Delivery System and Payment Reform

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The University of New Hampshire Department of Nursing and the Institute for Health Policy and Practice, Citizens Health Initiative received the Advanced Education Nursing Workforce grant through the Health Resources and Services Administration. The grant focuses on two areas: to address behavioral health issues and the opioid crises and limited providers caring for underserved and rural populations.

UNH will work with health care providers throughout New Hampshire to address the behavioral health and opioid crises. The grant will fund nurse practitioner students annually who will be immersed in high need areas of the state to strengthen the integration of primary and behavioral health.

This project provides traineeship/tuition reimbursement funds for longitudinal, immersive clinical training experiences with rural and underserved populations for primary care student nurse practitioners. Preceptors involved in the program will receive continuing education units (CEUs) through educational training on cutting edge topics, including value-based reimbursement, behavioral health, substance use disorder, and telepractice. They will be invited to participate in UNH Project ECHO^® sessions, a virtual case-based all-teach, all-learn model. Preceptors can receive funds to attend additional conferences and trainings.

UNH is a Project ECHO Hub participant and has created the Partnership for Academic-Clinical Telepractice (PACT), which is led by the UNH Institute for Health Policy and Practice, NH Citizens Health Initiative. 

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The NH Purchasers Group on Health is a Coalition of public purchasers working to improve quality and efficient, effective healthcare and share best practices on areas of benefits, wellness, and contracts. Institute for Health Policy and Practice (IHPP) provides facilitation and staffing for NHPGH to advance their goals, apprise them of best practices and market data, and bring in expert resources on a project-specific basis. For more information about the NH Purchasers Group on Health, call (603) 862-1128 or email info@nhpgh.org.

The NH Hospital Scorecard is sponsored by the NH Purchasers Group on Health; it highlights the quality and cost of healthcare in our state, and is an effort to get the public and the systems that provide medical care involved in a conversation about what we can collectively do to improve quality and cost.

The Accountable Care Project (ACP) Learning Network leverages a set of analytic reports developed by the Center for Health Analytics. The reports include measures of quality, utilization and cost across systems and regions. The reports are an important source of information for systems undergoing transformation to measure and compare their performance. The ACP analytic reports include two sets of report types:

• The claims-based reports, driven by the NH Comprehensive Health Information System (NHCHIS) data, have both private access for participating organizations and a "public" access for non-participating health care stakeholders. The full report suite includes data for Commercial, Medicaid and Medicare populations.
• The Electronic Medical Record (EMR) quality report is based on self-reported data from participating organizations. The aggregated median rates report provides a benchmark for comparison around key quality measures. Access to the EMR reporting tool is limited to participating partners.

The purpose of these reports is to provide data and analysis on which our Accountable Care Project Learning Collaborative can share learning and develop action plans that can be adopted by healthcare innovators in New Hampshire. The Accountable Care Project was formed with funding from the Robert Wood Johnson Foundation.

 

The dynamic we-based resource, MapNH Health, projects the health and health system needs of New Hampshire in 2020 and 2030, based on current health outcomes and population projections. It is also a catalyst for conversation around the implications of shifting demographics and economics, disease burden, primary care demand, and what we can do in our state to ensure an adequate health future for all our residents.

The NH Pediatric Improvement Partnership (NHPIP) is a multisectoral collaborative of private and public stakeholders dedicated to improving child health through the use of measurement based quality improvement processes in primary care settings in NH. The NHPIP is coordinated by the Institute for Health Policy and Practice at UNH, with Medical Director leadership from the Children’s Hospital at Dartmouth. Examples of project work conducted by the NHPIP include:

• Developmental Screening QI Learning Collaborative (Cohort 2): assisting NH pediatric and family practice clinicians in implementing developmental screening at the AAP recommended intervals of nine, 18 and 30 months.
• Pediatric Neurology Telehealth Project: in collaboration with NH Family Voices, NH Special Medical Services, the Children’s Hospital at Dartmouth, and the Dartmouth Center for Telehealth, supporting up to four NH pediatric primary care practices with implementation of tele-consults and telehealth visits for children with epilepsy.
• Delivery of Oral Preventive Health Services in Primary Care Settings Environmental Scan: assessing where and how to promote the optimal delivery of AAP recommended oral preventive health services in pediatric primary care settings in NH
• HPV Vaccination QI Learning Collaborative (Cohort 1 & 2): assisting the National Improvement Partnership Network with recruiting NH pediatric and family practice clinics to participate in the HPV immunization quality improvement learning collaborative.

The NH Citizens Health Initiative’s Behavioral Health Integration Learning Collaborative (BHI LC) focuses on the integration of behavioral health in the primary care setting with a focus on depression, anxiety, and substance use disorders as they present in primary care. The BHI LC hosts in-person, webinar and phone conference call for learning content, information and data sharing and peer support; delving into topics such as different BHI models, Payment, HIT Integration and Using Data to Track Outcomes.

The Northern New England Practice Transformation Network (NNE-PTN), a partnership between the New Hampshire Citizens Health Initiative at the University of New Hampshire Institute for Health Policy and Practice, Maine Quality Counts, and Vermont Program for Quality in Healthcare, Inc., will receive up to $15 million over four years to provide technical assistance support to help equip clinicians in New Hampshire, Maine and Vermont with tools, information and network support needed to improve quality of care, increase patients’ access to information, and spend healthcare dollars more wisely.

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The NH Citizens Health Initiative is pleased to be working with the NH Community Health Institute, under contract with the NH Division of Public Health Services, to develop and support a Technical Assistance Network for NH Rural Health Clinics. The network will equip Rural Health Clinics with the tools and resources necessary to effectively and efficiently serve their rural populations. The NH RHC Technical Assistance Network will provide support for NH RHCs specific technical assistance needs relative to practice management, RHC recertification, financial reporting, billing, data collection and reporting, and quality improvement. The network will also provide support for an RHC Hypertension Learning Collaborative, including clinical quality management reporting and quality improvement practices to improve hypertension clinical processes. Participating Rural Health Clinics will also have access to the Initiative’s Accountable Care Project reporting tools.