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OB Adverse Events Affinity Group

OB Adverse Events Affinity Group. March 27, 2013 Lynne Hall. OB Adverse Events Affinity Group. Data Legislation Getting the word out. Data. Data. Data. Data. Legislation. DCH is lead agency for health care planning, purchasing and oversight DCH Program Areas:

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OB Adverse Events Affinity Group

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  1. OB Adverse Events Affinity Group March 27, 2013 Lynne Hall

  2. OB Adverse Events Affinity Group • Data • Legislation • Getting the word out

  3. Data

  4. Data

  5. Data

  6. Data

  7. Legislation • DCH is lead agency for health care planning, purchasing and oversight • DCH Program Areas: • Medicaid / PeachCare for Kids • State Health Benefit Plan (SHBP) • Health Care Facility Regulation • Health IT

  8. Legislation • The EED Budget item is in the amended budget for FY 2013 • DCH has said they are willing to recognize that the $5.5M savings they are required to achieve in FY 2013 has already been accomplished due to the work done by the HEN and others • Starting April 1, 2013 – they will require providers to begin noting on claims the gestational age as well as modifiers describing whether an early delivery was medically necessary or not

  9. Legislation • DCH has said they are open to hearing from providers about the medical necessity criteria • DCH has said they will not instruct the CMOs as to which criteria the CMOs should use • DCH would then do a hard stop on reimbursement on July 1, 2013 • So providers will effectively have a 90 day trial period before they start seeing payment penalties

  10. Getting the Word Out • What do we need to do? • Physician Engagement and buy-in • Engage Stakeholders • Community

  11. Getting the Word Out: Physician Engagement and Buy-in • From Dr. Peter Grubb (Principal Investigator and Medical Director for TIPQC): • We get “them” to do what “we” want them to do. • Approach by asking who is the “we”? This is decision- maker engagements • Engaging all of the decision makers that play a role in the system • Conversations need to be had at a peer-to-peer level • Challenges: • Underestimate system contributors to high EED rates • EED solutions may not fit other OB events

  12. Getting the Word Out: Engaging Stakeholders • Engage Stakeholders through: • evidence-basis and increasing awareness, • a data-driven perspective, • address barriers, • and then identify facilitators • Get the community engaged and think about why they are delivering early • Address Barriers: Working with centers as a group to address fears/barriers. • Patient Demand: Patient is a consumer and a customer

  13. Getting the Word Out: Community • Promote websites for mothers such as: March of Dimes or Department of Public Health • CineMama: Developed by March of Dimes. A woman can track her pregnancy thru 39 weeks.

  14. Getting the Word Out: Community • Text4Baby.org: • Must sign-up for this • Get text updates and information about pregnancy • Text from CDC website: • It’s a free cellphone text messaging service for pregnant women and new moms. • Three times per week, you’ll receive tips on how to have a healthy pregnancy and a healthy baby, and how to care for your baby up to one year of age. • The timely tips are based on your due date or your baby’s date of birth. • CDC - http://www.cdc.gov/features/

  15. Getting the Word Out: Community • CDC - CDC Helpful Link • Tools for Pregnant Women and New Moms • Mobile app on alcohol and pregnancy • Test your knowledge • Folic Acid Quiz • Birth Defects Quiz

  16. Questions? Lynne Hall lhall@gha.org 770-249-4525

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