Performance Improvement
Improving performance in a dynamic and complex health care environment is difficult for even the most advanced health care organizations. Clinicians, administrators, and operational staff must navigate a world of continuous change, including revised clinical practice guidelines, new health care reimbursement models, organizational governance and ownership changes, new IT and quality reporting platforms, and more.
Because managing change can be overwhelming for any organization, HMA’s approach to providing performance improvement technical assistance will be to work with ACOs and Community Partners (CPs) to determine the necessary actions, deliverables, and rapid results that will help the ACO or CP move forward. We will work with TA recipients to determine which phase(s) of performance improvement would benefit from our help:
Plan: Through experience helping many providers across the health care continuum, we have developed an approach to strategic planning and performance improvement plan design that clearly defines success, is responsive to stakeholder feedback and environmental constraints, is time-bound, and measurable. Plans should be translatable into concrete actions.
Implement: Our consultants have worked on the front lines of health care. Our experience includes technical and adaptive change management approaches that help build stakeholder consensus and buy-in, define and re-define roles and responsibilities, facilitate re-engineered work processes through workflow and driver diagrams, improve team communication, and conduct rapid cycle testing.
Measure: Successful performance improvement requires reliable information and data capture, and consistent measurement reporting. Our consultants have worked with providers to define and specify measures; build databases, data warehouses, and performance dashboards; perform complex data analysis and reporting; exchange data between systems; and extract, translate and load data. We also have experience establishing data governance and compliance programs.
Evaluate: As part of continuous performance improvement, it is important to determine what worked and what did not. HMA consultants have helped providers evaluate interventions including changes in cost, quality, and health outcomes. This work can include interviews, focus groups, data analysis, and root cause analysis (e.g., fishbone diagrams).
For more information, contact [email protected]
Meet Our Team
Given the wide variety of work that may be performed under the Performance Improvement Domain, HMA has selected a large and diverse set of colleagues to bring a wealth of knowledge and expertise to ACOs and CPs. Led by Rob Buchanan, our colleagues have direct experience working with providers across all areas of performance improvement including planning, implementation, measurement, and evaluation.
Meggan Christman Schilkie
Senior Vice President, Practice Groups Health Management AssociatesNew York, NY
View Our Recent Work
OneCity Health Patient-Centered Medical Home Transformation
- Project Challenge or Goals: Improve integrated care offered through partner providers in the NYC Health and Hospital’s (H+Hs) Performing Provider System (PPS), OneCity Health. Working with up to 30 partner practices in 4 boroughs in NYC, with goal of getting all recognized as NCQA Level 3 PCMH under 2014 standards.
- Project Period: 5/17/2016-3/31/18
- Project Description: HMA provided technical assistance (TA) services OneCity Health, NYH+H’s DSRIP (Delivery System Reform Incentive Payment Program) performing provider system (PPS) for patient-centered medical home (PCMH) transformation working with up to 30 partner practices in 4 boroughs in NYC, with the goal of getting all recognized as NCQA Level 3 PCMH under 2014 standards. TA included readiness assessments, on site coaching, establishment of a Learning Collaborative including a learning portal, webinars, Hub Calls for practices in a given borough, and onsite learning sessions over an 18 month period. On site TA included support in completing applications to NCQA.
HMA served as the Coordinating Vendor to One City Health, providing project management services for the entire PCMH Transformation project, including development of the project plan, incorporation of information and activities, oversight of the PPS Learning Collaborative and provision of a quarterly assessment and status reports to OneCity Health. There were a total of 3 TA vendors and up to 90 practices engaged in this effort.
- Project Achievements: Twenty-nine 29 sites submitted applications to NCQA by the September deadline, and 4 additional sites have submitted to date. Seven (7) sites are still working on their initial applications with the intention to submit by January 31, 2018 (the NCQA-imposed deadline).
Current notes: All practices that agreed to coaching achieved Level 3 PCMH recognition despite challenges due to lack of time, interest by practices, and limited funding.
Behavioral Health Strategic Planning and Technical assistance for Catholic Charities Neighborhood Services (CCNS)
- Project Challenge or Goals: This is an engagement that has spanned and incorporated many projects in the context of helping ensure the viability of Catholic Charities Neighborhood Services and their ability to continue to meet their mission to serve some of the most vulnerable individuals with a range of complex behavioral health needs.
- Project Period: 7/16/13-2/28/2018
- Project Description: HMA helped CCNS adopt and implement key programmatic changes within their mental health clinics and worked with key behavioral health leadership to establish associated measures to monitor progress. HMA identified strategies to establish strong collaborative relationships between Behavioral Health Services and strategic CCNS partners in IT, HR, QM and Fiscal, attracting and retaining personnel, staff training, and real time reporting of agreed upon indicators. HMA also analyzed Electronic Health Record implementation. HMA developed a primary care integration strategy as well as a way to identify and prioritize potential community providers with which to partner. Working with CCNS leadership, HMA created an outreach plan and timeline and facilitate outreach. HMA also analyzed CCNS’s residential program and identified additional synergies with behavioral health services. Finally, HMA create a development/fundraising strategy and assisted with the writing of many grants including securing several millions of dollars in additional funding.
- Project Achievements: Since 2013, HMA has provided provide strategic planning and technical assistance to CCNS, a large behavioral health and social service provider, to identify strategies and streamline operations to be positioned for success throughout the health care reform changes occurring in New York State. HMA facilitates CCNS’ Care Coordination Workgroup, a cross-sectional team representing care coordination, finance, information technology, and executive staff. The workgroup identifies and implements improvements to internal operations and seeks ways to further the organization’s primary care/behavioral health integration strategy, including models of care, potential partners, and funding opportunities. With HMA’s assistance, CCNS has pursued and secured partnerships with primary care providers to expand behavioral health services to communities of need, obtained capital funding to consolidate separate behavioral health and substance use disorder clinics into one location with expanded access and integrated health care, responded to a myriad changes in NYS Health Home reimbursement rates through implementing a fiscal planning and monitoring system, and assisted with implementation of a quality program for care coordination services.
OhioHealth System Neuroscience Center Collaborative Care Implementation
- Project Challenge or Goals: Health system has limited access to behavioral health resources including psychiatric services in the Columbus, OH area and wished to enhance their care through implementing the evidence-based Collaborative Care Model of integrated primary care and behavioral health
- Project Period: July 2017 – July 2018
- Project Description: Provided assessment, model design and training and implementation support (see below)
- Project Achievements: HMA was engaged by the OhioHealth System Neuroscience Center, a multi-specialty inpatient and outpatient center, to help implement and successfully launch a collaborative care pilot program in 10 primary care clinics located in central Ohio. HMA conducted readiness assessments/gap analyses and model design, offered training, oversaw implementation across all 10 clinics, and provided post-implementation support. The project is ending with improved patient outcome measures and patient and provider satisfaction.