Project Participation Opportunity

“Project 11” – OUTREACH AND ENGAGEMENT TO FACILITATE ADMINISTRATION OF A Patient Activation Measure (PAM) SURVEY AND LINKAGE TO HEALTH BENEFITS AND PRIMARY CARE AND PREVENTIVE SERVICES

October 9, 2015

Request Category / Request Detail
  1. Background and Purpose
/ Through the Delivery System Reform Incentive Payment program, DSRIP, New York State Department of Health (NYSDoH) has allocated $6.42 Billion Medicaid dollars to fundamentally restructure the health care delivery system to transition care delivery from a largely inpatient-focused system to a community-facing system that addresses both medical needs and social determinants of health. DSRIP is a 5-year, performance payment-based program with the primary goal of reducing avoidable hospital use by 25% over 5 years. At the end of program life, the aim is for the newly-transformed system to be sustainable.
The New York City Health and Hospitals Corporation (HHC) has formally partnered with hundreds of provider and service organizations in order to achieve DSRIP transformation goals. Such a partnership is referred to by New York State Department of Health as a Performing Provider System (PPS). HHC’s PPS is referred to as OneCity Health. HHC has created a Central Services Organization (CSO), OneCity Health Services, which is a wholly-owned subsidiary of HHC and whose function is to provide operational, program, IT and other support to all OneCity Health partners and OneCity Health governing bodies.
The purpose of this communication is to identify OneCity Health Partners that are interested and capable ofdelivering training on the Insignia Patient Activation Measure 10-question survey (PAM-10), a product of Insignia Health; and/or conducting outreach and engagement to administer the Insignia PAM-10 survey to uninsured individuals and low utilizing or non-utilizing Medicaid members.
  1. DSRIP Project Description
/ The goal of “Project 11” is to increase patient activation related to healthcare by pairing outreach efforts with resources to engage and help patients gain access to and utilize their health benefits, particularly primary and preventive services.
The objectives of “Project 11” are to outreach and engage, educate and link uninsured individuals and non-utilizing or low-utilizing Medicaid members into community-based prevention, care, treatment and support services.
“Project 11” focuses these efforts on the following distinct populations as defined by NYSDoH:
  1. “Uninsured: individuals who are not enrolled in Medicaid, do not have commercial insurance, or do not have any other qualifying insurance at the time of INSIGNIA PAM-10 survey administration”
  2. “Low Utilizing Medicaid Member (LU): Medicaid eligible member who has two or fewer primary care visits in the last 12 months (particularly despite a need for visits such as follow-up from hospital or ER use or chronic disease management)”
  3. “Non-Utilizing Member (NU): Medicaid eligible member who has no claims for qualifying services as identified by NYSDOH through the member roster and claims sharing processes”
NYSDOH also defines “qualifying services” as including“a wide variety of health care services, such as those received in primary, specialty, emergency room, or acute hospital inpatient settings.
“Individuals who receive care through the following settings should not be considered LU or NU members:
  • Ongoing services for developmentally disabled
  • Nursing home or other ongoing Long Term Supports and Services”
NYSDoH has mandated that OneCity Health utilizethe Insignia PAM survey, an evidenced-based tool, to measure and document patient engagement.
  1. Description of Partner Participation Roles and Responsibilities
/ Partners may indicate interest inconducting one or bothof the following options:
  1. Delivery of training on administration of Insignia PAM-10 survey
  1. Conduct at least two (2) three and one half (3.5) hour training events inclusive of training venue, materials and instructor time, for a minimum of twelve (12) and maximum of fifteen (15) participants per training
  2. Provide the following a minimum of ten (10) business days prior to commencement of first training event: training plan including a schedule, venue(s) and sample training materials
  3. Provide the following a maximum of five (5) business days following the first training event:
  1. Proof of completion for each training event: attendance sheet with date and venue of training, and participants’ names, contact information, organizational affiliations and signatures for each training session
  2. Summary of participant evaluations and participant evaluation forms
  1. Outreach and engagement to administer the Insignia PAM-10 survey including:
  1. Administration of a minimum of one hundred fifty (150) Insignia PAM-10 surveys in a thirty (30) day period;
  2. Direct linkage or facilitation of “warm hand off” of uninsured individuals to health insurance navigator agencies, to enable determination of health insurance eligibility, selection of health plan, identification of primary care provider and scheduling of the initial appointment with the selected primary care provider; and
  3. Facilitation of the identification of a primary care provider, change in primary care provider and/or appointment scheduling with a primary care provider.
Partners will be required to document, track and report all activitiesby the 5th business day of the following month in a manner specified by OneCity Health.
  1. Required Partner Qualifications/Criteria
/ Partners must attest to meeting the following requirements:
  1. Delivery of training on administration of Insignia PAM-10 survey
  1. Must be able to allocate at least one (1) staff memberpreviously trained by Insignia under their Train the Trainer model, to conduct training in PAM survey administration(proof of prior completion of Insignia PAM training of trainers required); or
  2. Must be able to allocate one(1) staff member to complete a three and a half (3.5) hour Training of Trainers on administration of the Insignia PAM-10 survey(October 28th or the 29th);
  3. Must be able to assume responsibility for all subsequent training logistics including securing space and providing training materials; and
  4. Must have electronic means of documenting, tracking and reporting of all activities in a manner specified by OneCity Health.
  1. Outreach and engagement to administer the Insignia PAM-10 survey:
  1. Must be able to allocate at least one staff member to a three and a half (3.5) hour Training of Trainers on administration of the Insignia PAM-10 survey (October 28th or the 29th), or provide documentation of prior staff training on the Insignia PAM-10 survey;
  2. Must have experience in and be willing to conduct outreach and engagementin “hot spot” areas with high numbers of the uninsured individuals, and low utilizing and non-utilizing Medicaidmembers;
  3. Must be able to support the administration of the Insignia PAM-10survey; and
  4. Must have electronic means of documenting, tracking and reporting of all activities in a manner specified by OneCity Health.

  1. Response Process and Timeline
/ The timelines for receiptof submissions, review, Partner selection and contracting, and implementation are as follows:
  • Interested Partners should email with the subject line “PAM Administration” expressing their intent to respond to this opportunity, and providing the name of at least one staff member who will attend a Training of Trainers session, by Friday, October 16th.
  • Interested Partners should fill out the attached form and email it back to with the subject line “Project 11” by Friday October 23rd OneCity Health will finalize Partner selection by October 26th.
  • The contract period for this phase will begin at a time after October 28, 2015 and will end on March 31, 2016.

  1. Timing of Future Requests
/ OneCity Health anticipates that this Project Participation Opportunity will be offered on a rolling basis, not less frequently than semi-annually and not more frequently than quarterly, through second quarter of DSRIP Year 2 (September 30, 2017).
  1. Partner Contracting
/ A Partner who responds to this Opportunity must sign theOneCity Health Master Service Agreement (MSA)and Schedule. The MSA will describe the terms and conditions of partnership between HHC, OneCity Health and a Partner. The Schedulewill describe the Partner and OneCity Health roles and responsibilities including performance, payment and reporting requirements and related timelines.
  1. OneCity Health Contact Information
/ Please submit any questions to . We will respond to your inquiries promptly.

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