Partner Spotlight Series: VillageCare Partner Spotlight Series: VillageCare

Partner Spotlight Detail

Partner Spotlight Series: VillageCare

VillageCare leadership works hard to engage and education its staff on DSRIP policies.

For nearly 40 years, VillageCare has been providing services to the frail and chronically ill in New York. VillageCare offers a multitude of services for its patients and clients across three service lines: post-acute services, managed care, and community programs.

Hira Ruskin, VillageCare Health Home Director, prides herself in the expansion of VillageCare's Health Home over the past two years. She said, "We're almost always selected for every single pilot in any lead health home we're in, because we have the ability to stack up quickly and we have the ability to execute.

VillageCare Credits Health Home Expansion to its Engaged Staff

Photo Courtesy of VillageCare

While VillageCare offers a myriad of different programs to its patients, its Health Home program has truly transformed over the last few years. According to Hira, there were 500 patients, 40 employees, and few formal quality initiatives when she started as Director of the Health Home program. In two short years, she and her team were able to completely expand and enhance the program. Currently, there are over 5,000 patients enrolled and 200 employees. The Health Home works hard to close gaps in care for patients by putting a care team in place and using the HEDIS measures, members receive preventative primary care services thereby reducing ER utilization and avoiding hospitalizations. “Seeing the growth of the program, as well as the value that we provide to our members is extremely satisfying and gives us the capacity and competency to step up for DSRIP projects,” said Hira. VillageCare’s Health Home is unique because there is a registered nurse that works directly with the Health Home and oversees the care management department. “We are different than most care management agencies," she said, "other agencies focus on social determinants— which we do as well, but we’ve also educated our staff on the use of diagnosis-based action plans which we implement at the point of enrollment.”

Photo Courtesy of VillageCare

Joseph LoPiccolo, RN and Clinical Director of VillageCare’s Health Home, oversees many of VillageCare’s DSRIP employees. Joseph makes an effort to communicate the DSRIP initiatives to his staff. “When there is something new on the Health Home horizon, particularly DSRIP, we see an opportunity to bring it back to the staff and analyze it from a global perspective and help our employees understand what’s going on in the community and how their jobs impact the overall goals of DSRIP", said Joseph. “The more engaged our staff is, the better they understand how their work impacts the success of DSRIP and the more committed they are to ensuring they meet DSRIP goals.

VillageCare’s Participation with MSPPS Allows for Collaboration with Partners

VillageCare is excited to be part of the Mount Sinai PPS and the opportunity to make an even greater impact on the lives of patients who turn to MSPPS.

Hira said of this collaboration, “We have the experience and ability to staff up quickly, which gives us the confidence to raise our hand to participate in pilot projects and thereby help the PPS to achieve its goals.”

Currently, VillageCare is working closely with MSPPS partner, The Brooklyn Hospital on Project 2.c.i, the Development of Community Based-Health Navigation Services, to identify high-risk patients to enroll in the Health Home. Joseph feels that the main goal is to have a shared web-based platform like Crimson be accessible within practices and CBOs so they will have access to a patient’s medical records and improve the collaboration and communication.

Photo Courtesy of VillageCare

MSPPS events such as Town Halls and project meetings have also been an excellent resource for VillageCare as they are able to interact with other organizations and discuss ideas. Joe said of this collaboration, “DSRIP has improved the approach. Instead of working in parallel, you can connect with someone directly to see how we can work together to ensure positive outcomes.”

While these meetings have given VillageCare and other partners the opportunity to collaborate, Michael Martin, Director of New Business and Project Management, feels these meetings can be improved. “We could be more productive at those meetings by having more people like Joe there - the ones who are doing the day to day work, to talk about barriers, issues, and how to figure out how we can solve them and utilize the providers to the greatest extent possible,” he said.

Besides its Health Home, VillageCare Offers a Myriad of Services for New York VillageCare Rehabilitation & Nursing Center (VCRN) is VillageCare’s post-acute facility that provides therapeutic rehabilitation and nursing care for patients to aid in their recovery from complex medical and orthopedic conditions. VCRN is a bridge to home -- all patients are discharged back to their homes and community. VCRN’s close collaboration with hospitals result in best possible outcomes for patients. “We want to be integral to our partners," said Randi Roy, Chief Strategy Officer at VillageCare. "Working with the Mount Sinai Beth Israel campus, we are currently designing care pathways to ensure that our 105 post-acute beds can serve as a complement or alternative as the Beth Israel facility transitions to 70 beds. The goal of this collaboration is to help us be essential to the health system as it seeks to consolidate beds in New York City.”

VillageCareMAX health plans are for individuals with long-term care needs. Their Managed Long-Term Care (MLTC) Plan is a New York State approved Medicaid Managed Long Term Care plan that coordinates health care services for chronically ill adults who have Medicaid and are nursing home eligible, and wish to remain in their own home and communities for as long as possible. VillageCareMAX also offers a Fully Integrated Duals Advantage (FIDA) plan, as well as a Medicare Advantage plan, which is a dual-eligible Special Needs Plan that covers both Medicare and Medicaid services.

Lastly, there are many services VillageCare offers under its community programs. These programs include an AIDS Adult Day Health Care program; Adult Protective Services; VillageCare at 46th and 10, a Medicaid Assisted Living Facility; and RANGO, a treatment adherence technology for persons with HIV/AIDS.

VillageCare is also involved in Projects 2.b.iv, 2.b.viii, 3.aiii, 3.b.i, 3.c.i, 4.b.ii, and 4.c.ii. To learn more about VillageCare, please visit here.