October 2015
In this issue:
In the October 2015 edition of the COPE Monthly Digest, we examine clinical project planning and process flows, consider investment programs with benefits from proposed mergers, compare DSRIP in Texas and New York, discuss the importance of quality reporting, and delve into the story of a health system that is ready to meet the needs of the future workforce. We’re here to empower you with the knowledge and tools to transform health care for tomorrow.

How COPE Health Solutions is Transforming Health Care

New York DSRIP Implementation: An Inside Look Into Clinical Project Planning and Process Flows

     Authors: Mallory Johnson, Sr. Consultant and Alexandra Milutin, Analyst

As we continue a series examining the implementation efforts for the New York Delivery System Reform Incentive Payment (DSRIP) Program, this piece will focus on the importance of clinical project planning and design for both short and long term clinical transformation and integration milestones. While the current structure of the DSRIP program draws down funds based on individual project implementation...

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Investment Programs that Ensure that Californians Receive Benefits from Proposed Mergers

  Author: Cindy Ehnes, Esq., Executive Vice President

The nation’s largest health insurance companies are actively courting Congress and the Department of Justice as they attempt to make some large changes in the industry. Aetna wishes to acquire its smaller rival Humana; Anthem is courting Cigna. UnitedHealth Group, now the largest of the five, is on the sidelines looking at its options. Centene, which specializes in offering Medicaid coverage, plans to buy Health Net (headquartered in Los Angeles)...

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Comparing DSRIP in Texas and New York

     Authors: Natalie Chau, Senior Consultant and Alexandra Milutin, Analyst

Delivery System Reform Incentive Payment (DSRIP) providers in Texas have been closely following the proposed extension to the Texas State Section 1115 Waiver as the Health and Human Services Commission (HHSC) prepares to submit an extension application to the Centers for Medicaid and Medicare Services (CMS). A main goal of the extension is to align the waiver with Medicaid managed care and other quality improvement efforts, ...

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The importance of a quality reporting process in a pay-for-performance environment

  Author: Mallory M. Johnson, MHA, Senior Consultant 

The term “pay-for-performance” (P4P) has matured in healthcare over the last decade from concept to reality as healthcare policy creators, administrators, and clinical providers work together to develop a more efficient, sustainable, and quality healthcare system focused on the patient. While Medicare demonstration projects and Medicaid Waivers have been around for many years,.....

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Citrus Valley Health Partners: Equipped to Meet the Workforce Needs of the Future

    Authors: Danielle Westermann, Regional Manager and Alice Tomuta, Director

Developing a caring, diverse and sustainable workforce to support compassionate and high-quality patient care is a critical success factor for today’s hospitals and health systems. In the post-ACA world, the majority of health care payments are transitioning from fee-for-service to value-based payment models,.....

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Team Member Spotlight

Natalie Chau, Senior Consultant

Natalie Chau specializes in the implementation of Delivery System Reform Incentive Payment Programs (DSRIP) under the 1115 Medicaid Waivers. Under DSRIP, providers have the opportunity to receive incentive funds for successful achievement of project milestones and clinical outcomes. Some of her favorite projects have been the expansion of women’s health services in Texas, patient navigation initiatives and clinical redesign to improve the management of chronic disease....

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About Us

COPE Health Solutions provides our clients with the tools, services and advice they need to be leaders in the health care industry. Focusing on all aspects of strategy, population health management, Medicaid waivers, and workforce development, we help drive our clients' success every step of the way.

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