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Reducing Health Disparities: The Journey of Brightpoint Health

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Brightpoint Health's CEO and President, Paul Vitale and Chief Clinical Officer, Dr. Barbara Zeller, share Brightpoint's journey, strategies and best practices to reduce health disparities in New York City's high-need neighborhoods.

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Reducing Health Disparities: The Journey of Brightpoint Health

  1. 1. Reducing Health Disparities: The Journey of Brightpoint Health Barbara Zeller, MD., Chief Clinical Officer Paul D. Vitale, President, Chief Executive Officer
  2. 2. The World We Faced Epidemic #2 Heroin Epidemic #3 Mass Incarceration Epidemic #1 Crack/Cocaine Reducing Health Disparities: The Journey of Brightpoint Health Epidemic #4 HIV/AIDS
  3. 3. Our historic experience with HIV care informed our development of an integrated care model. • The Bronx, New York City 1990 • Face of HIV/AIDS had changed in New York City • Brightpoint began with residential care Our History Reducing Health Disparities: The Journey of Brightpoint Health
  4. 4. Reducing Health Disparities: The Journey of Brightpoint Health Our Integrated Care Model: A Provider’s Nirvana All aspects of physical, behavioral and social care coordinated and customized to each patients needs. Shelter Resident Food 4. Art Therapy 3. Health Education 1. Substance use Treatment • Individual Counseling • Group Sessions • Structured Daily Schedule • Housing Structure • Assignments 2. Social Services • Case Management • Legal Liaison • Family Program 4. Therapeutic Recreation 3. Acupuncture 1. Medical Care 2. Nursing Care 24/7 PT/OT Resident Council
  5. 5. Industry Forecasts Demand New Strategy • Reduced payments for in-patient care • Reduced HIV population • Smaller margins mandate scale • Growth in managed care • Medicaid transformation Reducing Health Disparities: The Journey of Brightpoint Health Challenges Faced In 2009 Underserved, HIV-Negative Population Needs Integrated Care Model • Multiple co-morbidities • Social exclusion, poverty and reduced opportunities • Limited use of preventative measures • Limited access to community based health care
  6. 6. Board Challenge: Change is difficult for all stakeholders Staff Patients Reducing Health Disparities: The Journey of Brightpoint Health
  7. 7. • Strategic planning • State reform program • Managed care and value based payments • Health home care management programs • Growth through strategic acquisitions and affiliations • Hospital system partnerships • Fiscal management • FQHC Status • Grants • Making very tough decisions Complex Challenges Require Multiple Solutions Reducing Health Disparities: The Journey of Brightpoint Health
  8. 8. Building Brightpoint Health • BUILD INFRASTRUCTURE TO SUSTAIN GROWTH • PROMOTE GROWTH • EXPAND SERVICES & IMPROVE QUALITY • EMPHASIZE CULTURE - Core Values - Culture Handbook - System for Organization-Wide Culture Development - Regular Retreats - System for leader Empowerment - Board Manual - Expand to Primary Care, Dental, and Health Home Care MGMT - Quality DEPT - Clinical Informatics DEPT - Electronic Health Record - Mobile Clinics - FQHC Designation - 8-22 License - Quality & Compliance Departments - HR DEPT - Advanced IT Infrastructure - Finance DEPT Maintains 30 day Reserve - BP Search Social Venture Agency - Business Development Program - Strategic Affiliations with Hospitals, FQHCS, BH Providers, and Community- Based Organizations - Managed Care DEPT - External Affairs DEPT (Marketing, Development, and GOVT Affair - Rebranding CONSISTENT STRATEGIC PLANNING IS AT THE FOUNDATION OF OUR EFFORTReducing Health Disparities: The Journey of Brightpoint Health
  9. 9. Solution: Effective Strategic Planning • Brightpoint concluded first strategic plan cycle in 2013 • 2014-17 Strategic plan based on five pillars Reducing Health Disparities: The Journey of Brightpoint Health
  10. 10. Reform was desperately needed in New York State. In 2010: • Medicaid costs per recipient were double the national average • Ranked 50th in country for avoidable hospital use • Ranked 21st for overall Health System Quality Governor Cuomo created the Medicaid Redesign Team (MRT). • 27 stakeholders representing every sector of health care • Developed a series of recommendations to lower immediate spending and institute reforms • Closely tied to New York’s implementation of the ACA Multi-year action plan–still being implemented Solution: New York State Initiated Revolutionary Changes in Health Care in 2011 Reducing Health Disparities: The Journey of Brightpoint Health
  11. 11. Solution: Managed Care and Value-Based Payment is the Future of Medicaid and HIV Organizations Fee For Service pays for inputs rather than outcome; an avoidable readmission is rewarded more than a successful transition to integrated care Transformation of the delivery system can only become and remain successful when the payment system is transformed as well Many of NYS system’s problems are rooted in payment models. Current payment systems do not adequately incentivize prevention, coordination or integration Reducing Health Disparities: The Journey of Brightpoint Health
  12. 12. We currently operate a Health Home office in each borough. • Care Manager develops comprehensive health plan for patients with multiple chronic conditions and health needs • Health records distributed, post consent, and diverse array of services are coordinated • Social barriers to care are addressed • Partnerships reduce likelihood of high-cost in-patient care Reducing Health Disparities: The Journey of Brightpoint Health Health Home
  13. 13. Reducing Health Disparities: The Journey of Brightpoint Health Expanded Reach: 24 Sites
  14. 14. • Brightpoint Merger with Community Health Action of Staten Island (CHASI) • Brightpoint gets: New services and service area • CHASI gets: Financial and infrastructure support, and scale from a larger organization • How it happened and why it worked • Merger was based on shared vision, culture, strategy and commitment to quality. • CHASI leadership integrated with Brightpoint. CEO key addition to our team Solution: Growth Through Affiliations and Mergers Reducing Health Disparities: The Journey of Brightpoint Health
  15. 15. • Brightpoint Health affiliated with a hospital partner • Took over the operations of the hospital’s outpatient clinic • Continues the hospital's residency programs • Expands scope of services • Introduces an integrated care model Reducing Health Disparities: The Journey of Brightpoint Health Hospital System Partnerships
  16. 16. Better Care • Over 85% of our primary care patients are satisfied with their care, provider access and engagement. Almost all would recommend Brightpoint Health to a friend. These Solutions Allow Us to Meet Our Overriding Objective: The Triple Aim Lower Costs Lower Costs • Identify high risk/high cost patients. • Provide more intensive care management and intervention toward reducing costly Emergency Department visits and inpatient care. Better Health • Our clinical results meet or exceed national and state benchmarks despite patients representing a less stable population than Medicaid recipients overall. Reducing Health Disparities: The Journey of Brightpoint Health
  17. 17. Our nursing home was our legacy. Not our future. Our nursing home was our legacy. Not our future. Solution: Making Tough Decisions In 2015, we made the very tough decision to sell our nursing home license to a proprietary group Heartbreaking but necessary for our long term success and ability to serve more patients, including those living with HIV. New care models and Value Based Payments discouraged inpatient Care. Patients were getting the same services and the same quality care on an outpatient basis. Reducing Health Disparities: The Journey of Brightpoint Health
  18. 18. Reducing Health Disparities: The Journey of Brightpoint Health Organizational Chart
  19. 19. Since 2012, Brightpoint Health has gone Result: Internal Growth and Adjusting to Change From four locations to sixteen From 300 employees to almost 800 From 90,000 health care visits to over 130,000 Reducing Health Disparities: The Journey of Brightpoint Health
  20. 20. We maintain our ten Core Values: Result: Internal Growth and Adjusting to Change Reducing Health Disparities: The Journey of Brightpoint Health
  21. 21. How? • Invested in quality • Invested in culture • Continuity in executive leadership • Brand ownership Result: Internal Growth and Adjusting to Change Reducing Health Disparities: The Journey of Brightpoint Health
  22. 22. Reducing Health Disparities: The Journey of Brightpoint Health WOW! Quality Service

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