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Proprietary and Confidential
Mercy Maricopa Integrated Care
November 18, 2014
Meeting with Provider CEOs
Proprietary and Confidential
Eddy D. Broadway, CEO Mercy Maricopa
Welcome
Proprietary and Confidential
Proprietary and Confidential
Wendy Briggs, Director Veridus, LLC
Legislative Updates
2015 Legislative Session
Wendy G. Briggs
Veridus
Election Results
• Doug Ducey elected Governor by a wide margin.
• Former CEO of Coldstone Creamery.
• Will need educating about Healthcare issues
• Budget Concerns, Jumpstarting Arizona’s Economy, Quality of K-12 Education are his stated priorities.
Election Results
• House will remain 36-24 in favor of the Republicans.
• Arizona Senate maintains its 17-13 Republican majority.
• Although the numbers remain the same in both chambers, the respective GOP Caucus leadership teams chosen the day after Election Day are definitely more conservative.
Election Results
• House Leadership:
– Speaker: David Gowan.
– Majority Leader: Steve Montenegro.
– Majority Whip: David Livingston.
– Minority Leader: Eric Meyer.
– Asst. Minority Leader: Bruce Wheeler.
– Minority Whip: Rebecca Rios.
Election Results
• Senate Leadership:
– Senate President: Andy Biggs.
– Senate Majority Leader: Steve Yarbrough.
– Senate Majority Whip: Gail Griffin.
– Senate Minority Leader: Katie Hobbs.
– Senate Minority Leader: Steve Farley.
– Senate Whips: Lupe Contreras and Martin J. Quezada.
2015 Legislative Session
• House Health Chair continues to be Rep. Heather Carter.
• Senate Health Chair continues to be Sen. Nancy Barto.
• Senate Appropriations Chair continues to be Sen. Don Shooter.
• House Appropriations Chair is Rep. Justin Olson.
2015 Legislative Session
• Budget Issues will be the focus.
• Where the revenue goes:
Graph Source: John Arnold, Office of Governor Jan Brewer
2015 Legislative SessionRevenue
FY 2014 Projected Actual
General Fund 3.6% 1.8%
Individual Income 3.1% 1.9%
Corporate -4.1% -13.1%
TPT 5.7% 3.7%
Source: John Arnold, Office of Governor Jan
Brewer
2015 Legislative SessionRevenue History
FY 2014
Source: John Arnold, Office of Governor Jan Brewer
2015 Legislative SessionHow Big of a Problem Do We Have?
FY 2014
Source: JLBC Finance Advisory Committee Briefing Materials
Proprietary and Confidential
Finance Updates
Ramon Dominguez, CFO Mercy Maricopa
Mercy Maricopa Integrated CareProprietary and Confidential
Mercy Maricopa Integrated CareDoing the right thing for the right reason
Proprietary and Confidential
November 18, 2014
Mercy Maricopa Business Priorities
Proprietary and Confidential
Mercy Maricopa Integrated CareProprietary and Confidential
Mercy MaricopaSix Business Priority Areas
17
• Arnold v. ADHS
• Children’s System
• Crisis System
• GMH/SA Network
• Integrated Care for Members with SMI
• Block Payment Reform
Mercy Maricopa Integrated CareProprietary and Confidential
Mercy Maricopa Business PrioritiesKey Terms
18
Executive Sponsor: A member of the Leadership Team who is ultimately responsible for strategic direction, resource allocation, and decision-making related to the project.
Business Owner: Key leader who reports to the Executive Sponsor and is responsible for daily oversight of project activities and communication with internal staff and external stakeholders
Mercy Maricopa Integrated CareProprietary and Confidential
Arnold v. ADHS
Mercy Maricopa Integrated CareProprietary and Confidential
Arnold v. ADHS
20
Arnold v. ADHS Overview
Executive Sponsor: Tad Gary, Chief Clinical Officer
Business Owner: Blythe FitzHarris, Adult System of Care Administrator
Intended Outcome: Fully implement a system of care for members determined to have a serious mental illness that supports the member in achieving their recovery goals, is consistent with evidence-based practices, and adheres to the Arnold v. ADHS agreement.
Mercy Maricopa Integrated CareProprietary and Confidential
Arnold v. ADHS
21
Goals
1. Fully implement SAMHSA evidence-based practices related to Assertive Community Treatment (ACT), Consumer-Operated Services, Permanent Supportive Housing (PSH), and Supported Employment (SE)
2. Transform the service delivery system to promote and incentivizehigh-quality care
3. Increase the network’s capacity to deliver ACT services
4. Increase network capacity to provide Supported Employment services
5. Increase permanency through Supportive Housing
6. Improve the accessibility of peer and family support services
Mercy Maricopa Integrated CareProprietary and Confidential
Arnold v. ADHS, Supported Employment
22
Accomplishments To-Date
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Launched two new ACT teams; CBI Forensic ACT team (FACT) in August; SW Network in November for a total of 17 teams across the system
Launched co-located SE services at the SMI clinics starting in November 2014
Launched PSH expanded capacity for an additional 425 subsidies and support services as well as expanded capacity for PSH support services for 200 members
Mercy Maricopa Integrated CareProprietary and Confidential
Arnold v. ADHS
23
Accomplishments To-Date (continued)
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
ySA
MH
SA
EBP
s
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d
Fam
ily
Enga
gem
ent
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
In process of finalizing the developmentof the Information and ReferralManagement Program based on RFI responses.
Providing TA opportunities to Consumer Run Agencies.
Implemented peer MHC and hospital transition programs
Implemented Family Psychoeducational Program
Mercy Maricopa Integrated CareProprietary and Confidential
Arnold v. ADHS
24
Accomplishments To-Date (continued)
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d
Fam
ily
Enga
gem
ent
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
14 Fidelity Reviews have been completed or are in process by Western Interstate Commission on Higher Education (WICHE)
Offered technical assistance to providers in response to WICHE findings and review process
Implemented incentive based contracts for ACT and PSH
Mercy Maricopa Integrated CareProprietary and Confidential
Arnold v. ADHS
25
Priorities Moving Forward
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Implement two additional ACT teams; Feb 2015 & May 2015
Monitor service utilization of available SE expanded capacity (375)
Offer expanded rental subsidies and supportive housing services per PSHmodel (425).
Implement Information and Referral Management Program
Implement Peer Health Navigator Program
Mercy Maricopa Integrated CareProprietary and Confidential
Arnold v. ADHS
26
Priorities Moving Forward (continued)
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Continue to expand peer and family service capacity (500)
Continue providing technical assistance to address fidelity challenges and to assist the system to align with SAMHSA requirements and implement self-monitoring process
Continue to identify and implement incentive-based contracts.
Mercy Maricopa Integrated CareProprietary and Confidential
Children’s System
Mercy Maricopa Integrated CareProprietary and Confidential
Children’s System
28
Children’s System Overview
Executive Sponsor: Tad Gary, Chief Clinical Officer
Business Owner: Karrie Steving, Children’s System of Care Administrator
Intended Outcome: Transform the children's system in a way that actively engages families and system influencers in the process and promotes member and family choice in where, how, and from whom they receive their services.
Mercy Maricopa Integrated CareProprietary and Confidential
Children’s System
29
Goals
1. Evaluate the children’s service delivery system to identify efficiencies and opportunities to enhance quality
2. Create a proactive service delivery system
3. Improve service coordination for children in foster care and children involved in multiple systems
4. Implement processes to support transition-age youth in successfully transitioning to adulthood
Mercy Maricopa Integrated CareProprietary and Confidential
Children’s System
30
Accomplishments To-Date
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Completed analysis of the children’s delivery system and system focus groups
Completed the Birth to Five environmental scan for clinical practice and adding a psychiatric care scan
Completed environmental scan of transition-age youth services
Mercy Maricopa Integrated CareProprietary and Confidential
Children’s System
31
Accomplishments To-Date (continued)
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Developed pilot project to provide comprehensive behavioral health servicesto children, youth, families, and caregivers involved in child welfare system and CMDP
Convened monthly meetings of the Mercy Maricopa Youth Leadership Council
Conducted System of Care Practice Reviews and Brief Practice Reviews to guide systems-level performance improvement
Mercy Maricopa Integrated CareProprietary and Confidential
Children’s System
32
Priorities Moving Forward
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Implement the Children’s Redesign Plan
Implement the CMDP Pilot Project
Hold Youth Involvement Kick-off Event (January 2015)
Continue Birth to Five Learning Consortium
Continue System of Care Practice Review and Brief Practice Review to inform the CSOC
Mercy Maricopa Integrated CareProprietary and Confidential
Crisis System
Mercy Maricopa Integrated CareProprietary and Confidential
Crisis System
34
Crisis System Overview
Executive Sponsor: Don Fowls, Chief Medical Officer
Business Owner: Gabriella Guerra, Head of Crisis and Cultural Services
Intended Outcome: Collaborate with system partners to enhance the current crisis system to maximize and align resources, and connect individuals to the services and supports they need to achieve their recovery goals and promote resiliency.
Mercy Maricopa Integrated CareProprietary and Confidential
Crisis System
35
Goals
1. Enhance crisis system capacity and effectiveness
2. Facilitate communication and information sharing across the provider network
3. Expand community-based service options
Mercy Maricopa Integrated CareProprietary and Confidential
Crisis System
36
Accomplishments To-Date
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Engaged stakeholders and community partners at the Crisis 360 stakeholder and workgroup meetings to discuss needs of children, youth, adults, and families during a crisis episode
Published the Crisis 360 Evaluation Final Report which included key findings and recommendations for Arizona’s crisis system
Identified recommended changes for the SMI and adult outpatient providers contract and provider manuals
Mercy Maricopa Integrated CareProprietary and Confidential
Crisis System
37
Accomplishments To-Date (continued)
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Developed and posted a Crisis Call Center and Dispatch Services RFI to solicit innovative ideas and implementation strategies for a comprehensive Crisis Call Center that includes:▪ nurse line ▪ centralized inpatient bed management▪ transportation▪ hospital rapid response▪ mobile crisis services▪ developmental disabilities and tribal team▪ children and youth rapid-response and
stabilization services▪ crisis navigators
Mercy Maricopa Integrated CareProprietary and Confidential
Crisis System
38
Accomplishments To-Date (continued)
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Convened groups (e.g., internal steering committee, external stakeholderworkgroup) to address ED/hospital holds issues
Created enhanced systems and procedures (e.g., daily data updates with hospitals, data dashboards) to track and address ED/hospital holds
Held discussions with providers about Crisis Respite and expanded locations for court-ordered treatment amendment
Mercy Maricopa Integrated CareProprietary and Confidential
Crisis System
39
Priorities Moving Forward
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Achieve and sustain hospital hold percentages of 10% or less, and 5% overlap by February 2015
Develop an approach for linking clinicalperformance measures to incentives
Enhance system partnerships to coordinate member access to services and support to prevent crisis episodes
Mercy Maricopa Integrated CareProprietary and Confidential
General Mental Health/Substance Abuse (GMH/SA)
Mercy Maricopa Integrated CareProprietary and Confidential
GMH/SA
41
GMH/SA Overview
Executive Sponsor: Eddy Broadway, President and CEO, Mercy MaricopaMark Fisher, President and CEO, Mercy Care Plan
Business Owner: Christi Lundeen, Chief Innovation OfficerMily Schroeder, Network Development AdministratorGabriella Guerra, Head of Crisis and Cultural Services
Intended Outcome: Implement an integrated and coordinated model of care for members with general mental health and substance abuse needs.
Mercy Maricopa Integrated CareProprietary and Confidential
GMH/SA
42
Goals
1. Expand integrated care service delivery models
2. Increase network capacity and infrastructure to deliver services according to an integrated care model
Mercy Maricopa Integrated CareProprietary and Confidential
GMH/SA
43
Accomplishments To-Date
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Expanded capacity of the network by increasing number of providers, modifying contracts, and/or establishing partnerships in the areas of:▪ women and children’s services ▪ behavioral health ▪ PCMH practices and FQHCs▪ ACOs▪ first responders ▪ hospital holds
Mercy Maricopa Integrated CareProprietary and Confidential
GMH/SA
44
Accomplishments To-Date (continued)
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Developed process of collecting data from contracted providers to determine number of GMH/SA providers and staff providing services
Identified and updated comprehensive provider roster monthly to determine service capacity
Mercy Maricopa Integrated CareProprietary and Confidential
GMH/SA
45
GMH/SA Provider Network Overview
GMH/SA Provider Type Number
Contracted Providers-Agencies 42
Outpatient Clinics 133
Sub Acute 8
Community Services Agencies 4
Behavioral Health Medical Professionals (BHMP) 67
Behavioral Health Professionals (BHP) 520
Behavioral Health Technicians (BHT) 1,249
Behavioral Health Para Professionals (BHPP) 262
Methadone Prescribers 16
Buprenorphine Prescribers 19
(Totals as of 11/14/14)
Mercy Maricopa Integrated CareProprietary and Confidential
GMH/SA
46
Priorities Moving Forward
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Implement the care management plan for integration at PCMHs, high volume community-based and FQHCs by December 2014
Identify a dual contracting process and payment methodology that allows providers to treat members for both physical and behavioral health services, when possible/practical
Mercy Maricopa Integrated CareProprietary and Confidential
GMH/SA
47
Priorities Moving Forward (continued)
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Successfully launch the health information exchange (HIE) in collaboration with HINAz and BHINAz April 2015
Successfully implement the population health management and care management tools April 2015
Recruit and train care managers/navigators to support providers
Enhance method to collect and update provider data
Mercy Maricopa Integrated CareProprietary and Confidential
Integrated Care for members determined to have a Serious Mental Illness
Mercy Maricopa Integrated CareProprietary and Confidential
Integrated Care for members determined to have a Serious Mental Illness
49
Integrated Care for Members with SMI Overview
Executive Sponsor: Don Fowls, Chief Medical Officer
Business Owner: Christi Lundeen, Chief Innovation OfficerMichael Hedden, Integrated Care Administrator
Intended Outcome: Transform the service delivery system for members determined to have a serious mental illness into a fully integrated care model that delivers high-quality medical and behavioral health services.
Mercy Maricopa Integrated CareProprietary and Confidential
Integrated Care for members determined to have a Serious Mental Illness
50
Goals
1. Expand system capabilities for providing integrated care
2. Promote care coordination across all providers
3. Enhance and improve systems to focus on member outcomes and quality of life
Mercy Maricopa Integrated CareProprietary and Confidential
Integrated Care for members determined to have a Serious Mental Illness
51
Accomplishments To-Date
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Deployed care management/coordination teams to provider network organization (PNO) sites to work with community-based case managers
Embedded care management staff at certain facilities to coordinate discharge planning for members (SMI, COE/COT)
Completed Phase 1 of HIN scope of work
Mercy Maricopa Integrated CareProprietary and Confidential
Integrated Care for members determined to have a Serious Mental Illness
52
Accomplishments To-Date (continued)
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Defined details for each of the various models (virtual, PCMH, PCHCH, etc.), developed provider requirements for consideration, and implementation details
Developed ongoing processes to provide data and support to ensure members’ physical/behavioral health needs are met
Mercy Maricopa Integrated CareProprietary and Confidential
Integrated Care for members determined to have a Serious Mental Illness
53
Accomplishments To-Date (continued)
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Collaborated with Learning and Performance to develop training modules for providers
Aligned Mercy Maricopa Integrated Care Academy with the MCP Integrated Care Academy to expand the provision of training and education to providers
Mercy Maricopa Integrated CareProprietary and Confidential
Integrated Care for Members Determined to have a Serious Mental Illness
54
Priorities Moving Forward
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Expand behavioral health services offerings at current PCMH, FQHC, and FQHC-like providers during 2015
Expand the number of integratedpractices available to persons with SMI by 3-5 centers each quarter
Continue to identify ways to expand the network of providers
Mercy Maricopa Integrated CareProprietary and Confidential
Integrated Care for Members Determined to have a Serious Mental Illness
55
Priorities Moving Forward
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Complete the Participation Agreements with HINAz and BHINAz
Increase trainings offered through the Integrated Care Training Academy to at least one per quarter in 2015
Mercy Maricopa Integrated CareProprietary and Confidential
Block Payment Reform
Mercy Maricopa Integrated CareProprietary and Confidential
Block Payment Reform
57
Block Payment Reform Overview
Executive Sponsor: Eddy Broadway, President and CEO
Business Owner: Ramon Dominguez, Chief Financial Officer
Intended Outcome: Align payment processes and incentives to purchase high-quality, cost-effective services that improve member outcomes and increase accessibility.
Mercy Maricopa Integrated CareProprietary and Confidential
Block Payment Reform
58
Goals
1. Transform the payment system in a transparent way that actively engages stakeholders/influencers
2. Develop payment methodology(ies) that incentivize high-quality care and improved member outcomes
3. Implement new payment mechanisms in a systematic way across the network
Mercy Maricopa Integrated CareProprietary and Confidential
Block Payment Reform
59
Accomplishments To-Date
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
First payment pilot implemented August 2014
Stakeholder forum convened September 2014
Second pilot project will be implemented in November 2014
Mercy Maricopa Integrated CareProprietary and Confidential
Block Payment Reform
60
Priorities Moving Forward
Area(s) of Influence/Impact
Item
Exp
and
serv
ice
cap
acit
y
HIE
/HIN
Imp
rove
/En
han
ceTe
ch
Cap
acit
y
SAM
HSA
EB
Ps
Co
ntr
ibu
te t
o
Inn
ova
tio
n
Pee
r an
d F
amily
En
gage
men
t
Co
mm
un
ity
Stak
eho
lder
En
gage
men
t
Co
ntr
act
Co
mp
lian
ce
Req
uir
emen
t
Full implementation of block payment reform by October 2017
Proprietary and Confidential
Discussion and Next Steps
Proprietary and Confidential
Thank You!
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