Meeting Minutes

Meeting #1

August 13, 10:30am - 2:00pm
Location: Albany School of Public Health, Edward S. and Frances Gilda George Education Center 1 University Pl, Rensselaer, NY 12144

Overview

This was the first meeting in a series of meetings for the Advocacy and Engagement (AE) Subcommittee (SC). The purpose of the meeting was to kick off the SC process, educate the SC members on Value Based Payments (VBP), as well as provide context for the purpose and timeline of the SC work. This meeting also served as a forum to discuss any questions related to the agenda items and raise questions or concerns.

The specific Agenda for this meeting included the following:

  1. Welcome and Introductions
  2. Subcommittee Process, Timeline, and Roles and Responsibilities
  3. Intro to Value Based Payments
  4. Agenda Item #1 - Incentives
  5. Next Steps and Action Items

Key Discussion Points

1) Welcome and Introductions

Kalin Scott (DOH) along with the co-chairs opened the meeting. The SC members, as well as other present parties, were given the opportunity to introduce themselves.

2) Subcommittee Process and Timeline

The SC purpose, process, and timeline were described to the members of the SC. It was noted that this SC differs from others in that it has much less defined directives in the Roadmap, allowing for flexibility to determine and raise the issues most important to Advocacy and Engagement.

The final recommendations of the SC will be organized into a recommendation report and submitted to the VBP workgroup for review and approval.

3) Intro to Value Based Payments (Reference slides 10-22)

During the meeting, NYS´s transformation efforts were reviewed as well as highlights of the VBP Roadmap.

4) Agenda Item #1 - Incentives

A discussion ensued about what should be the focus of the A&E SC for VBP and additional clarification was requested by many of the SC members. The co-chairs referred to the Roadmap section on incentives for s and encouraged all SC members to familiarize themselves with the Roadmap and these questions. SC members discussed a Medicaid Members´ right to know versus what they actually need to know, as well as their legal rights. SC members also talked about what can be done to help patients make decisions not only about their health, but also about where to get good healthcare. The SC members reviewed slide 24, "What are We Trying to Incentivize?" and brainstormed for additional areas that included incentivizing people to:

  1. Make practical housing choices
  2. Engage with a patient navigator or coach
  3. Complete surveys that collect Patient Reported Outcomes (PROs)
  4. Avoid using the Emergency Department when not necessary and visit a PCP instead
  5. Engage and participate in post-natal care and well-child care and
  6. Prevention across populations.

The SC also brainstormed what appropriate incentives would be and identified the following:

  1. Incentivize the patient at point of service in the Emergency Department to connect with a PCP
  2. Work with a patient coach/navigator (also falls under list above)
  3. Incentivize the patient to obtain and maintain good health and
  4. Assistance with transportation.

Several members of the SC posed questions and concerns about taking on too many issues/problems, and made suggestions in an effort to guide the SC´s direction going forward.

The SC members reviewed slide 25, "Incentive Program Guiding Principles" and decided to include "Equity Not Equality" to the list. The discussion on guiding principles continued around flexibility. The group felt that it should not only refer to flexibility in exploring alternative plans (as stated on the slide) but also flexibility in selecting different incentive programs across communities, regions, PPSs, etc.

Other questions that arose were: How will incentives be paid? Will savings from VBP go back into incentive programs? Can we align incentives with plans to address social determinants? It was suggested, and consensus was established, that the SC should research and gather information on incentive programs in New York State, including private insurance companies for the next meeting.

Materials that were distributed prior to the meeting:
# Document Description
1 Advocacy and Engagement Meeting 1 Final A PDF presentation of the slide deck created for Meeting #1, which introduces VBP, details the roles of the SC, explains key areas of SDH, and calls out relevant questions found in the Roadmap.
2 Advocacy and Engagement Patient Incentives Policy Brief A document reviewing current patient incentives at the Federal and State level as well as past programs around the country.

Key Decisions

SC members will research any current incentive programs in New York State as well as information concerning incentives.

Action Items

  1. Please email Josh McCabe (joshuamccabe@kpmg.com) if you attended the meeting on the phone or did not sign the attendance sheet.
  2. Please email Josh McCabe (joshuamccabe@kpmg.com) with any articles or information concerning incentives and any programs in New York State. He will share all information with SC members.
  3. Please familiarize yourself with VBP Roadmap, if you have not done so already, especially the pages pertaining to incentives.

Conclusion

The next meeting agenda will include a discussion of information found by SC members in order to begin developing recommendations for incentive program(s).