Establishes the hospital-home care-physician collaboration program in the department of health

2 Co-sponsors

• William J. Larkin Jr.
• Catharine Young

BILL NUMBER:S5258

Title of bill

An act to amend the public health law, in relation to establishing a hospital-home care-physician collaboration program

Purpose

To facilitate improvement, efficiency and strengthened infrastructure in the health care system though collaborative hospital, home care and physician initiatives. Provides support for these initiatives through funding and regulatory flexibility. Also includes nursing homes, multidisciplinary providers and practitioners, payors, and other service entities as additional potential partners.

Summary of provisions

Section one establishes a new section 2805-w of the public health law, "Hospital-Home Care-Physician Collaboration Program."

Subdivision 1 states the purpose, to provide a framework to support collaborative hospital-home care-physician initiatives for improving patient care access and management, patient health outcomes, cost-effectiveness in the use of health care services, and community population health. Collaborating partners may also include skilled nursing facilities, other interdisciplinary providers and practitioners, payors and others.

Subdivision 2 defines key terms used in the section.

Subdivision 3 authorizes the Commissioner of Health to provide support to facilitate these initiatives, including:

(a) Grants, rate adjustments, premium adjustments or other financing, to the extent available to support the program. Includes as potential funding sources state-secured waivers (e.g., the state is seeking through waivers $10 billion in federal health care reinvestment funding.

(b) Regulatory flexibility waivers for the program. Subdivision 4 specifies categories and subcategories of collaborative initiatives under the program, including but not limited to:

(a) Integration initiatives, including: Transitions in care; Clinical pathways; Application of telehealth/telemedicine services; Facilitation of physician house calls; Prevention of avoidable hospital readmissions and emergency room visits; Health Home development; Development and demonstration of new models of integrated or collaborative care and care management not otherwise achievable through existing models; and Bundled payment demonstrations for hospital-to-post-acute-care.

(b) Recruitment, training, retention and placement of essential direct care personnel.

(c) Initiatives in the care and management of special needs, high-risk and high-cost patients, through best practices, training and education

of direct care practitioners and personnel. Subdivision 5 provides for reporting requirements.

Section 2 establishes an immediate effective date for the bill.

Justification

Communities and the providers which serve them face increasing challenges in adapting to the changing health care system and to meeting citizens' health care needs. Both patient and system needs are growing in complexity, diversity and demand.

Provider collaboration is a highly effective and vital vehicle to coordinate and maximize both clinical efforts and local resources in meeting patient/community needs. In addition, such collaboration leads to better integration of health care services and is critical to facilitating quality of care, advanced care management techniques and health care cost-efficiency.

The major benefits of hospital, home care agency and physician collaboration are being seen in the overall improved management and delivery of services, in effective patient care transition programs, telehealth/telemedicine services, specialty care management, physician house call programs, preventive as well as post-acute and chronic care initiatives, and other innovations. These collaborative initiatives hold potential for further, far-reaching benefit to patients and to the evolving system, particularly in resource-limited areas. These initiatives are in sync with the state's major health care reform policies, its 1115 waiver and waiver reinvestment proposals, the federal Affordable Care Act, and industry-led trends.

The benefits of these initiatives compel state policy, program and financial support. In supporting these initiatives, this legislation will facilitate patient care management, outcomes, efficiency, health care infrastructure and population health.

Legislative history

New bill.

Fiscal implications

This bill will promote efficiency and coordination in service delivery, with better outcomes, reduced costs, and ultimately sustainability and access of care.

Effective date

The bill would take effect immediately.