QPI Achievement Breakout Session June 9, 2016

QPI Achievement Breakout Session June 9, 2016

QPI Achievement Breakout Session Overview RHP3 QPI Analysis Presentation Group Breakout Session (fishbone diagram) Group Discussion: QPI Challenges/Causes and QPI Solutions www.setexasrhp.com 2

Fishbone Diagram www.setexasrhp.com 3

DY3-4 QPI Goals and Achievement Individuals served Encounters provided Percent of QPI goal achieved Percent increase over baseline MLIU individuals served MLIU encounters provided Percent of MLIU goal achieved www.setexasrhp.com 4

Projects with Individual or Encounter QPIs Number of Projects Project Type Behavioral Health Primary Care Specialty Care Chronic Care Emergency Care Navigation/Case Mgmt Prevention and Wellness General TOTAL www.setexasrhp.com Individual QPIs Encounters QPIs 46 5 3 14 2 14 14 5 103 11 27 25 0 1 2 1 2 69 5

Individuals Served QPI Project Type/# Behavioral Health/46 Achieved Goal % Goal Achieved DY3-5 Goal 33,045 60,369 54.7 99,133 9,833 14,634 67.2 26,888 Specialty Care/3 102,611 25,740 398.6 62,325 Chronic Care/14 174,844 92,696 188.6 161,958 9,431 3,200 294.7 6,800 11,887 66,918 17.8 101,787 2,626 69,672 3.8 105,308 196,148 95,127 206.2 174,727 540,425 428,356 126.2 738,926 Primary Care/5 Emergency Care/2 Navigation/Case Mgmt/14 Prevention/Wellness/14 General/5 TOTAL www.setexasrhp.com 6

Encounters Provided QPI Achieved Project Type/# % Goal Achieved Goal DY3-5 Goal Behavioral Health/11 44,487 55,492 80.2 89,922 Primary Care/27 705,002 881,550 80.0 1,438,225 Specialty Care/25 397,214 254,144 156.3 389,869 - Chronic Care/0 Emergency Care/1 Navigation/Case Mgmt/2 Prevention/Wellness/1 40,780 600 2,800 - 4,200 262,640 15.5 393,960 3,000 20.0 4,500 15,200 - 42,400 General/2 TOTAL www.setexasrhp.com 1,188,083 1,474,826 80.6 2,363,076 7

Increase Over Baseline - Individuals QPI Pre-DSRIP Baseline Project Type/# Achieved % Increase Over Baseline Behavioral Health/46 26,047 33,045 226.9 Primary Care/5 30,223 9,833 132.5 Specialty Care/3 - Chronic Care/14 4,941 Emergency Care/2 - 102,611 - 174,844 3638.6 9,431 - 4,230 11,887 381.0 Prevention and Wellness/14 334 2,626 886.2 General/5 153 196,148 128301.3 65,928 540,425 919.7 Navigation/Case Mgmt/14 TOTAL www.setexasrhp.com 8

Increase Over Baseline - Encounters QPI Pre-DSRIP Baseline f Project Type/# Behavioral Health/11 Achieved % Increase Over Baseline 5,627 44,487 890.6 Primary Care/27 529,331 705,002 233.2 Specialty Care/25 221,413 397,214 279.4 Chronic Care/0 - - Emergency Care/1 - - Navigation/Case Mgmt/2 Prevention/Wellness/1 General/2 TOTAL www.setexasrhp.com - 20,390 40,780 300.0 300 600 300.0 - - 777,061 1,188,083 252.9 9

MLIU Individuals Served QPI Goal Project Type/# Behavioral Health/46 Achieved % Goal Achieved 25,818 27,108 105.0 7,080 8,881 125.4 Specialty Care/3 88,245 82,707 93.7 Chronic Care/14 124,408 107,833 86.7 6,790 4,432 65.3 10,111 10,780 106.6 1,158 1,989 171.8 141,074 156,341 110.8 404,684 400,071 98.9 Primary Care/5 Emergency Care/2 Navigation/Case Mgmt/14 Prevention and Wellness/14 General/5 TOTAL www.setexasrhp.com 10

MLIU Encounters Provided QPI Goal Project Type/# Behavioral Health/11 Achieved % Goal Achieved 33,832 28,880 85.4 Primary Care/27 204,034 216,658 106.2 Specialty Care/25 189,453 205,504 108.5 Chronic Care/0 - - - Emergency Care/1 - - - Navigation/Case Mgmt/2 Prevention/Wellness/1 General/2 TOTAL www.setexasrhp.com 9,379 17,953 191.4 600 600 100 - - - 437,298 469,595 107.4 11

Conclusions Individuals Served 540,425 BH, PC, N/CM, P/W – Less than goal SC, CC, EC, Gen – More than goal Encounters Provided 1,188,083 BH, PC, N/CM, P/W – Less than goal SC – More than goal www.setexasrhp.com 12

Conclusions Increase Over Baseline Individuals Served – 9 fold increase Encounters Provided – 2.5 fold increase MLIUs Individuals Served BH, PC, N/CM, P/W, Gen – More than goal SC, CC, EC - Less than goal Encounters Provided PC, SC, N/CM, P/W- Equal or more than goal BH – Less than goal www.setexasrhp.com 13

Fishbone Diagram Group Discussion www.setexasrhp.com 14