1115 Waiver Success Story: Baptist Hospitals of Southeast Texas’ SMART Health Clinic/Patient Navigation DSRIP

Dear Region 2:

 

If anyone would ask me if I like my job, I would have to say, “No!”  Why would I say such a thing?  Because, I would be lying if I didn’t say, “I LOVE my job!”  While keeping up with the technicalities of the 1115 Healthcare Transformation Waiver can be rather arduous at times and the reporting process somewhat grueling, the benefits and outcomes of the waiver projects are truly beginning to positively impact healthcare delivery for many of our region’s most vulnerable individuals.  And, I also LOVE my job because of the people in the region that my team and I support each and every day in our role as anchor–dedicated providers and community stakeholders who are eager to work together to find innovative solutions to real, concrete needs.  And, rightfully so.

 

Of the nearly 1.5 million individuals residing within the 16-counties that comprise Region 2, 25% of the population is uninsured and another 27% are Medicaid or Medicaid/Medicare (dual eligible) recipients.  The region covers some 14,500 square miles, and much of its densely rural areas are often referred to as “Deep East Texas.”  While a large portion of Region 2 is widely known for picturesque images of tall Pines, blooming Dogwood trees and freshwater lakes, the fact remains that more than 50% of the geography is designated as a Health Professional Shortage Area in primary care and mental health services.  These statistics amplify the importance of waiver projects and reconfirms why performing providers within our Regional Health Partnership continue to be focused on executing well-defined, purposefully-crafted, measurable outcomes.

 

In traveling extensively through the region since the inception of the waiver, many similar themes have surfaced.  Regardless if visiting with providers practicing in more populous counties, like Galveston or Jefferson, or trying to understand challenges from practitioners in more rural parts, like Angelina or San Augustine County, the need for better coordinated healthcare is always at the top of the “wish list.”  One might think that coordinating care for people with complex, chronic conditions isn’t as difficult of a process in more metropolitan markets; but, while admittedly easier, coordination is only as successful as the system put in place.  This was one of the most obvious opportunities identified in the comprehensive Region 2 Community Needs Assessment, and a key strategic focus for many regional providers like Beaumont-based, Baptist Hospitals of Southeast Texas.  During the planning process, Baptist leadership quickly committed to utilizing the waiver as a means to identify, evaluate, prioritize various processes to help their most at-risk patients better navigate the healthcare system.  Part of this commitment was to hire, train and deploy patient navigators: individuals who are knowledgeable about the community and its resources, sensitive to the cultural diversity of the individuals they support and capable of shepherding patients throughout the continuum of care.  As a result of Baptist’s foresight to the improvement of clinical outcomes through better coordinated care, and, by their support of the 1115 Healthcare Transformation Waiver, two (2) Delivery System Reform Incentive Payment (DSRIP) projects were designed to turn the vision into reality.  Within the projects, a variety of milestones and metrics were carefully crafted over a four-year period, including measures to educate and encourage targeted patients to properly utilize the appropriate healthcare channels (right care, right place, right time).  As reported in the Beaumont Enterprise in November 2014 (http://www.beaumontenterprise.com/news/article/Local-navigators-steer-patients-toward-better-5920009.php#photo-7196542), individuals like Anthony Joseph, a Baptist Beaumont patient and triple-bypass survivor, have benefited from the waiver through the creation of the Baptist Smart Health Clinic and the Baptist Patient Navigation Program, both of which emphasize patient-centered care.  

So, I am proud to report that it’s stories like this that provide a tangible look at the impact the waiver is making in our region and across the state each and every day.   And, furthermore, it’s stories like this that make me say, “I LOVE my job!”

Thank you,
Craig

1115 Waiver Success Story: A DSRIP Project to Enhance Interpretation Services and Culturally Competent Care

[Attached] is an article that I am extremely proud to share with performing providers and interested stakeholders within Region 2.  It showcases one of many successful DSRIP projects under the 1115 Medicaid Waiver within the 16-counties that comprise our region.  As you will read, The University of Texas Medical Branch (UTMB) Patient Services Department made its initial purchase of iPads in April 2014 and began Video Remote Interpretation (VRI) services in designated units throughout the hospital.  This new service was one component of the DSRIP project designed to “enhance interpretation services and culturally competent care” at UTMB.  It utilizes the tablets to offer patients on-demand video language interpretation services with a live person.  According to Martha Livanec, Director of Patient Services, “Language interpretation services are vital to patient safety.”  Livanec also notes, “If a patient doesn’t understand what is going on with their condition because of a language barrier, they and their family members can’t make informed decisions about their care.”  Since the VRI tablets were introduced, they have assisted UTMB’s Patient Services staff to ensure that patients who require an interpreter have access to services even when staff and/or department interpreters cannot be present in person. 

In addition to the great outcomes (to date) and the overwhelming support of this project from UTMB providers, staff members and patients, Ms. Livanec’s VRI project was selected to be highlighted at the National Patient Safety Foundation’s (NPSF) Annual Patient Safety Congress in late April via a poster presentation.  With the assistance of Susan Seidensticker, Director of Waiver Quality Operations for the Region 2 Anchor Office, a national audience will be able to see the impact of translation services to patient safety.  Seidensticker said, “Presenting on this topic at an event like the NPSF Congress is not only an excellent opportunity for UTMB to share how effective communication directly impacts good clinical outcomes; but, how the Texas waiver helped make this projects and other transformational opportunities possible.”   

On behalf of Katrina Lambrecht, JD, MBA, Vice President, Institutional Strategic Initiatives, and the entire Anchor Office team, I would like to congratulate both Ms. Livanec and Seidensticker.  They also join me in requesting that performing providers within Region 2 share/submit success stories related to their DSRIP project(s).  As HHSC leadership works with CMS to negotiate a (possible) waiver renewal or extension, stories like the one highlighted above help illustrate the value of the waiver in Texas and demonstrate that the tremendous work being done through the 1,491 active DSRIP projects supports the Triple-Aim of healthcare: improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care. 

Thank you,
Craig

CMS letter lifting the UC deferral

Dear RHP 2 1115 Waiver Stakeholders –

Yesterday, HHSC received the [attached] letter from CMS that formally removes the UC deferral issued in September 2014.  As we anticipated, the letter notes that CMS plans to work with Texas to do further analysis related to its concerns around private hospital IGT financing arrangements.  As outlined in the letter, if CMS determines that any of the financing arrangements violate federal law and/or any regulations, they expect that Texas would  make necessary adjustments by December 2015.

My office will continue to keep you updated on this issue as we are apprised of new developments by HHSC or other sources. 

Thank you,
Craig

1115 Waiver Update: RHP level PPA and PPR Now Available

RHP 2:

RHP level PPA and PPR data is now available for download and review on the HHSC Waiver website (http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml.) This is Medicaid/CHIP data from calendar year 2012, along with a descriptive summary document.  

On behalf of the UTMB/RHP 2 Anchor Office team, we want to wish you much peace and joy during the holiday season.  Thank you for all you do for the success of DSRIP in RHP 2.  As we go into 2015, we will look forward to continuing to work with you to serve for the health and wellbeing of Texans, both in the 16 counties we serve and beyond.

Thank you,
Craig

RHP 2 -January 2015 – Important Upcoming Dates and Deadlines

Given the approaching holidays, I wanted to share a quick snapshot of upcoming dates and deadlines for January 2015.  Please feel free to share with others in your organization who may be responsible for certain aspects of the 1115 Waiver. 

January 2015 – Important Upcoming Dates and Deadlines

January 1 – IGT Entity Change Form due to HHSC for Entities that have changes in funding DSRIP projects.  DY4 Monitoring IGT will be calculated based on IGT commitments as of this date.

January 2 – IGT Entities enter payments into TexNet and submit Trace Numbers.

January 5 – IGT due from IGT Entities for metrics that were approved in the current DY3 October reporting period (round 2) or approved but unpaid in previous rounds.

January 15 – Requests due to HHSC for any provider who needs to “true up” Category 3 Baseline Rates that were submitted in October.

January 16 – Deadline for providers to respond to metrics marked as “Need More Information” with additional documentation using the Online Reporting System.

January 30 – DY3 October Reporting payment issue date for DSRIP Providers.

Thanks,
Craig

Feb 17

1115 Waiver Success Story: Baptist Hospitals of Southeast Texas’ SMART Health Clinic/Patient Navigation DSRIP

Dear Region 2:   If anyone would ask me if I like my job, I would have to say, “No!”  Why would I say such a thing?  Because, I would be lying if I didn’t say, “I LOVE my job!”  While keeping up with the technicalities of the 1115 Healthcare Transformation Waiver can be rather …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2015/02/17/1115-waiver-success-story-baptist-hospitals-of-southeast-texas-smart-health-clinicpatient-navigation-dsrip/

Feb 10

1115 Waiver Success Story: A DSRIP Project to Enhance Interpretation Services and Culturally Competent Care

[Attached] is an article that I am extremely proud to share with performing providers and interested stakeholders within Region 2.  It showcases one of many successful DSRIP projects under the 1115 Medicaid Waiver within the 16-counties that comprise our region.  As you will read, The University of Texas Medical Branch (UTMB) Patient Services Department made its …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2015/02/10/1115-waiver-success-story-a-dsrip-project-to-enhance-interpretation-services-and-culturally-competent-care/

Jan 14

CMS letter lifting the UC deferral

Dear RHP 2 1115 Waiver Stakeholders – Yesterday, HHSC received the [attached] letter from CMS that formally removes the UC deferral issued in September 2014.  As we anticipated, the letter notes that CMS plans to work with Texas to do further analysis related to its concerns around private hospital IGT financing arrangements.  As outlined in …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2015/01/14/cms-letter-lifting-the-uc-deferral/

Dec 22

1115 Waiver Update: RHP level PPA and PPR Now Available

RHP 2: RHP level PPA and PPR data is now available for download and review on the HHSC Waiver website (http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml.) This is Medicaid/CHIP data from calendar year 2012, along with a descriptive summary document.   On behalf of the UTMB/RHP 2 Anchor Office team, we want to wish you much peace and joy during …

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Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/22/1115-waiver-update-rhp-level-ppa-and-ppr-now-available/

Dec 22

RHP 2 -January 2015 – Important Upcoming Dates and Deadlines

Given the approaching holidays, I wanted to share a quick snapshot of upcoming dates and deadlines for January 2015.  Please feel free to share with others in your organization who may be responsible for certain aspects of the 1115 Waiver.  January 2015 – Important Upcoming Dates and Deadlines January 1 – IGT Entity Change Form …

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Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/22/rhp-2-january-2015-important-upcoming-dates-and-deadlines/

Dec 16

Waiver Updates and Important Information – Region 2

Dear Region 2: Thank you to our amazing and dedicated performing providers in Region 2 who collectively submitted $71,600,633 (total value) for metric achievement during the recent DY3 October Reporting Period.  169 of the 243 total submitted metrics were “approved,” with 59 “provisionally approved” and 15 flagged for “Needs More Information.”   Please see additional details …

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Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/16/waiver-updates-and-important-information-region-2/

Dec 16

Update on UC Deferral

Transformation Waiver Stakeholders – We want to give you a brief update on the September UC deferral.  HHSC expects to receive from CMS next week the letter formalizing the lifting of the deferral.  This is very encouraging, and we want to thank those of you that helped get the deferral lifted by providing supporting documentation …

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Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/16/update-on-uc-deferral/

Dec 15

RHP 2 Regional Meeting Information-December 3, 2014

Below is the link to review the information and attachments from RHP 2’s Regional Meeting on Wednesday, December 3, 2014.  https://ispace.utmb.edu/xythoswfs/webview/_xy-8665668_1  

Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/15/rhp-2-regional-meeting-information-december-3-2014/

Dec 10

1115 Waiver – 12/05/14 Anchor Update

October Reporting and Review HHSC will complete its review by Dec. 8.  Providers will be able to login to the DSRIP Online Reporting System to view the HHSC Signoff and HHSC Comments for each metric.  HHSC will also send summary information to anchors and providers during the week of December 8 with the signoff status …

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Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/10/1115-waiver-120514-anchor-update/

Dec 10

RHP 2 – Mid-Point Assessment Update

Dear RHP 2: As you know, Mid-Point Assessments of DSRIP waiver projects in Texas are actively being done.  As part of this assessment, Myers and Stauffer are conducting site visits of selected providers in each RHP on behalf of CMS as well as visiting with anchoring entities.  Region 2 is scheduled for next week.  Given …

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Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/10/rhp-2-mid-point-assessment-update/

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