Future of Health Care 2020

THE FUTURE OF HEALTH CARE // PAYMENTS AND REIMBURSEMENTS
Programs look for new funding options as DSRIP ends
CONTINUED FROM PAGE 36
we need for them in a measured way.“
But some programs will end unless
new funding can be identified. ECMC
announced in mid-April it will distribute
$7.24 million to its partners to help
ensure ongoing access to services, but
there’s no guarantee all existing programs
would be funded.
BestSelf Behavioral Health
BestSelf had contracts with
Millennium and Community Partners
through DSRIP. One of the most
successful was the hospital bridger
program that posts a staffer at ECMC
to ensure patients ready for discharge
are linked up with care.
Another program funded through
a $300,000 annual DSRIP contract
links behavioral-health clients with
primary-care providers to get care
for chronic conditions. UBMD Family
Medicine has an office at BestSelf’s
clinic, so patients can develop that
relationship while they’re in for
treatments or therapy.
People with mental-health and
addiction conditions often fall through
the cracks or forgo traditional healthcare
needs, said Elizabeth Woike-Ganga,
BestSelf’s chief operating officer.
“We’re looking at different options
for sustainability,” she said. “We have
some grants for this year to try to transition
it into a different type of model,
but that would be a big loss.”
Most of those services can’t be billed
to Medicaid, so finding new funding
is vital, especially with revenue and
patient volume down and many private
funders focused on Covid-19.
Niagara Falls Memorial
Medical Center
Niagara Falls Memorial will absorb
costs to enable some DSRIP programs
to continue. That includes one to help
behavioral-health patients connect to
outpatient services within seven days
of discharge.
The hospital hired therapists to
conduct home visits after discharge,
which often provided a window to
other issues to improve care.
Another program enabled
screenings for mental-health patients
when they arrived in the ED and
identified conditions such as diabetes
and heart disease. And a third program
provided help for mental-health
patients to adhere to their medications.
Funding from DSRIP totaled more
than $400,000 annually.
“We were really identifying a lot
of people with underlying conditions
that really could be very problematic if
they didn’t take care of those issues,”
said Sheila Kee, executive vice president
and chief operating officer.
To keep that going, the hospital has
restructured its workflow to allow
continued screenings in the ED. Home
visits are on hold during the coronavirus
pandemic, but Kee hopes to find a
way to allow that to resume as well.
“For the ED screening, the hospital
is providing it at its own cost,” she
said. “For the home visits, we’re taking
our 15 staff and restructuring workflow
and workloads to continue to do
what we can, keeping them on the
payroll with other responsibilities.”
As fewer people come into the ED or
are admitted unnecessarily, the hospital
reduces expenses, Kee said.
“In our world, I think
it was extremely
beneficial and we
would not have been
able to do all these
things without it. I
am disappointed we
don’t have DSRIP
Round 2, but we’ll
figure it out.”
BONNIE SLOMA, senior vice
president, People Inc., speaking
about DSRIP funding
Catholic Charities of Buffalo
Catholic Charities had several programs
funded by DSRIP, including
a community health-worker program
that tracked down patients who
missed appointments.
Megan Lostracco is project coordinator,
overseeing three staffers with a
caseload of up to 75 patients. She said
the agency was hoping a federal extension
of the DSRIP waiver would enable
the program to continue. Without that,
the program is funded only through
June.
“Right now we’re still just in the
process of reaching out and talking
with community providers within our
network that we already work with to
try and figure out if there are additional
funding opportunities,” she said.
The goal is to keep the three workers
on the payroll for now, even if the job
titles and responsibilities change. The
program has had successful outcomes,
which could help the agency find support
through a value-based payment
model, Lostracco said.
Without the program, a physician
might label someone as non-compliant
for not showing up. The community-health
worker, who could provide
job training or access to food stamps,
might find out the patient lost a job
and couldn’t afford the co-pay.
“We had some people who didn’t
understand they should have a voice
in their care decisions,” she said.
Catholic Charities has linked up
with the Western New York Integrated
Care Collaborative to find ways to
adapt or expand that could lead to
new funding sources. The agency also
is requesting funding from the annual
appeal.
People Inc.
People Inc. developed a telemedicine
program through DSRIP with
Community Partners of Western New
York three years ago. The program
sends a nurse with telemedicine tools
to see people with developmental disabilities
to avoid ambulance rides and
ED visits.
Launched with an initial grant of
$200,000, the program has worked.
Independent auditors assessed Medicaid
data to show ED visits declined
by 30%. Those numbers helped People
Inc. land a $500,000 grant from the
Mother Cabrini Health Foundation to
keep the program going.
An early grant from the Tower
Foundation helped provide access to
telehealth as the DSRIP program was
ramping up. The results are especially
validating as everyone shifts to telemedicine
during the pandemic, said
Bonnie Sloma, People Inc. senior vice
president.
“There wasn’t pushback, but there
was a lot of apprehension on the ability
to provide quality care and can it be
done,” she said. “But it did work, and
the outcomes were very good.”
The Cabrini grant could allow
expansion and to train house supervisors
about telemedicine.
Sloma said the DSRIP funding was
clearly valuable.
“In our world, I think it was
extremely beneficial and we would not
have been able to do all these things
without it,” she said. “I am disappointed
we don’t have DSRIP Round 2, but
we’ll figure it out.”
WORD FROM THE SPONSOR: GBUACO
G-Health Enterprises’ Community Response Plan
G-Health Enterprises has always
strived to transform healthcare
by removing barriers created
by social determinants of health in
underserved communities. With all
the news of COVID-19 cases and death
disparities in minority communities,
this mission has become more
important than ever. To that end, Dr.
Raul Vazquez and his Value Based
Payment team are leading the charge
with The Community Response Plan.
The Community Action Response
Plan’s initiative is to unite churches,
community based organizations, and
medical partners in Western New
York for a comprehensive approach
Raul Vazquez,
M.D., is President
and CEO of the
Greater Buffalo
United Accountable
Care
Organization
(GBUACO)
to combat the
coronavirus
and mitigate its
effects on the
community.
Testing is
available for high
risk patients of
Urban Family
Practice, all
primary care
providers in
the GBUACO
Network, and
now to members
of the community
whose providers
are outside of our
network, in which case we will send
the results your primary provider.
If an individual has no primary
provider, Urban Family Practice will
make an appointment through them
to ensure everyone has the option to
get tested. Insurance covers COVID-19
tests and for those who do not have
insurance and qualify for medicaid,
we can connect you with an GBUAHN
outreach enroller who will help get
set up with insurance.
Before visiting our COVID-19 testing
locations, please complete a screening
by our nurses to determine if you are
eligible. You can begin this process
by downloading the UFP, GBUAHN
or GBUACO apps and completing the
COVID19 surveys or by calling our
Nurse Advice Line 716-604-0504.
G-Health Enterprises is a health
care organization which encompasses
several affiliates: The Greater Buffalo
United Accountable Healthcare
Network (GBUAHN), The Great
Buffalo United Accountable Care
Organization (GBUACO), Urban
Family Practice (UFP) and The
Greater Buffalo United Independent
Physician’s Association (GBUIPA)
facilitated by CEO and President Raul
Vazquez, MD.
G-Health Enterprise’s mission
is to cultivate hope and quality
healthcare in children, families, and
communities.
38 THE FUTURE OF HEALTH CARE BUFFALO BUSINESS FIRST