data-sharing agreements among your partners

2. Map and assess your current data collection process

3. Training about how to use standard outcomes and definitions

Standard Measures Web Portal – an online and centralized data collection tool your network can use to enter quarterly data

Collaborative Network Committee to begin identifying report templates to be used with Web Portal

Care Share IT Committee is creating IT Assessment Toolkit and identifying IT systems / products for networks

Question and Answer Section

Do you have any questions for Kellan, Shelisa, or Linda?

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More Information and Presentation Materials

•For more information, log-on to our Knowledge Bank: https://www.CareShareHealth.org/index.lasso?id=46&cat=6

•The audio-recording and the powerpoint slides for this webinar will be posted within the “Webinars and Teleconferences” section shortly after the presentation is finished.