DHRB Discussion July 25 2013 16 Del C Chapter 93 of the Delaware Code relating to Health Planning and Resources Management 9303 Delaware Health Resources Board 9306 Review Considerations ID: 592550
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CPR Review ConsiderationsDHRB DiscussionJuly 25, 2013
16
Del. C
., Chapter 93 of the Delaware Code relating to Health Planning and Resources Management
§ 9303. Delaware Health Resources Board
§ 9306 Review ConsiderationsSlide2
§ 9306. Review ConsiderationsAKA Criteria upon which CPR is decided
“In conducting reviews under this chapter, the Board shall consider as appropriate at least the following:
(1) The relationship of the proposal to the Health Resources Management Plan adopted pursuant to § 9303 of this title. Prior to adoption of a Health Resources Management Plan by the Board, the State health plan last in use by the Health Resources Management Council shall comprise such plan;”Slide3
Criterion #1: Notes, Variables & Context
DE Health Resources
Mgmt
Plan adopted 10/26/95 & last updated 3/6/10
Note resource documents listed; are different or additional resources available in July 2013?
7 General principles of
Mgmt
Plan:
HRB challenge: balance access, cost & quality of care issues
Complexity of medical
indigency
Support managed, coordinated approach
Proximity to referral centers/out-of-state resources
Financial restraint
Enhancement of meaningful markets: balance quality & cost
Preventive activities – progress toward Healthy DelawareSlide4
Criterion #1: Notes, Variables & Context, continued
Bed need formulas & projections (M/S-acute, OB, NH)
1990-95 Population change calculated
2005 Occupancy rates
2010 projected bed needs
What or how have details or context changed? Beds added/deleted since 2010? Population? Occupancy? Demographics?
Guidelines within each subcategory (M/S, OB, NH)
Medical Technology: New & emerging re: use in DE
Devices
(major medical equipment)
& procedures
(health services)
Balance access, cost, quality of innovative technology
What or how have details or context changed?Slide5
Criterion #1: Notes, Variables & Context, continued
Charity Care Policy & Implementation Requirements
Appendix A. 2009 Federal Poverty Guidelines & 2005-07 DE 3-year average median household income
Appendix B. Charity care write-off for free standing surgery centers
Appendix C. CHAP/VIPII programs for uninsured
What has changed in July 2013? What do we know today that we did not know in 2009? What contextual changes have altered the economic/cost, access & quality climate?Slide6
Criterion #2:
“(2) The need of the population for the proposed project;”
Notes, Variables & Context
Variables that determine need? What do we know? What don’t we know?
Contributing, antecedents/precipitating factors
Detracting, antecedents/resulting outcomes
Confounding
What in healthcare environment is changing?
Context that helps, hinders defining/describing need? Formula? Definitions of 3 types of beds?Slide7
Criterion #3:
“(3) The availability of less costly and/or more effective alternatives to the proposal, including alternatives involving the use of resources located outside the State;”
Notes, Variables & Context
Less costly than what? What is measure or standard against which cost is evaluated? Indirect? Direct? Cost to whom? Cost impact on whom?
More effective that what? What is measure or standard against which effectiveness is evaluated?
Would outside state resource as alternative cost more because of indirect cost to family? Client? Loss to State?Slide8
Criterion #4
“(4) The relationship of the proposal to the existing health care delivery system;”
Notes, Variables & Context
What is the state of the current health care delivery system? Nationally? Within Delaware? Static? Dynamic?
What outcomes or changes are proposed, hypothesized or predicted about the health care delivery system? Slide9
Criterion #5
“(5) The immediate and long-term viability of the proposal in terms of the applicant’s access to financial, management and other necessary resources;”
Notes, Variables & Context
What are the time parameters for immediate? For long-term? What variables & context are important?
How is viability determined? What variables & context are important?Slide10
Criterion #6:
“(6) The anticipated effect of the proposal on the costs of and charges for health care;”
Notes, Variables & Context
Parameters used to determine or compare costs, charges for health care?
Local or national cost variables?
How are costs & charges accounted for, determined, retrieved, and analyzed?Slide11
Criterion #7
“(7) The anticipated effect of the proposal on the quality of health care;”
Notes, Variables & Context
What is “quality”? What measures and standards are used to determine quality? Good quality? Poor quality? Standardized scales? National, regional, state or setting-determined standards?
Nature of the data used to define quality? Qualitative or quantitative? Derivation of data?