0706 Industry Day Talking Points_cjm draft 4 jmob edits.docx

Industry Day Talking Points

Housekeeping and Framing (Joey Eakle, Dan Kane)

Introduction to Partnership for Patients (Don Berwick)

· (Title slide) Thank you. And my very sincere apologies for the audio difficulties we’ve had.

· (Title slide) We’re delighted to have you all with us. The Partnership for Patients represents an unprecedented opportunity to improve patient safety and care transitions across the nation, and we’re optimistic that the funding opportunity we’re laying out today will contribute to that significantly.

· (A Three-Part Aim) Our work at CMS – and across the Department – is rooted in something we call the three-part aim. This describes what we must do to transform the health care system, and no work could be more urgent. We seek improve health care and health while lowering costs through improvement

· (A Three-part Aim) The Affordable Care Act, a wonderfully rich piece of legislation, provides us with a number of opportunities in this regard. We’ve decided to start by focusing on patient safety, in part because of the seriousness of the problem but also because we have pockets of brilliant success all around the country that give us confidence that great change is possible.

· (Partnership for Patients) Here again, briefly, are the aims the Secretary announced when we launched the initiative on April 12 (restate aims).

· (Partnership for Patients Update) Since we’ve launched, we’ve observed great energy in the form of launch events (more than 60 across the nation), media events and sign-ups (slide provides data on pledges). Importantly, a number of Affordable Care Act provisions – including the Medicaid Provider-Preventable Conditions Rule, Medicare IPPS Rule, Medicare Value Based Purchasing Rule, and Community-Based Care Transitions Program - have been aligned with Partnership activity.

· (How Will Change Actually Happen?) For all of this momentum, though, the fair question to ask is how we will actually see the change we seek. We hypothesize that there will be three keys: (1) thoughtful incentives to build will for change; (2) development of a rich store of case examples and excellent ideas; and (3) Intensive supports for the painstaking work of improvement at the front lines of care. When we launched the Partnership we announced up to $1 Billion in funds to provide technical assistance to hospitals and communities, starting with $500M for the Community Care Transitions Program, Section 3026 of the Affordable Care Act, and today, through the authorities of the new CMS Innovation Center, we introduce even more.

· (The Innovation Center) The Innovation Center allows is a remarkable new entity – a major jewel in the crown of the legislation – that has very clear aims and very exciting possibilities. It must test new models for reducing cost and improving quality or it must bring models known to be successful at reducing cost and improving quality to scale. What we will be doing together here represents a major test of scale; we are determining how we can expand those pockets of success I mentioned earlier and seeking to

· (Partnership for Patients Supports) Our intent today is to focus on the so-called Hospital Engagement Contracts (HECs), in particular, but we will also share information about the larger set of contracts we will be letting and, for those of you who are newer to federal funding opportunities like this one, we’ll guide you through some of the specific steps you’ll need to take. Our goals in creating these opportunities include:

· Providing meaningful, rigorous support to hospitals;

· Getting support to the field rapidly;

· Making sure that all hospitals and communities will have access to some form of technical assistance;

· Creating broad eligibility (through contracts and subcontracts) so that many types of organization and geographic areas will be covered.

· [An acknowledgement of the aggressive timelines we’re going to be holding applicants to given our desire to start this work in the field as fast as possible; otherwise, turn over to Joe to go into more detail about the Hospital Engagement Contractors.]

Overview of HEC Contracting Opportunity (Joe McCannon, John O’Brien)

· (Title Slide) Thanks, Don, and I’d like to also extend my apologies for the audio difficulties we’ve had. It’s really unacceptable and I take responsibility for it. We’ll look into options for recovery as soon as we finish the call. I’d like to say thank you, as well, to Dan Kane, Joey Eakle, Doug Nock, Carol Sevel, John O’Brien and a number of others who’ve worked very hard in preparation for this call.

· (Title slide) I’d like to echo Don’s energy and enthusiasm about what is possible here. We have an opportunity to do something historic and crucially important together and we’re grateful the interest of those tuning in. I also a note an undercurrent real seriousness in everything Don has said -- we have to find a way to get this right and we’re looking for true excellence in execution here.

· (Slide 26/The Hospital Experience) Our general strategy for the contracts we’re introducing to support improvements in hospitals is one that hypothesizes that a number of forces will ultimately lead hospitals to the improvements in safety that we seek. In keeping with what Don has said, we imagine that a number of thoughtful incentives, from forthcoming payment changes to increased patient and family engagement (and expectations), in addition to intrinsic desires to provide good care, will drive leadership to make deep commitments to improvement. We also think that we have to create a rapidly-updating system for collecting and diffusing effective practice – basically, a platform that will enrich our learning. But above all, we believe that the highest awareness levels in the world or the very best of ideas are only prelude to the real work of improvement and that’s at the heart of the set of contracts the Innovation Center is introducing, and especially the Hospital Engagement Contractor opportunity we’re discussing today.

Essentially – and in support of the approach I’m describing here - there are five contracts that are being introduced by the Innovation Center, the first of which will take the majority of our focus:

· The first contract will seek to provide intensive local supports to all hospitals through large systems, associations and state consortia that will host rigorous local learning activities and support hospitals in targeting ten key adverse events and building a culture of safety. These are the so-called Hospital Engagement Contractors, as many as 100 large systems or associations or state and regional constoria who will be arrayed across the nation.

· In the second contract, we seek a contractor that will develop a national learning platform with content and expertise accessible to PfP participants and all other contractors. We refer to this as the National Content Developer.

· In the third contract, we seek a contractor that will develop a community of ambitious organizations – referred to as advanced participants – who will act as a vanguard, attempting to achieve major reductions in harm and readmissions on a very fast timeframe and pioneering new forms of improvement that will lead to improvement not simply on specific, isolated adverse events but in all forms of harm across the whole facility, tending to issues of leadership, management and culture. We expect that these hospitals will be self-selecting and must agree to total transparency in their progress against their bold aims, with the possibility that some will emerge as outstanding performers and be recognized and supported as mentors for the rest of the nation. We refer to the organization that will manage this network as the Advanced Participant Network contractor.

· We expect that both the National Content Developer and the Advanced Participant Network conveners will supply information and support to the Hospital Engagement Contractors, and the Hospital Engagement Contractors will also offer insight and make specific requests for support.

· Two other contracts will also be let, one to support enhanced public engagement – raising patient and family awareness, involving them in the redesign of care and supplying them with resources and tools to help reduce complications in their care – and the other to measure national change in harm and evaluate the overall impact of the program.

· I should note that the final four contracts I mentioned – that is, those contracts other than the hospital engagement contractor – are subject to separate solicitations, which we will not discuss here today. The government has identified a series of separate, appropriate contracting vehicles for these opportunities, and associated subcontracting opportunities are possible.

· Taken together, all of these contracts should create a national network of learning and improvement that will support hospitals in the hard work of change and help them to learn from one another.

· (The Hospital Experience – Diamond slide) You can understand this with more specificity in the next slide. What you can see here is that all of the contracts seek to ultimately create value and support for participating hospitals and providers. With the hospital engagement contract activity as a mainstay of support to – we hope - thousands of organizations across the nation, coming together in groups of tens or hundreds at a time to learn from each other at a state or system or association level, and the advanced participant network contractor, the patient and family engagement contractor and the national content developer together providing the will, ideas, content and expertise that will support that work and take the nation to new levels of performance.

· (The Hospital Experience: Map Slides) Another way to think about this is to imagine a map of the United States. Here you can see an example of a state where, perhaps, thirty or forty organizations might come together through a hospital engagement contractor – a state consortium - to learn and improve together. In addition, in the next slide, a large association or system might orchestrate the activities of constituent facilities. By and large, these are the kinds of collaborations we would want Hospital Engagement Contracts to support. Over time, as we’ve said, these Hospital Engagement Contractors should be in close learning relationships with ambitious hospitals that are a part of the Advanced Participant group, and they should also, gradually, begin to benefit from the input of engaged, activated patients and families, as well. And, then, in the final slide you can see that we would expect a the National Content Developer to be regularly collecting ideas and innovation from around the country and supplying best practices broadly, while the evaluation contractor would help us assess progress, learn and improve as we go.

We believe that but pulling out all of these stops – and requiring ourselves to collaborate fully and rapidly – we can actually make a run at driving the change we seek.

· (Hospital Engagement Contract Overview: Base Contract Requirements) Our chief focus here today is on the Hospital Engagement Contractor solicitation – again, the opportunity for contractors to bring together groups of hospital, across the nation, for intensive learning and support. I’m going to turn to my colleague John O’Brien to discuss that in great detail but first let me say a word about eligibility for these contracts, in particular. Eligible organizations include:

· An organization that is a national, regional, or state association of hospitals as identified through an organizational charter or agreement and a governing body that represents affiliated members

· An organization that is a national affinity organization that represents hospitals which address specific patient and/or regional health issues identified through an organizational charter or agreement and a governing body that represents affiliated members

· An organization that holds corporate ownership and operational control of a hospital chain of at least 25 hospitals

· There are, I would note, ways for organizations and groups to cooperate to meet these criteria, but more on that in a moment. For now, let me ask John O’Brien to describe the core tasks that the contractor must complete and lay out a few key criteria.

· Thanks, Joe and everyone who has joined today’s call. The full scope of work for the Hospital Engagement Contractor may be found as Section C of the full solicitation, though we appreciate the opportunity to walk through these tasks from a general and practical perspective.

· As Joe described, the Hospital Engagement Contractor will convene hospitals with whom they are affiliated, and work with them to conduct patient safety training activities and quality improvement projects, support them in their progress and provide them with technical assistance, and establish the improvement measures with which they will monitor performance.

· An important item to mention early is that each contractor will be expected to work closely with other Partnership for Patients contractors and participants. For example, much of the content used to conduct the work under this solicitation will be created by the National Content Developer accountable under a separate contract. More detail about this collaboration will be provided during the kick-off meetings.

· A key first step in this work is finalizing the design of the campaign, and planning how the hospitals will be enrolled. Because hospitals may only work with one convener, the contractor is also responsible for ensuring each hospital is not participating in an activity convened by another contractor funded under this solicitation. The plan should describe how you plan to develop and deploy the learning networks and engage the participating hospitals in the work of improvement. This includes your approach – for example, face to face meetings, large conferences, and webinars – as well as which 10 HACS you plan to address.

· Contractors are then expected to conduct training activities that address up to 10 Hospital Acquired Conditions and care transitions – and no fewer than 7 – for the hospitals you seek to support.

· Again, collaboration with the National Content Developer is essential, as they will make available the educational resources to support these activities at no cost. Of course, you are welcome to develop additional materials to augment or enhance these resources. The mix of activities and resources should support and foster widespread participation by as many hospitals as possible

· The contractor shall provide a training activity report within 15 days of a scheduled event identifying:

Technical Assistance

· The next task is pretty straightforward, providing technical assistance and direct support to participating hospitals. This can include establishing learning collaboratives, developing data sharing networks, developing mechanisms to support peer to peer training among hospitals, conducting conference calls, and conducting site visits to participating hospitals. It is important to note, however, that keeping hospitals thoroughly engaged and robustly participating throughout the initiative is essential to the Partnership for improvement efforts.

· Another key first step in this scope of work is working with constituent hospitals to develop measures for each improvement project. These should be useful measures that support improvement activity and reflect the capabilities of each hospital. Each improvement project should include at least one process measure and one outcome measure. The success of each contractor will in large part be assessed through these objective measurements of the ten core events and the events chosen to be addressed.

· After the development of measures with the constituent hospitals, the contractor shall establish and implement a system to track and monitor hospital progress towards operational and quality improvement goals, and collect data to track improvements in care in compliance with HIPAA and other federal laws related to privacy and information security. It will also be important to support the hospitals in their measurement activity, including providing them with basic educational materials about the use of statistics and the role of measurement in quality improvement.

· The contractor will be responsible for providing ongoing ad hoc status information at the request of the contracting officer’s technical representative, as well as formal quarterly reports to CMS and Innovation Center staff explaining progress and identifying issues and lessons learned during each quarter of the performance period.

· The specific requirements for these reports are contained in the Scope of Work, and also include the reporting of: noteworthy aggregate improvements and milestones, identification of areas of outstanding improvement, and identification of areas where progress has not been made, as well as successes, failures, pitfalls and areas of improvement in each requirement performed by the HEC. The update shall also provide recommended next steps to the government for the continuation of the work in both the option year of this particular contract and as well as potential future contracts or other activities.

· We can’t state enough the importance of collaboration with other Partnership for Patients contractors and participants. In particular, the contractor will coordinate with other PFP Participants to collect and share data and other elements necessary to successfully implement, operate, and evaluate the PFP, as well as providing copies of the monthly, quarterly, and annual progress reports to the evaluator described earlier.

Evaluation of Proposals

· The proposal will also be evaluated upon its corporate organizational experience and capacity. For example, the applicant, including any subcontractors, will be evaluated on their organizational strength and capacity to successfully carry out all of the goals and tasks of the project with the following considerations:

· The applicant has experience in successfully implementing and operating large scale projects related to health care quality and patient safety in hospitals.

· The applicant has experience in successfully operating conferences, seminars, webinars, and other activities.

· The applicant has a record of successfully completing large, complex projects on health care service issues in a cost efficient manner.

· The applicant has sufficient organization structure; staffing, and other key resources identified to successfully implement the program.

· The organization is capable of guaranteeing buy-in and participation from hospitals and other key participant organizations

· Lastly, the proposals will be evaluated on the relevant experience and knowledge of key personnel. Specific experience and capabilities that must be addressed in the proposal are as follows:

· Demonstrated knowledge of topics related to patient safety, reducing all-cause patient harm, HACs, and CMS hospital quality improvement initiatives.

· Demonstrated knowledge of effective care transitions and methods to reduce avoidable readmissions.

· Demonstrated experience designing, implementing, and operating educational campaigns.

· Demonstrated experience conducting educational workshops and conferences via multiple methods.

· Demonstrated experience engaging healthcare providers and hospitals in collaborative learning networks.

· Demonstrated experience tracking quality improvements.

· Again, the specific details about the scope of work and criteria for evaluation are contained in the full solicitation.We appreciate your interest in participating, and your careful attention to the solicitation.

· At this time I’d like to turn the call back over to Joe McCannon, for additional considerations and the answers to some anticipated frequently asked questions. Joe….

· Thanks, John, for that helpful summary, and, as has been noted, there is even more detail in the posted solicitation. Before we wrap up this segment, I just want to briefly underline what we view as some of the keys to successful applications and anticipate a couple of questions, as well.

· (Hospital Engagement Contract Overview: Other Key Considerations) Description of the characteristics of successful applications and successful execution, emphasizing that we seek:

· Results-oriented proposals – what do you believe will actually lead to changes in behavior? Mere activities aren’t enough.,

· Attempts to collaborate with appropriate local partners to encourage collaboration and avoid duplication of effort – we know that local coordination and alignment will lead to a better experience for hospitals, with more coherence and less duplication;

· Demonstrations of prior experience and established relationships and commitments from local hospitals – we want to know your track record and how you’ve succeeded in the past.

· (Hospital Engagement Contract Overview: Frequently asked questions) Frequently asked questions include (I’d like to anticipate a couple of these and answer them proactively):

· Do we have to address all ten adverse events?

· Again, Hospital Engagement contractors must address up to ten, and no fewer than seven adverse events. This acknowledges that there might be good, local work occurring in some of the adverse event areas already, for which reason we would not ask Hospital Engagement Contractors to repeat it but compliment it instead.

· Can two smaller systems combine to meet these criteria?

· Prime and subcontracting arrangements are encouraged as good business decisions on the part of the vendor community; however, accountability for successful performance rests ultimately with the prime contractor.

Now, we’ll have time for more questions as we go forward but I am going to turn now to Carol Sevel, the lead Contracting Officer on this work. Let me emphasize just how important it is to tune in closely to this part of the presentation, particularly for those of you who are unfamiliar with the federal contracting process, which is not trivial at all and which we’re asking for you to complete on a very aggressive timeframe….so thanks for now and over to you, Carol.

Introduction to Government Contracting and Proposal Submissions (Carol Sevel)

Q/A and Wrap-up (OAGM, Joey Eakle)