Meeting Minutes Practice Transformation Workgroup 03/22/2016 | 2:00 – 4:00 MT | HCPF Type of Meeting: Chairs:

Workgroup Meeting Mindy Klowden

SIM Representative:

Nicole King

Note Taker:

Matthew Welchert

Members in Attendance:

Jo Anne Doherty, David Brody, Beth Neuhalfen, Anita Rich, Pam Jones, Nicole Deaner, Margaret Huffman, Lori Stephenson, Susan Mathieu, Patrick Gordon, Claudia Zundel, .

Ex Officio and Gusts:

Heather Stocker, Emily Haller, Maggie Dunn, Ellen Kaufmann, TriWest Representatives— Tonya Aultman-Bettridge and David Bartsch.

Action Items and Decisions:  

Provide Feedback on any roadblocks around attribution to be discussed in future meetings. Get more guidance from The Colorado Health Foundation on whether practices may apply for funds more broadly or if they will need to be specific. As well as how flexible the funding and the budget can be in the application. Finally, get feedback on whether “supporting” staff could include hiring, repurposing, and contracting ass all three would provide greater flexibility for practices.

Discussion Summary: 

Split Tool: Kyle Knierim of the University of Colorado Denver presented on the Shared Practice Learning and Improvement Tool (SPLIT). o Kyle demonstrated aspects of the tool, its functions, how it would be used by provides and coaches, and next steps for the tool. o Next Steps:

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The project described was supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent t he official views of HHS or any of its agencies.

Meeting Minutes The SPLIT Tool team will be working on continued bug fixes, providing training and technical assistance, improving administrative features for the PTOs.  A quality measures reporting tool will be coming out soon.  Developing new features and functionalities, and preparing the tool for use by other initiatives such as EvidenceNow, TCPI, and the CBHC Bi-Directional integration effort.  Future efforts depend on feedback from stakeholders and involved practices and PTO’s so please provide any recommendations or comments. The tool is evolving and so guidance will be important in helping develop it in a useful way. o Use for evaluation: TriWest is committed to creating the least burden for all involved in performing its evaluation work. As such, they are keen to use the data from SPLIT as a preexisting data source and have discussed with UCD about how to do so. o To find out more information on the tool as well as additional in-depth webinars on the tool people may visit practiceinnnovationco.org which is a central location for all University of Colorado resources on practice transformation. 42 CFR Part 2: Providing comments on potential rule changes. o The SIM Office will provide feedback, as it relates to function and goal of SIM, as one of a number of state agencies submitting comments. Comments are due April 11th. o Overall, proposed changes will seek to walk the tightrope between increasing the ability to share data related to items covered by 42 CFR while maintaining the necessary degree of security.  SIM will provide feedback in relation to the applicability section, which outlines the different programs and providers covered, as well as potential changes to the consent form, which may allow for a greater breadth of information sharing.  SIM will be looking to hear back on what 42 CFR covers as well as if a statement of understanding could be incorporated into the consent form. These two issues seem to cause the greatest confusion. o SIM is looking for feedback on what it will be suggesting and what else it should comment on. Please provide feedback to the SIM Office to assist with the formation of comments. Payment Reform Attribution Models: o The Multi-Payer Collaborative is looking into which cases it makes the most sense for them to use their own payment attribution methodologies and will provide 

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The project described was supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent t he official views of HHS or any of its agencies.

Meeting Minutes

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those recommendations. This will help SIM understand when and where to implement its standard attribution method. o SIM will develop and adopt a standard attribution method from ACPD data.  Milliman and CIVHC have done a lot of work on Attribution methodology and developed an attribution set.  The SIM standard attribution will be used for evaluation and engagement, and will not affect payment methods.  Please provide feedback on any roadblocks you may encounter. Future meetings we will focus more in these issues once we receive feedback from the MPC. Current SIM Cohort Funding Structure: o The Colorado Health Foundation will provide roughly $3 million with a potential federal match.  Both of these sets of funds will have certain restrictions placed upon their use and distribution:  The Federal restrictions and the TCHF restrictions apply to different areas and as such we can use the TCHF funds to cover what is restricted by the Federal funds.  Important to think through what practices may need, what the priorities may be, and then what set of funds that may come from.  Care management software and disease registry software seems to be missing. o The Feds have issue with technology, there needs to be a demonstrable need for the technology and illustration that the service could not have been handled by a more conventional means.  Small Grants Applications: additional sets of funds which practices may apply for.  Each cohort will get a chance to apply, and we want practices to be able to understand in advance what they could potentially apply for. o UCD will bring up the applications at the learning Collaboratives to get practices thinking about the application early. o They may be able to apply more broadly to the TCHF funds, but they will have to be specific in regards to the federal dollars.  Criteria for determining funding distribution: o At the high level: demonstrated practice need and project impact will be most important. 3

The project described was supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent t he official views of HHS or any of its agencies.

Meeting Minutes

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o Have a consideration for innovation in addition, but a separate fund for innovative tasks will not likely be feasible. The grants could be an incentive to provide further evaluation feedback to TriWest. o If it can be streamlined with existing processes, it may be a good way to provide an extra incentive to gain greater insight.

Referrals: 

N/A

Public Comments: 

N/A

Next Meeting:

04/12/2016 2:00-4:00 HCPF 303 E. 17 th Ave. 11C

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The project described was supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent t he official views of HHS or any of its agencies.