Innovation Driving Change

MHVC is pleased to introduce this new section of our website featuring creative approaches and activities within our MHVC region, as well as important national best practices initiatives that our network can incorporate into the integrated delivery systems and drive outcomes and improve patient care.

MHVC Announces Innovation Fund Awards

Nineteen win competitive grants

In June 2017, MHVC announced a new funding opportunity for MHVC contracted partners and Tier 1 Community Based Organizations (CBOs) through the Innovation Fund Pilot Project Program. Providers and CBOs throughout MHVC’s seven-county region submitted proposals for collaborative pilot projects to address social determinants of health and develop outcomes-driven models of care. After extensive review, Innovation fund contracts have been awarded to 12 contracted partners and 7 new Tier 1 CBO partners, totaling $3,158,726.

“We are excited by the spirit of innovation and new partnerships being formed across the Hudson Valley,” said Marlene Ripa, MHVC Network Director. “We are confident that our provision of funding and continued technical assistance will result in successful projects with the ability to demonstrate a return on investment within a year or two.”

The funding is also consistent with the New York State Department of Health’s CBO Value-Based Purchasing Roadmap. “The state recently distributed a webinar focused on CBO VBP, and we were encouraged to see that our ongoing CBO integration strategy is very much aligned with what was outlined in the webinar and roadmap,” continued Ripa.

Below is a list of the nineteen organizations that have been awarded Innovation Funding for the project period October 1, 2017 through September 30, 2018:

Planned Parenthood Mid-Hudson— Newburgh-focused project
Project Name: Health Benefits of asthma education, screening, diagnosis/treatment, AAP, and rescue medication in the Newburgh Housing Authority homes
St. John’s Riverside Hospital—Yonkers-based project
Project Name: Decreasing Potentially Avoidable ER Visits through patient incentives, increased CBO involvement & Increased Health Home Enrollment
Yonkers Public Library—Yonkers-based project
Project Name: Offering Support Services for Library Patrons
Arms Acres—Hudson Valley region
Project Name: "Bridging the Gap": Certified Recovery Peer Advocates Engaging SUD Patients in Crisis
Hudson River Healthcare—Hudson Valley region
Project Name: Engaging Behavioral Health (BH) Clients through Nontraditional Strategies
Hudson Valley Care Coalition—Yonkers-based project
Project Name: Development of Sustainable Engagement Models that Target Hard to Reach Members of the Westchester Community
CANDLE of Rockland—Rockland-based project
Project Name: LGBT/Q Cultural Competency Training for Providers of Primary Care
Cornerstone Healthcare—Newburgh-focused project
Project Name: Using Shared Data to Target High-Risk Populations and Reduce ED Utilization-Homeless engagement
Rockland Paramedics—Rockland County
Project Name: Community Paramedicine Health Gap Services
Westchester Jewish Community Services—Yonkers-based project
Project Title: DBT-Informed Response to Care in Yonkers
MHA of Orange County—Newburgh-based project
Project Name: Standardized Care Management Education, After-hours Response to Individuals Enrolled with a Care Management Agency and/or in Need of Care Management Services that Present at an Area Hospital, and Community Education on the Role of Care Management
United Hebrew Geriatric Center—Westchester-focused project
Project Name: Transitional Post-Acute support
Human Development Services of Westchester—crisis-related program in Mamaroneck
Project Name: The Living Room: Crisis Day Respite Hospital Diversion Program of HDSW
Maternal Infant Services Network—Newburgh-focused project
Project Title: The Power of Health: Engaging Youth and Teens in Primary Care and Prevention
Student Assistance Services—Yonkers-based project
Project Title: Wonders of Wellness (WOW) Engagement of Youth in Preventive Care
Nyack Hospital—Rockland County-based program
Project Title: Nyack Hospital Community Paramedicine Collaboration
Cabrini—Westchester-focused project
Project Name: Building Transition in Care Partnerships to Benefit Pulmonary Patients and Reduce Readmissions
Meals on Wheels of Rockland—Rockland-focused project
Project Name: Engagement with Clinical providers & Training of MOW staff to conduct Health Status Monitoring
TOUCH of Rockland & Orange Counties—Rockland-based Stanford Model project addressing food insecurity
Project Name: Medical Case Management and Medical Nutrition Therapy for people living with Type 2 Diabetes

What Matters to You?

MHVC and its partners have embraced the new initiative, "What Matters to You?" (WMTY) and made it their own.

5 Ways Healthcare Organizations Can Amplify The Voice Of The Patient

Embedding “the voice of the patient” is an aspiration many healthcare organizations hold, yet one that most find challenging to operationalize. Sachin H. Jain, President and CEO of the CareMore Health System, an integrated health plan and delivery system, offers five approaches to make the patient voice real within his organization:

  1. Make Senior Leadership Accessible to All Patients
  2. Proactively Engage Patients in Informal Settings
  3. Require Non-Patient Facing Organizational Leaders to Connect with Patients Regularly
  4. Explicitly Use Patient Input to Drive Program Design
  5. Tell Patient Stories Often

Read the full article here.

“Open Access” Provides Better Access for BH Patients

How one system found -- and solved -- scheduling issues

Many MHVC behavioral health (BH) partners report struggling with access and availability to services and appointments for patients. In response MHVC continues to design special programs, offer workshops, and highlight best practices that can improve access and care for patients. This month we are highlighting the innovative work at Montefiore’s Behavioral Health Centers (MBHC) to increase access to BH services.

Those who attended the breakout sessions at the MHVC Behavioral Health Learning Collaborative #2 on June 8, 2017, heard about the MBHC walk-in clinics from the Clinical Director of MBHC, Thomas Betzler, MD. “We had a lot of no-shows in our Comprehensive Outpatient Program Services (COPS) referrals. These are patients that we are mandated to see within five business days, and includes patients discharged from Psychiatric inpatient units and Emergency Departments (EDs),” said Betzler, “so we asked ourselves, ‘What can we do?’”.

In the past, COPS provided specific reimbursement in exchange for the provision of enhanced outpatient services. Although the enhanced reimbursement has stopped, the State continues to mandate a follow-up appointment within five days. However, Dr. Betzler found that only 30-40% of patients actually show up for those valuable slots, and the percentage for primary care referrals was 35%. “We decided to make those empty slots available for walk-ins, and we set up a schedule and a list of priority patients for the spots,” explained Betzler.

The success of this approach is evident in the data. “According to PSYCKES data for rehospitalizations, MBHC is at 11.4%, which is below the state 14.3% and regional rates, 14.3% and 16.4% respectively (with a very comparable patient population).” Betzler believes improved access is a large part of that positive result. “The Open Access model is the only way to drive down rehospitalizations. It cannot be a fixed window in time: It must be nimble so patients view the clinic as the primary place for quick and efficient care. We adjust our provider schedules to accommodate the needs of our patients and community.”

“We know the importance of connecting with these patients early, and making it easy for them to come back,” said Dr. Betzler. “Once they make it to the clinic, 79% return for a follow up visit within 30 days.  When we look at the return visit rate within three months, over 90% return for a follow up visit. Getting them to MBHC is important -- the walk-in service doesn’t shame the patient  for missing an appointment and then allows them easier access to behavioral treatment within the community.”

Read the complete article in our MHVC July/August newsletter here.

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