Clinical Advisory Panel Public Notices

The role of the Clinical Advisory Panel is to ensure broad community provider advocacy and engagement while encouraging providers to build networks of care that enhance patient outcomes consistent with the goals of the Triple Aim; better health, better care and lower cost.


CAP Charter
Date Chartered
Authorizing Charter: August 1, 2012
Timeline
This is a standing/ongoing panel. The Charter will be reviewed annually in January by the CAP members. Any amendments will be brought first to the Trillium Community Health Plan Executive Team (ET) for approval with final approval by the CCO Governing Board.
Meeting Frequency
The CAP meets face-to-face no less than once per month. Additional meetings will be held as needed and attendance can be virtual. Standing sub-committees will meet as directed.
Sponsor
Trillium Governing Board
Purpose
Engage providers in the region to build networks of care that enhance patient outcomes consistent with the goals of the Triple Aim – improve patient outcomes, improve patient satisfaction and reduce cost. Coordinate with community leadership to define and advocate for:
  • The goals and objectives for clinical delivery of services
  • The optimal delivery of care
  • Identification of opportunities to direct funding to innovative cost saving programs
  • Identification of opportunities to reduce overutilization of costly services
  • Integrated community health systems
  • Patient-centered standards, guidelines and protocols for delivery of care
  • Quality performance measures/metrics
  • Optimization of care processes
  • Evidence based practices
  • Provider development and support programs
  • Provide input to the CCO board regarding clinical credentialing and privileging criteria
  • Payment mechanisms which support the CCO care model
Oversight
Ensure broad community provider advocacy and engagement within the following domains:
  • Quality
  • In concert with community clinical leadership, design and implement sustainable care models and new service lines
  • Active engagement and leadership in the larger healthcare community regarding the development of healthcare reform
  • Improve clinical outcomes
  • Environment of care, including service excellence and patient experience
  • Transitions of care within and across the network
  • Regional networks of care
  • Electronic Medical Record/Health Information Exchange
  • Provider satisfaction/wellness
  • Shall make recommendations to the Executive Committee and the CCO Board regarding:
  • • The implementation of clinical guidelines;
    • Mechanisms to assess outcomes and
      the cost-effective utilization of services;
    • Educational services for CCO providers.
Scope
All contracted provider practices in Lane County
Operating Principles
All members adhere to established CCO participant agreements/ground rules. CAP meetings are closed to the public, guests may attend at the discretion of the chair.

The CAP will clarify its decision-making model.
Fifty-one (51)% of CAP members constitutes a quorum. A majority of members present after a quorum has been established will be adequate to make all decisions. All CAP members are voting members.

The Clinical Advisory Panel is staffed with appropriate management and analytic services representation.

At the discretion of the Chair, representatives of any CCO participant may attend CAP meetings as observers.

The CAP will charter sub-committees—as well as convene ad hoc "project teams"—as needed.

When conflicts arise, the members will discuss and resolve the conflict with the CAP Chair. If unable to resolve, the CCO CEO will resolve the difference in the best interests of the Trillium Community Health Plan.
Chair and Vice Chair
The CAP will review a slate of nominees for Chair, from which it will select a Chairperson and Vice Chairperson.

Both the CAP Chair and the CAP Vice Chair will hold their positions for a 2-year term. They may be nominated for reappointment for one additional term.

The CAP Chair will represent the CAP in all matters. The CAP Chair is accountable for:
  • Convening and leading meetings
  • Developing, prioritizing and approving meeting agendas
  • Ensuring engagement of CAP members
  • Facilitating conflicts among CAP members
  • Providing leadership to CAP members
  • Ensuring regular communication to CAP members regarding decisions made by other groups that impact this CAP
  • Providing semi-annual reports and recommendations to the Governing Board on behalf of the CAP
  • Oversight and appointment of CAP sub-committees and the CAP member who chairs them.
The CAP Vice Chair is accountable for:
  • Partnering with the CAP Chair to achieve the duties listed above.
  • Covering the duties of the Chair in his/her absence
The CAP Vice Chair will be considered by the CC membership as a potential nominee for the CAP Chair role.
Member Accountability
Each council member is responsible for fully and actively participating on the team in order to achieve the goals of the team as described in this Charter—accepting his/her responsibilities diligently and carrying his/her share of the team's work.
  • The members should advocate for innovation in the community and among their peers
  • The members should act as a liaison for the community and _for their individual groups
  • The members should look for avenues to transform care
  • The members should have commitment to the community and the CCO
  • Members will be expected to be active contributors to the accomplishment of the CAP's agenda, both during meetings and in their practice/organizational settings.
  • Each CAP member's performance will be evaluated annually. Continued participation on the CAP will be contingent on the extent and value of their contributions to the work of the CAP. Members can be voted off of the CAP committee by a simple majority at any time.
CAP Membership
  • The Trillium CCO Compliance Officer will be an ad hoc member who receives the minutes.
  • Total membership shall not be more than 17 members
  • A representative and proportional number of providers from Cottage Grove, Eugene and Florence to include a minimum of:
    • 3 Primary Care Providers
  • • 3 Surgical Specialty Providers
    • 2 Medical Specialty Provider
    • 3 Behavioral Health Provider
    • 1 Hospitalist
    • 1 Allied Health/Expanded Care Provider
    • 1 Public Health Officer
    • 1 Community Service Organizations
    • 1 Practicing Dentist
    • 1 Post Acute or LTC member
  • Support Staff Non-voting Members: CCO Medical Director, Behavioral Health Director, Analytic/Finance, Senior Services, and necessary Administrative Support. The explicit responsibility of the support staff is to assist the committee with an understanding of the regulatory rules that pertain to their area of expertise.
Individual CAP members may be considered as representing more than one required constituency. CAP Provider members should be credentialed and provide services to CCO members.
Selection Process
Any CCO provider is entitled to submit their name for consideration as a CAP member. Organizations participating in the CCO are also eligible to submit nominations for CAP membership.

The LIPA Board will review and select nominees to fill vacancies in accordance with the CAP membership requirements. The Lipa Board will then forward the selected - nominees - to the CCO Governing Board for consideration.
Terms
Panel members serve a term of 3 years and will not serve more than 2 consecutive terms. Initial terms will be staggered to provide for both regular turnover and continuity in committee membership.

The CAP Chair is responsible for ensuring CAP member vacancies are announced in April.

The nominating process takes place in May.

The selection process is concluded in June to ensure new members effective July 1.
Monitoring Effectiveness
The CAP Chair will present an annual summary of the Clinical Advisory Panel's outcomes and accomplishments and plans/future goals to the CCO Board.