Structuring Our Network FL Neighborhood Network (Diana, Sandra, Gabriel, Shirley, Maria)

Structuring Our NetworkFL Neighborhood Network(Diana, Sandra, Gabriel, Shirley, Maria)

Nature of our networkExisting legal relationships among our network partners (contractor/subcontractor, partnership, memorandum of understanding, … )•Grant agreements include target objectives(5 years), MOUs with non grantees•Contracts with consultants•Community health workers have formal agreements with partner agencies and they are required to complete training

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Nature of our networkOur next step(s) to further develop the capability of our network:• CHW training for lay leaders• Id fiscal intermediary for Medicare billing• Obtain agreement with health plan for piloting the EBPs• Building relationships with provider groups• Maintain relationships and momentum during this final year – this is a challenge because limited funding; need to id what we can offer• Make a stronger case to the board (December)

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Our network as a community assetFeatures that appeal to our customers

• Programs are delivered by people and organizations they trust, in their communities

• Services are brought to them - convenience

• EBPs are peer-led, not clinical, culturally appropriate

• Low/no cost – added value• Participants can share their point of

view – not possible in clinical setting• Goal is to continue to offer as a benefit

of health plan• Menu of services provided by network

Features that appeal to contracting organizations• History, comfort level – 5

years working as collaborative• Regional collaborative – so

serve every zip code, easy access

• All programs are EB• All programs are monitored

for fidelity• New registry will allow for

immediate connection

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Our network as a community asset

The next action(s) we will take to develop the image and influence of our network:•Image already exists, but will turn advisory council into steering committee to open doors•Staff and volunteers can also continue outreach in community by people who know the community•Find champions that can help open health care organization doors•Review existing brochures and expand /tailor for new health plans•Bring in experts in business to communicate with health plans and hospitals; present data in focused way

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Organizational issues we need to address• Need a more formal structure for liability issues• Third party billing will require review and make sure structure

meets the requirements of the new model• Health IT will need to be acquired• Our advantage is the collaborative is a neutral platform for all

partners• Health organizations are seeking us out• Health Foundation is a critical partner

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Our network as a business enterprise

Entity/entities that can bill for services

• Few entities can currently bill for services (Medicare)

• Health Choice Network – MSO to support FQHCs (nonprofit, close to Health Foundation – exploring as billing partner)

• Partnerships with hospitals that have billing capacity

• In future establish Medicare billing capacity internally if large volume

Entity/entities that can receive and distribute payment

• All agencies can receive payment

• Health Foundation has been distribution agent; if we enter into organization that performs billing services, may also be able to distribute

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Our network as a business enterprise

Special requirements we must meet to secure and deliver on a contract•HIT – interface with EMRs•Billing partner•Contract that will pay•Pilot will employ nurse/social worker will need liability for this position•Better liability insurance for network partners•We already have the network for delivery, fidelity

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Our network as a business enterpriseAction steps(s) we will take to strengthen the business capability of our network:•Review how we present ourselves – our image – value-based; maintain our ground and value in the community providing social support and services – community road map•Language that resonates with providers – id examples•Aligned with mission and vision of organization; uniform approach and message– collaborative is seen is one entity – identify and use approaches from others/lessons learned? •Bring in health services expertise to help us translate how are services model brings value to health care plan/organization (local person who understands both worlds)•HIT and data management is critical for FFS or reimbursement

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Insights

Our biggest insight(s) from this session on Structuring Our Network is/are… •Martha’s presentation – what we know/we are on the right track•It takes time – maintain and build on success•Many strategies over 5 years, need for creating the network – we’ve come a long way•Consolidate and integrate learnings that apply into our approach•Solid network

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Action Steps

The action step(s) we will take in the next month to further structure our network are:•Confirmed demonstration of HIT on December 3rd

•Set up committee to review action steps identified over the 2 days to ensure implementation•Advisory committee meeting in December 5th•Board meeting December 4threview of action steps and implementation of action steps in January•HARC meeting mid December; coordinators meeting December 11th

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Parking Lot (Issues for later, additional questions for speakers)

• List here

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