Memorial Regional Health convenes hospital transformation project partnerships
September 20, 2018
CRAIG — Changes in how the state reimburses payment for Medicaid patients are expected to trigger a transformation in how hospitals are asked to treat patients and engage with the community.
The Colorado Hospital Transformation Project is an initiative mandated by Senate Bill 17-267 and under development by the Colorado Department of Health Care Policy and Financing Department.
According to HCPF, the HTP is "set to change health care delivery. Delivery system reform incentive payments, or DSRIP, will be used to support hospital-led projects to:
• Improve patient outcomes through care redesign and integration with the community- based providers.
• Improve the patient experience in the care delivery system and support appropriate care in appropriate settings
• Lower Health First Colorado (Colorado's Medicaid program) costs through reductions in avoidable care.
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For the incentive payments, the state will leverage hospital supplemental payment funding generated through existing hospital provider fees authorized under the Colorado Health Care Affordability Act of 2009.
"The impact on Colorado's hospitals, in dollars, is 1 billion. One billion in funds are at risk as a part of this program," said Memorial Regional Health CEO Andy Daniels.
To receive the same level of Medicaid payment under HTP, the hospital will spend the next year working to create stronger community partnerships and preparing for compliance.
On Tuesday, Sept. 11, MRH convened a meeting of individuals, organizations, and agencies that provide care in the community.
"These changes cannot just be viewed by the impact they will have on how MRH delivers care; we must consider how patients are able to access care and other community resources," Daniels wrote in his invitation. "MRH isn't the only caregiver in Northwest Colorado. The services you provide through your organization demonstrate the care and concern you have for our community. We are all making a difference in the community independently; imagine what we could achieve collaboratively."
HCPF's Matt Haynes and Stephanie Fillman, from the Colorado Hospital Association, described the HTP process during a 90-minute meeting facilitated by MRH Director of Population Health Management Paula Davison.
Haynes explained that the state has identified focus areas to include high-utilizers, vulnerable populations, behavioral health and substance use disorder coordination, clinical and operational efficiencies, and community development efforts to improve population health and reduce total cost of care.
"There is a penalty for some hospitals by Medicare for readmissions within 30 days. That penalty does not apply to Medicaid, yet, as part of the HTP, that penalty is coming. As a result, we need to make a shift from volume to value," Davison said.
She added that many caregivers in the room were serving many of the same people.
"As we go down this path, you are going to be hearing social determinants of health that impact not just medical well-being, but also physical and mental well-being," she said.
Hospitals will be expected to engage with their communities to recognize and address the social determinants of health to provide a "road to better health," Haynes said.
A neighborhood engagement process will begin across the rest of the state next month.
"We are not waiting," Davison said. "We are moving ahead and being proactive in our approach."
Missing from the first meeting were representatives from the business community.
"As we grow this conversation, they will be an essential part. … We know that this conversation will get bigger," Fillman said.
The next meeting will be held from 5:30 to 7 p.m. Wednesday, Oct. 17, in the conference room at The Memorial Hospital, 750 Hospital Loop.
"I don't want people to think that this is all about the hospital. This is really about the community," Davison said.
For more information about the meeting or the community health, engagement project, contact Davison at 970-826-3113 or email@example.com.
Contact Sasha Nelson at 970-875-1794 or snelson@CraigDailyPress.com