KickStarting HCAP Operations

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Kick-Starting HCAP Operations
Developed and Presented by Management Systems
Integration, Inc. Mark B. Wilcox -
mwilcox_at_mgmtsysint.com R. Edward Forester -
eforester_at_mgmtsysint.com Lisa A. Baumann -
lbaumann_at_mgmtsysint.com For the Healthy
Communities Access Program March 23, 2006
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Kick-Starting HCAP Operations

• Introduction
• Welcome
• HCAP Program Ending
• Short time to
• Become Fully Operational
• Establish a Multifaceted Base
• Gather Support for Ongoing Operations

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Kick-Starting HCAP Operations

• Agenda
• Why?
• Major Tasks
• General Considerations
• Resources Available
• Primary Tasks
• Secondary Tasks
• Closing - Questions Answers

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Kick-Starting HCAP Operations
COALITION BUILDING
STRATEGIC BUSINESS PLANNING
MANAGEMENT ADMINISTRATION
ACTION PLANS
MIS ACQUISITION DEPLOYMENT
LOGISTICS SUPPORT
STRUCTURAL DEVELOPMENT
PROGRAM OPERATIONS
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Kick-Starting HCAP Operations

• Why Kick-Start Operations?
• Four Months Left in HCAP Program
• Sustainability Planning is Critical
• Clients Need Continuity of Care
• Resources are Available to Help

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Kick-Starting HCAP Operations

• Major Tasks
• Primary Tasks
• MIS Acquisition and Deployment
• Strategic Business Planning
• Coalition Building

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Kick-Starting HCAP Operations

• Major Tasks
• Secondary Tasks
• Program Operational Development
• HCAP Grantee Structural Development
• Management/Administrative Tasks
• Logistics/Support Tasks

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Kick-Starting HCAP Operations

• General Considerations
• Action Plans
• Accounting and Budget

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Kick-Starting HCAP Operations

• General Considerations
• Action Plans
• Identify Goals and Objectives
• Realistic Goals
• Tied to Existing Plans
• Functional Approach

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Kick-Starting HCAP Operations

• General Considerations
• Action Plans
• Building Action Plans
• Detailed by Area
• Specific
• Tasks
• Time Deadlines
• Individual Responsibilities

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Kick-Starting HCAP Operations

• General Considerations
• Action Plans
• Building Action Plans
• Convergence (Synchronicity) Planning
• Prioritize by Time Needed for Completion
• Prioritize by Importance to Coalition
• Revisit/Revised as needed

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Kick-Starting HCAP Operations

• General Considerations
• Action Plans
• Action Plan Resources
• Action Plan Template
• Open Excel Spreadsheet A - Action Plan

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Kick-Starting HCAP Operations

• General Considerations
• Accounting and Budget Analysis
• Accounting Position
• Obligated Funds Real position
• Commitment Requirements

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Kick-Starting HCAP Operations
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Kick-Starting HCAP Operations
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Kick-Starting HCAP Operations

• Resources Available
• Internal Resources
• Local Resources
• External Resources

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Kick-Starting HCAP Operations

• Resources Available
• Internal Resources
• Existing Documents
• Grant Application
• Logic Model
• Project Management Matrix
• Project Work Plan

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Kick-Starting HCAP Operations

• Resources Available
• Internal Resources
• Program Team

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Kick-Starting HCAP Operations

• Resources Available
• Local Resources
• Coalition members - MOA
• Stakeholders
• Local Organizations
• Local Volunteers

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Kick-Starting HCAP Operations

• Resources Available
• External Resources
• HCAP Technical Assistance
• HCAP Web Site
• National Organizations (CJA, ACHI, RWJ, United
  Way, etc.)
• Consultants - Contracting

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Kick-Starting HCAP Operations

• Primary Tasks for Kick-Starting
• MIS Acquisition and Deployment
• Strategic Business Planning
• Coalition Building

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Kick-Starting HCAP Operations

• First Primary Task MIS Acquisition and
  Deployment
• Building a Functionality Matrix
• First, Figure Out Whats Needed!
• Involve All Partners and Stakeholders
• Work with Evaluators
• Then, Make It Look Professional!
• The Secret Weve already done that part for
  you!
• Open Excel Spreadsheet B - Functionality Matrix

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Kick-Starting HCAP Operations

• Primary Task
• MIS Acquisition and Deployment
• Buy or Build Decision
• Quick Hint Unless you have tons of time and
  money, BUY!
• RFI Process/RFP Process
• Look at HCAP TA Website for Documents
• Contract Negotiations
• Get Help! Its Technical and Complex!

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Kick-Starting HCAP Operations

• Primary Tasks
• MIS Acquisition and Deployment
• Infrastructure Requirements (Tech. Details)
• Infrastructure Acquisition
• Infrastructure Deployment
• MIS Deployment
• Policy/Procedure Development
• Administrative/Staff Training

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Kick-Starting HCAP Operations

• Primary Tasks
• MIS Acquisition and Deployment
• Resources
• HCAP Website
• TA Calls and Materials
• HCAP Technical Assistance
• Consultants

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Kick-Starting HCAP Operations

• Primary Tasks
• Strategic Business Planning
• Business Plan Development
• NECESSARY, BUT NOT EVIL!
• Business Planning Process Components
• Plan
• Marketing
• People
• Money

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Kick-Starting HCAP Operations

• Primary Tasks
• Strategic Business Planning

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Kick-Starting HCAP Operations

• Primary Tasks
• Strategic Business Planning

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Kick-Starting HCAP Operations

• Primary Tasks
• Strategic Business Planning
• Resources
• HCAP Technical Assistance
• Local MBAs/Business People
• Service Corp of Retired Executives
• Chamber of Commerce
• SBA

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Kick-Starting HCAP Operations

• Primary Tasks
• Strategic Business Planning
• Resources
• State/Local Business Planning Offices
• United Way
• Communities Joined in Action (CJA)
• Provider Executives/Financial Officers
• Consultants/Contracting

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Kick-Starting HCAP Operations

• Primary Tasks
• Strategic Business Planning
• Sustainability Strategy
• ROI/ROCI
• Prospective vs. Actual

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• Petersen, Nonurgent Emergency Department Visits
  The Effect of Having a Regular Doctor. Medical
  Care 36 (8) 1249-55, 1998
• Plauth and Pearson, Missed opportunities
  Prevention and resource utilization among HMO
  members who do not receive periodic health
  examinations. Preventive Medicine in Managed
  Care 1(1)35-42

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• Kaiser, Family Foundation Sicker and Poorer
  The Consequences of Being Uninsured p77,p95,
  2002
• Vigdor, Coverage Does Matter The Value of
  Health Forgone by the Uninsured Raleigh, NC
  Duke University. Stanford Institute of Public
  Policy (Institute of Medicine, Hidden Costs,
  Value Lost Uninsurance in America), p3, 2003
• Kaiser, Family Foundation Sicker and Poorer
  The Consequences of Being Uninsured p95, 2002

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• (a) Rogoff, Creating the business Case for
  Integrated Health Care Safety Nets, 2002
• Lorig, et al. 1999 Evidence suggesting that a
  chronic disease self-management program can
  improve health status while reducing
  hospitalization A randomized trial. Medical
  Care 37 (1) 5-14
• Gibson, Powell, Coughlan, et al. 2003
  Self-management education and regular
  practitioner review for adults with asthma In
  The Cochrane Library Issue 2. OxfordL Update
  Software

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• Ukens C. Partner for disease management,
  Asheville risk manager disease. Drug Topics.
  1999143(9).
• Lazarus A. The promise of disease management.
  Psychiatric Services. 200152(2) 169-71.
• Beck J., Logan K., Hamm R., Sproat S., Musser K.,
  Everhart P., McDermott H., Copeland K.
  Reimbursement for pediatric diabetes intensive
  case management a model for chronic diseases.
  Pediatrics. 2004 113 e47-e50.

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Start Here
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Kick-Starting HCAP Operations

• Primary Tasks
• Coalition Building
• Roles and Relationships
• Reasons for Joining/Why Us?
• Return on Investment
• Stakeholders
• Identification
• Buy-in

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Kick-Starting HCAP Operations

• Primary Tasks
• Coalition Building
• Resources
• HCAP Technical Assistance
• Peer Coalitions (CJA)
• United Way
• Consultants

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Kick-Starting HCAP Operations

• Secondary Tasks
• Program Operational Development
• HCAP Grantee Structural Development
• Management/Administrative Tasks
• Logistics and Support Tasks

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Kick-Starting HCAP Operations

• Program Operational Development
• Internal Operations
• Network Operations
• Outreach Operations
• Evaluation Operations

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Kick-Starting HCAP Operations

• Internal Operations
• Staff/Administrative Job Descriptions by Role
• Internal Operations Flow Chart Development
• Policies and Procedures Manual Development
• Training Program

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Kick-Starting HCAP Operations

• Network Operations
• Network Operations Flow Chart Development
• Policies and Procedures
• Training Program

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Kick-Starting HCAP Operations

• Outreach
• Operational Structure
• Media Campaign
• Performance
• Contracting

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Kick-Starting HCAP Operations

• Evaluation
• Evaluation requirements needed for grant(s)
• Evaluation and reporting requirements for
  operations
• Data elements required for evaluation
• MIS support for evaluation needs
• Contracting

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Kick-Starting HCAP Operations

• HCAP Grantee Structural Development
• Organizational Development
• Coalition Building/Cohesion
• Partner Buy-in
• Stakeholder Identification/Buy-in
• Information Dissemination

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Kick-Starting HCAP Operations

• HCAP Grantee Structural Development
• Organizational Development
• Identify and document organizational roles and
  relationships
• Develop organizational agreements
• HIPAA compliance documents
• Business Partner Agreements
• Develop and define fiduciary responsibilities
• Develop and define financial responsibilities

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Kick-Starting HCAP Operations

• HCAP Grantee Structural Development
• Coalition Building/Cohesion
• Goal Definition
• Mutual Goal Seeking
• Convergence of Goals

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Kick-Starting HCAP Operations

• HCAP Grantee Structural Development
• Partner Buy-in
• Partner ROI needs
• Partner reporting needs
• Partner roles in coalition
• Equitable buy-in from Partners

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Kick-Starting HCAP Operations

• HCAP Grantee Structural Development
• Stakeholder Identification/Buy-in
• Identify ALL Potential Stakeholders
• Prioritize by potential ROI
• Provide equitable buy-in mechanism
• Market coalition to stakeholders

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Kick-Starting HCAP Operations

• Deal-Making for HCAP Grantees
• Sample Block-Buster Deals for HCAP Grantees
• Address Sustainability
• Reduce Dependence Upon Grants

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Kick-Starting HCAP Operations
Deal 1Hospital System
Element Find the uninsured and help them
navigate access to services Intervention
Establish medical home, access to preventive
services Stakeholder Local
Hospital Statement Through our outreach
efforts we have enrolled 239 clients into our
coordinated primary system of care saving your
hospital ER 53,058 per year in uncompensated
care Deal Pay the salary of one outreach
worker _at_25,000/yr
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Kick-Starting HCAP Operations
Deal 1Hospital System

• Other Potential Deals
• 1. Invest in media campaign
• 2. Invest in upgrading computer system for
  primary care appointment scheduling at ER
• 3. Invest in integrated delivery system

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Kick-Starting HCAP Operations
Deal 2Business Community
Element Facilitate enrollment of the
uninsured into insurance program if eligible,
or link to affordable primary care Intervention
Reduce the number of uninsured without access
to primary care Stakeholder Business Owners
with no employee health insurance
coverage Statement Access to regular care and
personalized care coordination can help to
improve employee productivity and absenteeism
Deal Contract with our program for 500 per
employee per year and we will help the employee
or employees family members find affordable
coverage in addition to providing
individualized health assessment and linking
employee to an affordable primary care source
or available needed services
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Kick-Starting HCAP Operations
Deal 2Business Community

• Other Potential Deals
• 1. Invest in media campaign
• 2. Invest in upgrading computer system for
  primary care
• appointment scheduling at ER
• 3. Invest in integrated delivery system

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Kick-Starting HCAP Operations
Deal 3Case Management

• Element Administer care coordination and
  disease management programs
• Intervention Teach self care skills
• Stakeholder Insurance provider
• Statement Teach self care skills to know when to
  call a provider and how to manage disease/focus
  on wellness
• Deal Through our care coordination efforts we
  provide case management services for your
  clients for 10 per member per month

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Kick-Starting HCAP Operations

• HCAP Grantee Structural Development
• Information Dissemination
• Get the Word Out
• Identify coalition operations and marketing
  information needed
• Create reports and marketing documents
• Update reports and marketing documents as needed

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Kick-Starting HCAP Operations

• Recap of Management Tasks
• Goal-Setting (Realistic)
• Budget Management
• Contracting
• Staffing

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Kick-Starting HCAP Operations

• Recap of Management Tasks
• Training
• Reporting/Monitoring
• Action Plan Development

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Kick-Starting HCAP Operations

• Sample Action Plan

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Kick-Starting HCAP Operations

• Action Plan Complete It or

RUN FAST !!!
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Kick-Starting HCAP Operations

• Ongoing Logistics and Support Tasks
• MIS
• Software and configuration
• Hardware
• Network
• Support
• Recurring Expenses
• Network
• Forms/Surveys/Documents
• Lessons Learned

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Kick-Starting HCAP Operations

• Resources
• Communities Joined in Action
• http//www.cjaonline.net/TechnicalResources.htm
• Association for Community Health Improvement
• http//www.communityhlth.org/communityhlth/index.j
  sp
• Books
• Hidden Costs, Value Lost Uninsurance in
  America, Institute of Medicine of the National
  Academies, The National Academies Press, 2003

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Kick-Starting HCAP Operations

• Questions Discussion