We outline the managed care initiatives for DD Services in New York State and how MediSked working towards providing a complete solution from providers to Discos and managed care companies.

1. Continuing the Conversation
MediSked & the future of DD services in NYS

2. 2
Agenda
• About us
• The goal in New York State
• Overview of Connect
• How Connect fits in with the new model of
care
• Our Premier Knowledge Transfer
Coaching process

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More than just a software company, we are advocates for provider
agencies through our technology & advisement solutions. Our products
& services span the complete spectrum of DD Service provision – from
oversight & insurance organizations down to the provider level.

4. from Alaska to
Maine…
with provider partners
in counties across NY,
from Erie to Suffolk
National reach Experts & thought leaders in human
services. Regular speakers at…
© Copyright 2014 MediSked, LLC
Leader in the country & NYS
The partnership between PHP and MediSked developed the Electronic HL7 Standards for
DD Care Coordination in NYS.
MediSked is the DD software representative in the international HL7 Object
Management Group Healthcare Services Specification Program (HSSP) & the care
coordination service work.

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The long-term goal of New York is for all Medicaid members
to be enrolled into comprehensive, fully integrated managed
care plans.
© Copyright 2014 MediSked, LLC
New York’s Medicaid program is working toward the Triple Aim:
better care, better health, and lower costs through Governor
Cuomo’s Medicaid Redesign Team’s (MRT) initiative of Care
Management for All

6. What is an Agency Management
Platform?
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Client Care
Centric

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Built in Workflows & Document
Tracking

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Billing Claim Lifecycle Management

10. 10
Living System

11. Real Time Reporting
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Integrated HR Management

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Everyone Uses It

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© Copyright 2014 MediSked, LLC
MediSked & the new managed care
model

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What is Connect Exchange?
MediSked Connect Exchange is the first Business
Intelligence Platform specifically for I/DD Provider Agency
groups, MCO/Insurance Companies and Oversight
© Copyright 2014 MediSked, LLC

16. With a multi agency business intelligence
platform; liberate core financial, clinical and BI
data. Set up key alerts.
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Link with Care Plan Manager, EHR
Assessments and Evaluations
Status Change
Documentation
Charts/Observations
Medication Administration
Monthly Summaries
Clinical
Encounters
Eligibilities
Service Authorizations
Billing
Financial
Life Plan Updates
Predictive Analytics
Personal Outcome
Measure: Prompts and
Results Analytics
Demographic Tracking
Waiting Lists/ Referrals
Business Intelligence
example data warehouse uses
Links to RHIO/HIEs are possible
© Copyright 2014 MediSked, LLC

17. Connect Exchange Data Feed and
Message Formats
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Financial Data
Clinical Data
BI Data
© Copyright 2014 MediSked, LLC

18. Connect Exchange Data Transactions
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Bi-Directional
Real time alerts
Proactive Decision Support
© Copyright 2014 MediSked, LLC

19. Platform agnostic: Providers can use electronic records from
any vendor, as long as they are able to send and receive
compliant HL7 clinical, financial, and BI data with the Exchange
Care Management Data + DD Data (via MediSked Connect Exchange)
Provider data inputs
HL7-
Compliant
Agency
Management
Platform
(AMP)
© Copyright 2014 MediSked, LLC
DISCO/MCO
Agency X Agency Y

20. OPWDD Person Center Planning
http://www.opwdd.ny.gov/opwdd_services_supports/person_centered_planning/understanding-person-centered-planning
Person-centered planning centers around a Life Plan
• Demographics and Profile
• CQL Personal Outcome Measures
• Health and Safety Supports
• Individual Protective Oversight Plan
• Service Authorizations
DISCOs – Responsible for:
Quality Assurance
Grievances and Appeals
Informed Choice
Person-Centered Planning
Care Coordination
Marketing of Programs and Services
© Copyright 2014 MediSked, LLC
Managed Care Tasks
Member Enrollment
Provider Enrollment
Prior Approval and Authorization of Care
Claims Processing and Payment
Internal Compliance and Auditing
Continuous Quality Improvement

21. Life Plan & Life Plan Updates
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The Life Plan is central to the
individuals being served at
providers. Receiving it from the
MCO and documenting on it in
real time is essential. Each time
the Life Plan has a change made
and is certified – that update is
pushed to the provider into
Connect. The Life Plan is truly a
living document.
Provider

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The Life Plan automatically assigns the Person-Centered CQL Personal Outcome
Measures which are instantly presented to the DSPs to document on in the service
note area of Connect. Each service the individual receives will have a different set of
POMs based on the unique goals in the service.
Personal Outcome Measures

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Health & safety supports and individual protective oversight measures listed in the
Life Plan are alerted directly to providers via Connect for immediate implementation
and documentation. They can be pulled up at any time when working with the client,
including mobile and tablet devices.
Health & Safety Supports, IPOPs

24. Based on a client’s Life Plan, specific charts and logs might be necessary (e.g. sleep,
weight, food intake, seizure, etc). When the clinical team makes a request for
observational data, a specific chart will automatically be created in Connect for data to
be collected. Aggregate data collection will help the clinical team be proactive in
spotting trends or abnormalities in a person’s health.
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Observation Logs

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Receive alerts in Connect
when units are authorized
or updates are made from
PHP. All of the information
necessary to provide
services comes pre-
packaged with the alert,
including the POMs and
goals service note
templates, total units and
plan information.
Service Authorizations
Provider
MCO/DISCO

26. The clinical team at the MCO and agency staff sends alert messages to all authorized
parties for changes to behavior, demographics, health, and natural supports. These
messages include a reason for change, priority level, immediate safeguard/action,
recommended follow-up and also free-form notes.
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Notification of Change Alerts

27. Provider agency staff capture real-time data on outcomes, staff supports, prompt
levels, and progress on a constant basis. This data is summarized on a monthly basis
to help the care coordination team in ensuring that the best services are being
outlined via the life plan.
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Monthly Summaries
Personal Outcomes offer a progress menu
with the following values (MONTHLY)
• No Progress
• Regression
• Progress Made
• Achieved/Met
When maintaining or actively attending,
outcome is written to reflect this.
Staff can send a priority comment to the care
coordinator about this outcome

28. How do you get from here…
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Dial in: 877-216-1555
Passcode: 1064079#

29. … to here
29
Dial in: 877-216-1555
Passcode: 1064079#

30. Premier Knowledge Transfer
Coaching
30
Dial in: 877-216-1555
Passcode: 1064079#
Envision
Plan
Train
Configure
Test
Go
Live

31. 31

32. THANK YOU!
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From this meeting, we will follow up with a tech
survey to learn how you are currently managing
your data and operations.
Please feel free to reach out to us at
sales@medisked.com or 866-633-4753