presentation 90-10-funding-opportunity-for-health-infomation-exchanges

HOW CAN HIES ACCESS 90/10 AND FEDERAL FUNDING AND EXPAND THEIREXCHANGEWEBINAR SPONSORED BY ORION HEALTH11/30/2016, 2:00-3:00PM ET

AGENDA• Introduction to Orion Health

• Introduction to Cedar Bridge Group

• Goals for today

• North Dakota HIN presentation

• CMS 90/10 Funding Plan

• Industry trends

• New foundational platform and pop health

applications requirements

• Q&A

GEORGE BECKETTChief Business Development Officer,Member of the board of the state of

Tennessee HIMSS Chapter

LAURA YOUNGDirector of Industry Relations & Solutions Consulting,

Vice Chair of the HIMSS Interoperability& Health Information Exchange Committee,

President of the board of the Arizona HIMSS Chapter

• 2016 © Orion Health™ group of companies

Orion Health | Interoperability and PHM Customers Around the World

55 PHM communities

worldwide

102 million patient records viewed

Over 60 US health

departments

30+ large CINs, ACOs, and HIEs in

the US


Our People | Global Footprint

1Mexico

243United States

16Canada

5Spain

2Italy

1Greece

1Turkey 1

Kuwait

34UK

4Ireland

4Belgium

2Netherlands

3Denmark

1Norway

2Austria

1Germany

1Sweden

1Finland

1Saudi Arabia 2

Qatar

1UAE

1India

1Thailand

1Hong Kong

1Malaysia

1Singapore

14Australia

20New Zealand

73China

2Korea

4Japan

1Russia

1Argentina

1South Africa

4France

Orion Health | Global Clients & Offices


Orion Health | Unique Qualifications in the New Era of Healthcare

FUTURE-PROOFARCHITECTURE

FOCUS

EXPERIENCE

POPULATION & PRECISION

HEALTH

END-TO-ENDSOLUTION

NDHIN FIVE YEARBUSINESS PLANBUILDING CAPACITY, USAGE, AND VALUE.

Presented by George Beckett, Cedar Bridge Group, for Sheldon H. Wolf, Director of the North Dakota Health Information Technology

North Dakota Facts

42Hospitals

186Provider

Organizations

2Major Payers:

Blue Cross & Sanford Health

880,000Patients in eMPI

19th Largest State

36Critical Access Hospitals

North Dakota Critical Access Hospitals & Referral Centers

NDHIN Innovative Services Today

Communicate HubDIRECT secure messaging(over 800 messages per week)

Alerts and notifications

Clinical portal withclaims and clinical data

(500 record look-ups per week)

Prescription drug-monitoring

program

Longitudinal medical record with

image viewing

Real-time public healthreporting

CedarBridge Group Contract Elements1) Environmental Scan

3) Future State Brief

2) Best Practices Brief

4)Return on Investment Brief

5) Five-Year Business Plan

NDHIN Current State• NDHIN Public/Private Partnership• Orion Health Technology Platform

• eMPI, patient matching• Provider Directory• Longitudinal Clinical Record• Image Exchange• ADT Alerting• Single Sign-on (SSO)• PDMP access w/SSO• Immunization Registry• Electronic Reportable Labs• Syndromic Surveillance• Access to 25-30 out State HIE’s

NDHIN Future State Additions

Infrastructure

• Orion Health Amadeus Platform Upgrade

• Provider Directory Upgrade• Medications• Additional Single Sign-on• C-CDA Discrete Data• Genomic Data

State Systems

• Cancer Registry• Enhanced Immunization System • Behavioral Health EHR• Developmental Disabilities EHR• Corrections EHR• State Vets Home EHR• University Health systems EHR

Federal Systems

• VA, IHS, DOD• South Dakota• Snow Bird aStates• 40 additional States

& HIEs


Payer

§ Access§ Data contribution§ All Plans

• Medicaid• Medicare• Commercial• Large Employer• Workman’s Comp

Patient

§ Global Personal Health Record§ Patient Reportable Data,

Telehealth, Wearables

MU Providers

§ Hospitals§ Clinics

• Traditional• Urgent Care• Pharmacies

§ Large Reference Labs§ Chiropractors§ Optometrists§ Dentists


Non MU Providers

§ Long Term Care• Assisted Living• Basic care

§ Behavioral Health§ Residential Treatment Centers

§ Home Health Care§ Hospice, Palliative Care§ EMS§ Pharmacies§ DME§ Audiology

§ Podiatry§ Prosthetics§ New Born Screening§ Local Health Departments

• K-12 Schools

NDHIN Future State Additions Strategic Statewide Applications

Care CoordinationCoordinate integrates with Engage - Social Services Referrals - Risk ScoresGaps in care - Clinical & Claims Data

Analytics, Population Health

Statewide Credentialing

Advance Directives, POLST/MOLST Registry

NDHIN- Tools

Patient-centeredcare

Shared care plans

Collaborative worklists

Referral management

Risk calculators

Patient engagement

Medication management

Assessments

Hospitals Clinics

Behavioral Health

Long Term Care

Local Public Health

Ø K-12 school nurses

ND DevelopmentalDisabilities

VA

Home Health

ND University System

IHS

Medicaid

ACOs

NDPERS/ state employees health plan

Commercial

SNAP

Foster care Child care assistance

TANF

Autism services

Special-needsadoption

LIHEAP

Transportation

Job programs

Housing Assistance

Department of Corrections

ND Veteran’s Home

Care Coordination Partners

Future State: Data Integration and Care CoordinationClinical Care - Behavioral Health - Social Services

KeyProvidersPayersHuman ServicesCommunity Services

Medicare

Self-insured Employers

VA

DODSSA

Chiropractors

Optometrists Hospice

EMS

Labs

Pharmacies

University Health

DMS

Audiology

Podiatry

New Born Screening

Prosthetics

CMS 90/10 FUNDING PLAN FOR NORTH DAKOTA HIN

GEORGE BECKETTChief Business Development OfficerCedarBridge Group

NDHINFiveYearBudget/R.O.I.

GetBigorGetOut

GetBigorGetOut


It’samoonshot


Patient“Lookup”won’tcutit

Facts

NDHIN Five Year Budget/R.O.I. 23

Population of 740,000

42Hospitals

36Critical Access

Hospitals

2Major Payers

Blue Cross & Sanford Health

880,000Patients in eMPI

19th Largest State

47th inpopulation density

NDHIN 5 year Development Plan

Amount spent in 3 years to

date: $8.8M*

Budget for the next 5

years: $47M

Total NDHIN investment:

$55.8M

*Total stakeholder investment to date: $0

NDHIN 5 year Development Plan

85% 15%

Federal Contribution

*Stakeholders only share $4.7M (8.5%)

$47m

North Dakota$7m

State ContributionProviders

Contribution

Payer Contribution

$2.33m $2.33m

$2.33m

CMS 90/10 Match Funding Opportunity

§ Funding is available through Sept. 30, 2021§ Non-competitive, No limit in funding amount§ You do not have to be a “State” HIE to receive monies

CMS offers states 90/10 matching funds for building HIE infrastructure to support Meaningful Use initiative.

Some categories of technology qualify for 75/25 and 50/50 matches.


n Where do we get the 10% Match?

o States- free-up current expensesu State Payrollu State HIE Infrastructure (Maturity)u Office, Travel, IT, etc.u On-boarding

o Outside Feesu Incremental Charge-backsu CMS Open to discussions


n What can it pay for?

o Operationsu Staffingu HIE Coreu Expenses


n Interfaceso Bundle Hub & Spoke Offeringso Negotiate with Vendors of

state-wide n On-boarding

o HIT/HIE Combinationu Awareness, Marketingu Contracting, Training

n Connectivity Projectso Diagnostic Image Exc.o Cancer Registryo Indian Health Serviceso Department of Defenseo Intra-state Exchangeo Personal Health Record

u Wearable reporting

CMS 90/10 Match Funding Opportunityn Participants & Data

o Clinical Datao Behavioral Healtho Social Determinateso Genomico Payer Data

u Claimsu Risk Scoresu Gaps in care

n State-wide applicationso Care Coordinationo POLST/MOLST Registryo PDMP Integrationo Credentialingo Analytics

n Roll-outs!!!

CMS 90/10 Match Funding Opportunityn State systems

o Correctionso Developmental Disabilitieso Foster Children Services

n MU Providerso Hospitalso Clinicso Chiropractorso Dentistso Optometrists

n Non-MU Providerso Local Health Departmentso New Born Screeningo K-12 Schoolso University Health Services

n Non-MU Providerso Long Term Care

u Assisted Livingu Basic care

o Behavioral Healtho Residential Treatment Centerso Home Health Careo Hospice, Palliative Careo EMSo Pharmacieso DMEo Audiologyo Podiatryo Prosthetics


n What about on-going funding?

o State-run – Combining with MMIS enterpriseu 75/25 match for Medicaid percentage of the pop.

o Non-profits and othersu 50/50 match for Medicaid percentage of the pop

Stakeholder Value Propositions

Where’s the value for

stakeholders?

Where’s the value for HIE?

Where’s the value for

your state?

R.O.I. Calculatorsn Three categories

o Initial Investmentu HIE Core/Operationsu Interfaces/Maint.

o Strategic Applicationso Specific savings

u Provideru Payer

POPULATION HEALTH FOUNDATION & APPLICATIONS


Industry Trends | Precision Medicine: The Right Treatment at the Right Time

FUTURE PROOFARCHITECTURE

A vast amount of untapped data could have a great impact on our health

Source: Health Aff (Millwood). 2002 Mar-Apr;21(2):78-93. The case for more active policy attention to health promotion.McGinnis JM, Williams-Russo P, Knickman JR.


Industry Trends | Healthcare Data Explosion

2012500 Petabytes

=

10 billionFour drawer

cabinets

202025,000 Petabytes

=

500 billionFour drawer

cabinets

The amount ofhealthcare data worldwide is expected to grow

by 50 times in 8 years


New Platform Requirements | Handling Data Complexity

Healthcare is changing from a closed community into an ecosystem centered around the patient and their record which will include many elements not traditionally captured.


Orion Health | Market Evolution


Population Health Management | Maturity Model


Orion Health Amadeus | Addresses Key Pop Health Needs in one solution

Quality and Compliance Reporting

Managing Revenue and Costs

Coordinating Care

‣ Monitor and manage key performance metrics under value based contracts:

‣ Pay for Performance‣ Shared Savings‣ Bundled Payments

‣ Give practices and providers the tools required to identify and close care gaps.

‣ Population exploration tools for care coordination staff

‣ Patient risk stratification tools

‣ High risk discharge and medication adherence analysis

‣ Tools to identify key contributors to costs:

‣ Readmissions‣ Utilization‣ PMPM

‣ Manage network leakage and referrals.


Orion Health Amadeus| Population Level


Orion Health Amadeus | Integration of Analytics & Care Coordination


Orion Health Amadeus | Drill down to Patient-Centric Longitudinal Health Record + Gaps in Care

Q&AContacts:

George BeckettChief Business Development [email protected]

Laura YoungDirector of Industry Relations &Solutions [email protected]