Phase I

As part of Phase 1, “Learning Sessions” were convened with noted authorities in healthcare transformation, including experts from the states of Oregon, Vermont and North Carolina. The Office of Healthcare Transformation, with support from the Milbank Memorial Fund and Hawaiʻi State Legislature, hosted two sessions (see participants of Learning Session 1 and Learning Session 2).

In addition, five committees were formed to identify priorities for transformation in various aspects of healthcare:

  • Delivery System Committee
  • Payment Innovation Committee
  • Health IT Committee
  • Government Policy Committee
  • ACA/PHCA Coordination Committee

Over the first half of 2012, the committees held more than 30 meetings aimed at gaining a common understanding and consensus regarding priorities for transforming our healthcare system.  The culminated in release of the Phase 1 Report in the summer of 2012, which elaborates on the priorities listed below.  

Matrix of THHP Transformation Priorities

  Patient-Centered Medical Home Community Care Network Accountable Care-Like Organization
Definition of Delivery System Priorities A PCMH is a primary care oriented practice that uses a variety of strategies to engage and accommodate patients. Hallmarks include enhanced access and care coordination made possible with a team of ancillary providers, use of registry functions to track and improve progress, and effective exchange and stewardship of patient records. The Community Care Network provides coordination and support to the PCMH. A CCN is a team of ancillary providers and care managers whose function is to coordinate care for patients within or between a PCMH, specialist, hospital, and other setting. Especially for solo and small practices, the CCN can be the means to support the continuum of care from PCMH through ACO. If needed, the CCN can also provide additional services such as medication reconciliation, nutrition counseling and other health education, primary behavioral health services and assistance in getting more advanced care. An ACO-like structure coordinates and shares responsibility for care across the continuum of health services, from PCMH through specialty care, to acute care and to long-term care. The ACO requires additional legal and structural agreements for sharing outcome expectations, clinical and performance data, and payments. The CCN provides coordination and support to the ACO.
Associated Payment Innovations
  • Pay for performance
  • Shared savings
 Explore appropriate support mechanisms in relation to patient-centered medical homes.
  • Pay for performance
  • Shared savings
  • Bundled payments
Data and Health IT Support Needed
  • Expand use of electronic health record and health information exchange.
  • Data repository and analytics to establish and measure quality, payment incentives, consumer, employer, payer information.
 Electronic sharing of patient information needed for care management.
  • Expand use of electronic health record and health information exchange.
  • Data repository and analytics to establish and measure quality, payment incentives, consumer, employer, payer information.
Government Policy & Purchasing Implement innovations in public programs (MedQUEST, EUTF, and Connector). Implement innovations in public programs (MedQUEST, EUTF, and Connector). Implement innovations in public programs (MedQUEST, EUTF, and Connector).