C O M M U N I T Y INTEGRATION L E A D E R S H I P I N S T I T U T E Advancing Outcomes

1. C O M M U N I T Y INTEGRATIONL E A D E R S H I PI N S T I T U T EAdvancingOutcomes JUNE 3 & 4 Holiday Inn Saratoga Springs

2. Presentation and Facilitation Prepared by Arthur Webb ArthurWebbGroup, Ltd June 3, 2014 Prepared by AWG

3. Community Integration Outcomes Manag-ing Care Prepared by AWG

4. Outcomes Definition: Something that follows as a result or consequence Advancing outcomes is aspirational in terms of managed care . We have a long way to go. Prepared by AWG

5. The Triple AIM: The Language of Reform Prepared by AWG

6. Pace of Change The pace of change and innovation is moving at record speeds. Changes in virtually every field. Where is the field of intellectual and developmental disabilities? Prepared by AWG

7. The New Narrative It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair. Charles Dickens, A Tale of Two Cities (1859) Prepared by AWG

8. The New Narrative U.S. spends twice as much on health care per capita, and 50 percent more as a share of GDP, as other industrialized nations do. And yet we fail to reap the benefits of longer lives, lower infant mortality, universal access, and quality of care realized by many other high-income countries. There is broad evidence, as well, that much of that excess spending is wasteful. Stabilizing health spending and targeting it in ways that ensure access to care and improve health outcomes would free up billions of dollars annually for critically needed eco­nomic and social investments—both public and pri­vate—as well as higher wages for workers. CONFRONTING COSTS: Stabilizing U.S. Health Spending While Moving Toward a High Performance Health Care System The Commonwealth Fund Commission on a High Performance Health System, January, 2014 Prepared by AWG

9. Big Trends In New York • Impact of implementation of the Affordable Care Act • Big Data, Big Information, Big Analytics • Mergers & Consolidations • State Medicaid Reform • Expansion of managed care for special populations • Pressure on nonprofits: A squeeze play with compliance, costs, compensation, & competition Prepared by AWG

10. The coming of managed care New York State is moving to enroll all 5.2 million recipients by 2017. Now taking on the most complicated and costly recipients: • Carve-in of behavioral health benefits in 2015 with special initiative called HARPs • Targeting foster care by 2016 • For persons with IDD, who knows??? Prepared by AWG

11. Framing the Challenges • Is managed care just another way to distribute public dollars? • Is managed care just another form of government regulation and control? • Is managed care really that effective for persons with complicated needs? • Is the field ready for managed care? • W hat are some of the first steps? Prepared by AWG

12. Focus on Change Care Coordination • Is there a best practice model for the field to use? • What is the level of effort in terms of cost, staff, time, and training that providers are making or have to make to offer an effective care coordination model? Prepared by AWG

13. Focus on Change Developing Meaningful Outcomes • Are outcomes of BH and IDD services really well developed? Are there good benchmarks? • How do social determinant variables, behavioral indicators, medical, and functional status get integrated into best practices? Prepared by AWG

14. Focus on Change Positioning Providers for a Managed Care Environment • What is the information needed to live in a managed care world? • How do providers live in two worlds—the now and managed care worlds? Prepared by AWG

15. On with the day Prepared by AWG