Two competing health systems in Rochester, NY - URMC and RRH - joined forces to form the Finger Lakes Performing Provider System (FLPPS) to implement New York's Medicaid 1115 waiver and DSRIP program. FLPPS includes 28 hospitals, over 3,000 providers, and 600 community organizations across a 13-county region. It has a governance structure that includes representatives from URMC, RRH, community organizations, and regional sub-networks to oversee its work. Through collaboration, FLPPS developed an approved DSRIP project plan and received $565 million in funding, more than any other private PPS in the state.
Online Conference Takes “Deep Dive” into Affordable Care ActPYA, P.C.
PYA’s Martie Ross, Principal, joined three other panelists in a full-day, online conference sponsored by the American Institute of Certified Public Accountants to offer an in-depth look at healthcare reform under the Affordable Care Act (ACA).
Leveraging Public Health Capacity to Increase Health System EfficiencyNASHP HealthPolicy
Presenter Sharon Moffatt Chief of Health Promotion and Disease Prevention with the Association of State and Territorial Health Officials, leading on prevention, access to care and health reform
Local Mental Health Authority
Medicaid Match Social Services Appropriations
Sub-Committee Legislative Report
September 2015
Prepared by: Utah Association of Counties
Expanding Access to Healthcare in Texas - Robert Greenwald, J.D.OneVoiceTexas
Robert Greenwald, J.D., Director of the Center for Health Law and Policy Innovation at Harvard Law School, looks at turning the Affordable Care Act challenges into Opportunities at the June 4, 2014 Designing Healthcare in Texas conference. (Hosts: One Voice Texas, Harris County Healthcare Alliance, Rice University Kinder Institute)
The learner visited senator Eleanor Sober in the senatorial residence of Florida. This was at the Old Library in Hollywood Boulevard Hollywood. There were other invited parties including senator’s assistants, Jeffrey Scala, Eric Reinarman, and Yale, Olenick. The meeting was scheduled at 10.00 am, December 2, 2015. The learner made a one-hour PowerPoint presentation in a forum also attended by other stakeholders in the health system of Broward County. Among these visitors were managers of heath facilities, administrators of the county’s health care, and local advisory panels. All these stakeholders were to offer insight in policy revisions. So as to facilitate audience’s understanding, the presenter issued handouts on the discussion topic. The presenter also answered questions raised by the audience as a way of addressing concerns and acquiring multiple perspectives about the health policy issue of interest.
Physician Expectations and Primary Care Shortages: Evidence from the Affordab...Gerrit Lensink
This paper is the first installment in my undergraduate thesis on physician expectations and their effect on primary care shortages in the United States. Over following semesters I will be strengthening my research with econometric models and further analysis. Updates will follow as completed.
El Progreso - Galicia no se resiste al auge imparable de la comida a domicili...EAE Business School
No es un secreto que los hábitos alimenticios han cambiado mucho. Cocinar uno mismo en casa algo que hace apenas unos años era una clara muestra de normalidad, ya no es una necesidad; y buena culpa de ello la tienen los emergentes negocios de hostelería a domicilio, que son cada vez más variados. La facilidad e instanteneidad que estos proporcionan son incluso más tentadores que los propios platos que ofrecen. Y eso, en un contexto social en el que el trabajo y las obligaciones distan mucho de ser algo accesorio, atrae.
Online Conference Takes “Deep Dive” into Affordable Care ActPYA, P.C.
PYA’s Martie Ross, Principal, joined three other panelists in a full-day, online conference sponsored by the American Institute of Certified Public Accountants to offer an in-depth look at healthcare reform under the Affordable Care Act (ACA).
Leveraging Public Health Capacity to Increase Health System EfficiencyNASHP HealthPolicy
Presenter Sharon Moffatt Chief of Health Promotion and Disease Prevention with the Association of State and Territorial Health Officials, leading on prevention, access to care and health reform
Local Mental Health Authority
Medicaid Match Social Services Appropriations
Sub-Committee Legislative Report
September 2015
Prepared by: Utah Association of Counties
Expanding Access to Healthcare in Texas - Robert Greenwald, J.D.OneVoiceTexas
Robert Greenwald, J.D., Director of the Center for Health Law and Policy Innovation at Harvard Law School, looks at turning the Affordable Care Act challenges into Opportunities at the June 4, 2014 Designing Healthcare in Texas conference. (Hosts: One Voice Texas, Harris County Healthcare Alliance, Rice University Kinder Institute)
The learner visited senator Eleanor Sober in the senatorial residence of Florida. This was at the Old Library in Hollywood Boulevard Hollywood. There were other invited parties including senator’s assistants, Jeffrey Scala, Eric Reinarman, and Yale, Olenick. The meeting was scheduled at 10.00 am, December 2, 2015. The learner made a one-hour PowerPoint presentation in a forum also attended by other stakeholders in the health system of Broward County. Among these visitors were managers of heath facilities, administrators of the county’s health care, and local advisory panels. All these stakeholders were to offer insight in policy revisions. So as to facilitate audience’s understanding, the presenter issued handouts on the discussion topic. The presenter also answered questions raised by the audience as a way of addressing concerns and acquiring multiple perspectives about the health policy issue of interest.
Physician Expectations and Primary Care Shortages: Evidence from the Affordab...Gerrit Lensink
This paper is the first installment in my undergraduate thesis on physician expectations and their effect on primary care shortages in the United States. Over following semesters I will be strengthening my research with econometric models and further analysis. Updates will follow as completed.
El Progreso - Galicia no se resiste al auge imparable de la comida a domicili...EAE Business School
No es un secreto que los hábitos alimenticios han cambiado mucho. Cocinar uno mismo en casa algo que hace apenas unos años era una clara muestra de normalidad, ya no es una necesidad; y buena culpa de ello la tienen los emergentes negocios de hostelería a domicilio, que son cada vez más variados. La facilidad e instanteneidad que estos proporcionan son incluso más tentadores que los propios platos que ofrecen. Y eso, en un contexto social en el que el trabajo y las obligaciones distan mucho de ser algo accesorio, atrae.
Ben Chaib : A California Based Entrepreneurial Professionalsubkavinsmith
Ben Chaib is an experienced entrepreneurial professional. In February 2009, he founded Sell & Succeed, LLC, and is serving as its Sales Expert at present.
Aprende a cuidar tu yo digital -Charla Universidad de ValenciaEva María Marcos
Si eres consciente del lado oscuro de las redes sociales, podrás cuidar de tu huella digital. Charla de reputación digital impartida en la Facultad de Economía (Universidad de Valencia), tanto en el Campus de Tarongers como en el de Ontinyent.
¡Mantente actualizad@! Sígueme en las redes: @evamariamarcos
Links comentados en la charla:
Take This Lollipop> http://www.takethislollipop.com/
Google Location History> Búscalo tal cual en tu navegador y descubre cómo rastrea Google tu smartphone
Owen Mundy> I know where your cat lives http://iknowwhereyourcatlives.com/cat/46dbc7f562
Chema Alonso> El lado del mal (blog)
http://www.elladodelmal.com/
Crea tus alertas> Talkwalker.com> http://www.talkwalker.com/alerts
the foodpanda group is a global mobile food delivery marketplace headquartered in Berlin, Germany, and operating in 40 countries and territories, including India, Pakistan, Russia, Brazil, Mexico and Singapore. The service allows users to select from local restaurants and place orders via the mobile application as well as the website. The company has partnered with over 58,000 restaurants.
Tesis Pregrado - Diseño de estrategias de Marketing Experiencial para la empr...Paúl Bracho Raleigh
Universidad Dr. Rafael Belloso Chacín
Trabajo de Pregrado para optar por el título de Licenciado en Administración Mención Mercadeo 2011
Autores: Almarza, Bracho, Jimenez, Vera 2011
Asesores: Drs. Lescher, Fuenmayor
Jurado: Padrón, Fuenmayor
Los líderes y expertos en marketing más reconocidos del mundo nos dejan valiosas lecciones que pueden aplicarse tanto en grandes empresas, como en negocios recién creados. Ellos rompieron el molde y hoy están al frente de importantes compañías, pero empezaron como todos, desde cero. Veamos qué nos pueden enseñar estos exitosos empresarios.
These slides use concepts from my (Jeff Funk) course entitled Biz Models for Hi-Tech Products to analyze the business model for Zomato, a food discovery site that is transforming the global restaurant business and that is a member of the WSJ’s billion dollar startup club. Not only does it connect users and restaurants, it is also helping restaurants manage their finances, food and equipment orders, and design restaurants. Its core business is helping users find, book, and evaluate restaurants and helping restaurants advertise their services to users and accept bookings. However, the global network that Zomato is building of users and restaurants is enabling Zomato to extend its business into all aspects of F&B.
Understand Legal Needs in Healthcare: Use The Medical–Legal Partnership ToolkitPractical Playbook
The Medical–Legal Partnership Toolkit
Developed by the National Center for Medical–Legal Partnership (www.medical-legalpartnership.org), This toolkit has what you need to create a successful medical-legal partnership. In fact, it’s got lots of useful information for most kinds of partnerships.
Although the impact of social problems on health is well-documented, legal needs aren’t in the language of health care. Legal care isn’t used to treat patients or address population health.
The connection between legal needs and health is invisible in current health care practice. Overcoming this invisibility requires changing the way health care team members understand and screen for these legal needs, and how clinics and health care teams respond to the identified needs.
“All medical-legal partnerships (MLPs) address health-harming legal needs that disproportionately affect people living in poverty. These partnerships are defined by their adherence to two key principles. First, health care and legal professionals use training, screening and legal care to improve patient and population health. Second, this legal care is integrated into the delivery of health care and has deeply engaged health and legal partners at both the front-line and administrative levels.”
The goal of such partnerships is to improve care for vulnerable populations.
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
White Paper - Building Your ACO and Healthcare IT’s RoleNextGen Healthcare
The tools needed to capture, organize, and share healthcare data are truly evolving at the speed of light. Patient Centered Medical Homes play a vital role in the path toward accountable care and technology, staff, and workflow transformation are necessary to achieve PCMH recognition. This transformation allows healthcare providers to deliver higher quality coordinated care by streamlining and rationalizing the patient experience.
4 hours ago
Amy Miller
RE: Discussion - Week 7
Collapse
NURS 6050C: Policy and Advocacy for Improving Population Health
Main Question Post. The Patient Protection and Affordable Care Act of 2010 created several positive healthcare policies such as affordable health care, lifting the preexisting health condition clause from health insurance, requiring facilities to make healthcare charges public knowledge, and enforcing healthcare providers to become active in improving quality and health outcomes for patients (Library of Congress, n.d.). The act addressed a combination of the health care drivers of cost, quality, and access. According to a report released by the White House Press Secretary on April 17, 2014, “The Affordable Care Act is working. It is giving millions of middle class Americans the health care security they deserve, it is slowing the growth of health care costs and it has brought transparency and competition to the Health Insurance Marketplace.” (The White House, 2014). However, the price some healthcare providers had to pay a heavy financial - forcing some providers out of business. The negative side of the act is seldom portrayed in the news and media.
Section 3131(a) of the act required payment for home health services to be rebased over a period of four years (Centers for Medicare & Medicaid Services, 2013); resultant in a 2.8% reduction beginning in 2014 for four consecutive years totaling a reduction in payment of 11.6%. The reductions were placed along with mandates for quality reporting, new forms, and new processes resulting in increased administrative overhead costs while shouldering the burden of financial reductions.
Initiating a Change in Policy Process
Living in a rural community, I witness firsthand the lack of access to care as there are limited numbers of primary care providers. Couple the limited access to providers with the amount of paperwork and forms that must be signed by a physician and patients are not referred to home health services as often as one should be – the result is the patient presenting to the emergency room or a hospitalization to have one’s health care needs met. Currently, Medicare and Medicaid do not allow physician assistants or advanced practice registered nurses (APRNs) to sign the necessary orders and plan of care for home health services – only a “doctor of medicine, osteopathy, or podiatric medicine” may sign for services (Government Publishing Office, 2014, p. 693). I would like to use the knowledge gained as an APRN to legislate for this mandate to be changed and allow both physician assistants and APRNs to sign for coverage of home health services.
The Kingdon Model would be utilized for the legislation process by finding the three streams of problem, policy, and politics to coordinate with the above-mentioned issue (Milstead, 2019, p. 24). The problem would consist of the burdensome amount of paperwork imposed upon.
By Thomas C. Ricketts and Erin P. FraherReconfiguring Heal.docxclairbycraft
By Thomas C. Ricketts and Erin P. Fraher
Reconfiguring Health Workforce
Policy So That Education,
Training, And Actual Delivery
Of Care Are Closely Connected
ABSTRACT There is growing consensus that the health care workforce in
the United States needs to be reconfigured to meet the needs of a health
care system that is being rapidly and permanently redesigned.
Accountable care organizations and patient-centered medical homes, for
instance, will greatly alter the mix of caregivers needed and create new
roles for existing health care workers. The focus of health system
innovation, however, has largely been on reorganizing care delivery
processes, reengineering workflows, and adopting electronic technology
to improve outcomes. Little attention has been paid to training workers
to adapt to these systems and deliver patient care in ever more
coordinated systems, such as integrated health care networks that
harmonize primary care with acute inpatient and postacute long-term
care. This article highlights how neither regulatory policies nor market
forces are keeping up with a rapidly changing delivery system and argues
that training and education should be connected more closely to the
actual delivery of care.
H
ealth care professionals are be-
ing challenged to find new ways
to organize care and develop
systems that hold providers ac-
countable for the quality, cost,
and patient experience of care.1 The once in-
cremental pace of change is accelerating, and
there is evidence that long-standing paradigms
are dramatically shifting.2 For example, the rela-
tively slow acceptance of prepaid and managed
care systems is being replaced by the rapid adop-
tion of bundled and risk-based payment mod-
els.3,4 Early adopters of accountable care organi-
zations (ACOs) are finding that their workforce
is shifting from acute care to community- and
home-based settings with increasing roles for
physicians, nurses, social workers, patient navi-
gators and outreach coordinators, and other
clinicians in providing enhanced care coordina-
tion, better medication management, and im-
proved care transitions.5
The training of health professionals, however,
lags behind these reforms because it remains
largely insulated from change behind the walls
of schools of medicine, dentistry, pharmacy, and
nursing. Medical training is done primarily in
hospitals, while the greatest challenges are
found in coordinating care in multiple out-
patient settings. This article describes how
health workforce policy was done in the past.
It illustrates some of the specific changes under
way and how they are changing the health care
workforce. Further, it suggests that closer links
should be built between the day-to-day caring for
patients and the training of the people who de-
liver that care.
Workforce Policy Center Stage Again
Health workforce policy took center stage in an
earlier Health Affairs thematic issue in 2002.6
Articles in that issue described future efforts to
doi: 10.1377/.
By Thomas C. Ricketts and Erin P. FraherReconfiguring Heal.docxjasoninnes20
By Thomas C. Ricketts and Erin P. Fraher
Reconfiguring Health Workforce
Policy So That Education,
Training, And Actual Delivery
Of Care Are Closely Connected
ABSTRACT There is growing consensus that the health care workforce in
the United States needs to be reconfigured to meet the needs of a health
care system that is being rapidly and permanently redesigned.
Accountable care organizations and patient-centered medical homes, for
instance, will greatly alter the mix of caregivers needed and create new
roles for existing health care workers. The focus of health system
innovation, however, has largely been on reorganizing care delivery
processes, reengineering workflows, and adopting electronic technology
to improve outcomes. Little attention has been paid to training workers
to adapt to these systems and deliver patient care in ever more
coordinated systems, such as integrated health care networks that
harmonize primary care with acute inpatient and postacute long-term
care. This article highlights how neither regulatory policies nor market
forces are keeping up with a rapidly changing delivery system and argues
that training and education should be connected more closely to the
actual delivery of care.
H
ealth care professionals are be-
ing challenged to find new ways
to organize care and develop
systems that hold providers ac-
countable for the quality, cost,
and patient experience of care.1 The once in-
cremental pace of change is accelerating, and
there is evidence that long-standing paradigms
are dramatically shifting.2 For example, the rela-
tively slow acceptance of prepaid and managed
care systems is being replaced by the rapid adop-
tion of bundled and risk-based payment mod-
els.3,4 Early adopters of accountable care organi-
zations (ACOs) are finding that their workforce
is shifting from acute care to community- and
home-based settings with increasing roles for
physicians, nurses, social workers, patient navi-
gators and outreach coordinators, and other
clinicians in providing enhanced care coordina-
tion, better medication management, and im-
proved care transitions.5
The training of health professionals, however,
lags behind these reforms because it remains
largely insulated from change behind the walls
of schools of medicine, dentistry, pharmacy, and
nursing. Medical training is done primarily in
hospitals, while the greatest challenges are
found in coordinating care in multiple out-
patient settings. This article describes how
health workforce policy was done in the past.
It illustrates some of the specific changes under
way and how they are changing the health care
workforce. Further, it suggests that closer links
should be built between the day-to-day caring for
patients and the training of the people who de-
liver that care.
Workforce Policy Center Stage Again
Health workforce policy took center stage in an
earlier Health Affairs thematic issue in 2002.6
Articles in that issue described future efforts to
doi: 10.1377/ ...
The Magellan Health clinical team for the Maricopa County RBHA designed and implemented a breakthrough plan for investing $27 million in Arizona state funds for peer and family roles.
The FMBHP is a collaboration among frontier/rural healthcare communities; Mineral Community Hospital’s Interdisciplinary Medical Education Center; iVantage, an industry leader providing comprehensive hospital evaluation tools; Mayo Clinic’s Practice-Based Research Network (PBRN); and the Appalachian Osteopathic Postgraduate Training Institute Consortium (A-OPTIC). The FMBHP will partner with CMS, IHS, Veteran Administration and other private insurers to develop a seamless and sustainable model of patient-centered and community-based healthcare that produces better outcomes cost-effectively.
2 health systems advancing population health via collaborationGrant Thornton LLP
Improving community health as a fundamental mission for nonprofit hospitals and health systems, and measuring the impact were described by two local leaders and the leader of a study of collaborations.
The Governance of Quality: Defining Experiences and Success Factors in Instit...HFG Project
he objective of the activity is to assess and document global experiences in institutional relationships that govern quality health services as well as provide practical and action-oriented guidance to countries on success factors in structuring institutional roles, responsibilities, and relationships. Countries seeking to develop new governance structures or to improve existing structures would have a resource, based on the results of documented country experiences, to successful approaches and lessons learned in structuring institutional roles, responsibilities, and relationships to enable, foster, and ensure ongoing quality.
The Governance of Quality: Defining Experiences and Success Factors in Instit...HFG Project
The objective of the activity is to assess and document global experiences in institutional relationships that govern quality health services as well as provide practical and action-oriented guidance to countries on success factors in structuring institutional roles, responsibilities, and relationships. Countries seeking to develop new governance structures or to improve existing structures would have a resource, based on the results of documented country experiences, to successful approaches and lessons learned in structuring institutional roles, responsibilities, and relationships to enable, foster, and ensure ongoing quality.
Similar to COPE_DigestJune-CompetingRochesterJoinForces (20)
The Governance of Quality: Defining Experiences and Success Factors in Instit...
COPE_DigestJune-CompetingRochesterJoinForces
1. Competing Rochester Health Systems Join Forces to
Revamp Care Delivery for the Community
The state of New York plans to transform health care delivery for
Medicaid patients through the Medicaid 1115 Demonstration Waiver it
has negotiated with the Centers for Medicare and Medicaid Services
(CMS). The Waiver aims to save $17.1 billion of Medicaid federal
money over a five-year period by reducing avoidable hospital and
emergency department admissions by 25%. To accomplish that goal,
the state is redirecting Medicaid funds to performance based Delivery
System Reform Incentive Payment (DSRIP) projects that will radically change how health care is delivered to Medicaid
patients. The DSRIP program uses incentive-based payments that must be earned, initially through the achievement
of process milestones and later improvement of clinical outcome indicators, to encourage providers to form regional
collaborations and focus on operational practices that will be successful in a value-based payment environment.
Similar to Texas’ Medicaid 1115 Waiver, which established Regional Healthcare Partnerships across the state, New York’s
waiver established 25 Performing Provider Systems (PPS) based on geography and regional care delivery. Although both
states have taken a regional approach to implementing pay-for-performance transformation projects, the responsibilities
placed on both the lead provider and the PPS as a whole are staggeringly different. In Texas, lead providers, “anchors”,
are responsible for the coordination and oversight of the DSRIP program in an informal administrative role. In New York,
PPS leads hold vast responsibility in a formal role to drive system outcomes as well as develop joint budgets and funding
distribution plans.
Additionally, the New York Waiver has other meaningful differences, some of which may inform potential renewals of
the Texas and the California DSRIP-based Medicaid Waivers, such as aggressive regional and state-wide performance
outcomes. For example, if the state has not hit 15% of its targeted goal at the halfway point of the DSRIP program, it will
reduce incentive funds for all providers across the state. Not only are the PPS’s financially accountable to the state and
their contracted providers, they also require a level of collaboration that is beyond what DSRIP programs have required
providers to achieve in other states.
Thought Leadership, Visionary Transformation
June 2015www.copehealthsolutions.org
Authors: Mallory Johnson, MHA
and Allen Miller
COPE Monthly Digest
Monthly tips empowering you to transform health care for tomorrow
2. June 2015www.copehealthsolutions.org
Competitors Join Forces to Enhance Quality and Access for Medicaid and Uninsured
In the Rochester region, the state asked two large health systems to join forces and form one PPS that would serve
a 13-county region and be responsible for more than 400,000 Medicaid lives. These two systems are the University
of Rochester Medical Center (URMC), an academic medical center with an 830-bed teaching and research hospital,
children’s hospital, and two community hospitals, and Rochester Regional Health (RRH), which has five acute care
hospitals and more than 80 medical practices. These organizations that have competed for market share in some high
profile services have now partnered to implement transformative projects and change the delivery of care across the
care continuum with hundreds of other health care providers including federally qualified health centers, independent
physicians, specialists, behavioral health organizations, skilled nursing facilities, long-term care facilities and local
agencies such as county public health and mental health departments.
Establishing joint ventures is always challenging and it is even more so when the partnership includes competitors. As
longtime leaders in their marketplace, URMC and RRH had many obstacles to overcome when joining forces. Such
obstacles include the fact that several new executives from each respective organization did not have a history of
collaborating with the other. Both URMC and RRH were willing to come to the table to discuss the possibilities and
challenges of a successful partnership after a previous joint effort in the Medicaid space led to the collaboration and
development of a New York state-certified Health Home. This successful operation showed the providers in the Rochester
region and the Department of Health that systems could form a much larger organization to implement Medicaid
redesign initiatives.
The first step to determine whether a joint venture between the organizations is viable is to bring both executive teams
together at the same table. In October 2014, 50 executives (25 from each organization) did just that. The leadership of
the two systems held a retreat to learn about the entire 1115 Waiver process, including the opportunities and risks the
DSRIP program presented, as well as the impact DSRIP programs could have on the community. They found common
ground around three key questions:
1. Does it make sense for URMC and RRH to compete for Medicaid patients or would the organizations benefit more by
building a financially sustainable system together to treat these patients with higher quality of care?
2. How could the organizations build common processes and systems of care to improve clinical outcomes for Medicaid
and uninsured patients?
3. How would the other providers in the region be impacted in the DSRIP program if URMC and RRH
remained separate?
In the end, the URMC and RRH successfully formed a new corporation named the Finger Lakes Performing Provider
System (FLPPS), which is a 501(c)3 corporation with UR Medicine and RRHS as the sole corporate members
responsible for the initial capitalization and bulk of the staffing and resource contributions during the start-up phase of
the DSRIP program. However, there is board and committee representation for the other health care stakeholders in
the collaborative. FLPPS is comprised of 28 hospitals, 3,000 healthcare providers and more than 600 healthcare and
community-based organizations in a 13-county region. This represents the largest geographic footprint of any PPS in
New York.
3. June 2015www.copehealthsolutions.org
Governance Structure
FLPPS is governed by a board of directors, which meets on a monthly basis. It is comprised of 19 individuals, broken into
the following categories:
• Five individuals from URMC
• Five individuals from RRH
• Five clinicians or lay executives from each of the five Naturally Occurring Care Networks (NOCNs), which are
geographic sub-regions in FLPPS
• Three representatives, one each from a federally qualified health center, county public health organization and county
mental health provider
• One individual who is Medicaid beneficiary served by the PPS
There are three operational committees—clinical quality, finance, and information technology—that develop organizational
strategies, policies and procedures and advise project teams. There are also four workgroups focused on the following
categories: housing, workforce, transportation and cultural competency/health literacy. The workgroups act as the subject
matter experts for the FLPPS’ 11 DSRIP projects. Each of these groups has roughly 10 to 25 members who represent all
of the different health care settings and geographic areas in the PPS.
Developing a strong operational governance structure is one of the reasons the FLPPS joint venture has been so
successful. It was imperative that all of the health care stakeholders—not just URMC and RRH—had a voice and the
ability to help design the DSRIP projects. Establishing trust is a key factor in the success of any joint venture. This
trust and success has been exhibited in a number of ways since the first joint meeting of RRH and URMC. The strong
partnership of these two organizations provided a lead in earning the trust of hundreds of organizations early in the DSRIP
program. This was accomplished by signing attestation forms as the first sign of a five-year commitment to the PPS and
its specific transformative DSRIP projects. These attestations ultimately led to the large number of Medicaid lives the
PPS is responsible for during the Waiver time period. The leads abide by their values of collaboration and transparency
and ensured the governing committees and individual project workgroups were sufficiently represented by provider type
and across the PPS geography. This wide-spread representation allowed for an incredibly well written, thoughtful, and
innovative application to be developed in only a few months and submitted by December 2014.
While New York State Department of Health (DOH) and their hired independent assessor were busy reviewing and
grading PPS applications across the state, FLPPS did not pump the breaks on any collaboration or setting the pace
for best practice development. In keeping with the spirit of communication and collaboration, FLPPS hosted a PPS-
wide summit in February bringing together providers to share a wealth of information and visionary strategy for DSRIP
implementation, transformation to value-based payment and PPS funds flow. This day-long session enabled bidirectional
communication between providers and the lead and facilitated the successful collection of vital information to be used in
the FLPPS implementation plans formally due to the DOH on June 1, 2015. During this time, FLPPS was also required
to facilitate the review and ranking of Capital Restructuring Finance Payment (CRFP) applications for all providers in the
PPS. While the CRFP is not directly linked to the 1115 Waiver and DSRIP, the DOH asked PPS leads to facilitate this
state-funded capital budgeting application process. FLPPS provided PPS providers adequate support and information
4. and created a ranking process that enabled the PPS to not have to redo any work while the DOH submitted applications.
This is a primary example of thought leadership that benefits the lead and all PPS providers and sets the tone for more
best-practice opportunities over the next five years and beyond.
The FLPPS teamwork in designing its DSRIP projects and full application has definitely paid off. Its application was
approved in February 2015, receiving the second highest overall score across the state and gaining approval for
123,000 more lives than the FLPPS initially projected. This high score and credit for additional Medicaid and uninsured
lives enabled FLPPS to receive a substantial valuation. Out of the $6.42 billion in funds available to New York’s DSRIP
program, FLPPS is eligible to earn $565 million in funds during the five-year period, which is more than any other private
PPS in the state.
For more information on how COPE can help you succeed with DSRIP or other Medicaid redesign efforts in New York or
and other states contact: DSRIP@copehealthsolutions.org.
June 2015www.copehealthsolutions.org