Brightpoint Health's CEO and President, Paul Vitale and Chief Clinical Officer, Dr. Barbara Zeller, share Brightpoint's journey, strategies and best practices to reduce health disparities in New York City's high-need neighborhoods.

1. Reducing Health Disparities:
The Journey of Brightpoint Health
Barbara Zeller, MD., Chief Clinical Officer
Paul D. Vitale, President, Chief Executive Officer

2. The World We Faced
Epidemic #2
Heroin
Epidemic #3
Mass
Incarceration
Epidemic #1
Crack/Cocaine
Reducing Health Disparities: The Journey of Brightpoint Health
Epidemic #4
HIV/AIDS

3. Our historic experience with HIV
care informed our development
of an integrated care model.
• The Bronx, New York City 1990
• Face of HIV/AIDS had changed in
New York City
• Brightpoint began with residential care
Our History
Reducing Health Disparities: The Journey of Brightpoint Health

4. Reducing Health Disparities: The Journey of Brightpoint Health
Our Integrated Care Model:
A Provider’s Nirvana
All aspects of
physical,
behavioral and
social care
coordinated and
customized to each
patients needs.
Shelter
Resident
Food
4. Art Therapy
3. Health Education
1. Substance use Treatment
• Individual Counseling
• Group Sessions
• Structured Daily Schedule
• Housing Structure
• Assignments
2. Social Services
• Case Management
• Legal Liaison
• Family Program
4. Therapeutic Recreation
3. Acupuncture
1. Medical Care
2. Nursing Care 24/7
PT/OT
Resident Council

5. Industry Forecasts
Demand New Strategy
• Reduced payments for in-patient care
• Reduced HIV population
• Smaller margins mandate scale
• Growth in managed care
• Medicaid transformation
Reducing Health Disparities: The Journey of Brightpoint Health
Challenges Faced In 2009
Underserved, HIV-Negative Population
Needs Integrated Care Model
• Multiple co-morbidities
• Social exclusion, poverty and reduced
opportunities
• Limited use of preventative measures
• Limited access to community based
health care

6. Board
Challenge: Change is difficult for all stakeholders
Staff Patients
Reducing Health Disparities: The Journey of Brightpoint Health

7. • Strategic planning
• State reform program
• Managed care and value based payments
• Health home care management programs
• Growth through strategic acquisitions and affiliations
• Hospital system partnerships
• Fiscal management
• FQHC Status
• Grants
• Making very tough decisions
Complex Challenges Require Multiple Solutions
Reducing Health Disparities: The Journey of Brightpoint Health

8. Building Brightpoint Health
• BUILD
INFRASTRUCTURE
TO SUSTAIN
GROWTH
• PROMOTE
GROWTH
• EXPAND SERVICES &
IMPROVE QUALITY
• EMPHASIZE
CULTURE - Core Values
- Culture Handbook
- System for Organization-Wide Culture
Development
- Regular Retreats
- System for leader Empowerment
- Board Manual
- Expand to Primary Care, Dental, and
Health Home Care MGMT
- Quality DEPT
- Clinical Informatics DEPT
- Electronic Health Record
- Mobile Clinics
- FQHC Designation
- 8-22 License
- Quality & Compliance Departments
- HR DEPT
- Advanced IT Infrastructure
- Finance DEPT Maintains 30 day
Reserve
- BP Search Social Venture Agency
- Business Development Program
- Strategic Affiliations with Hospitals,
FQHCS, BH Providers, and Community-
Based Organizations
- Managed Care DEPT
- External Affairs DEPT (Marketing,
Development, and GOVT Affair
- Rebranding
CONSISTENT STRATEGIC PLANNING IS AT THE FOUNDATION OF OUR EFFORTReducing Health Disparities: The Journey of Brightpoint Health

9. Solution:
Effective Strategic Planning
• Brightpoint concluded first
strategic plan cycle in 2013
• 2014-17 Strategic plan based
on five pillars
Reducing Health Disparities: The Journey of Brightpoint Health

10. Reform was desperately needed in New York State. In 2010:
• Medicaid costs per recipient were double the national average
• Ranked 50th in country for avoidable hospital use
• Ranked 21st for overall Health System Quality
Governor Cuomo created the Medicaid Redesign Team (MRT).
• 27 stakeholders representing every sector of health care
• Developed a series of recommendations to lower immediate spending
and institute reforms
• Closely tied to New York’s implementation of the ACA
Multi-year action plan–still being implemented
Solution: New York State Initiated
Revolutionary Changes in Health Care in 2011
Reducing Health Disparities: The Journey of Brightpoint Health

11. Solution: Managed Care and Value-Based Payment
is the Future of Medicaid and HIV Organizations
Fee For Service pays
for inputs rather than
outcome; an avoidable
readmission is
rewarded more than a
successful transition to
integrated care
Transformation of the
delivery system can
only become and
remain successful
when the payment
system is transformed
as well
Many of NYS system’s
problems are rooted in
payment models.
Current payment
systems do not
adequately incentivize
prevention, coordination
or integration
Reducing Health Disparities: The Journey of Brightpoint Health

12. We currently operate a Health Home
office in each borough.
• Care Manager develops comprehensive health plan for
patients with multiple chronic conditions and health needs
• Health records distributed, post consent, and diverse array of
services are coordinated
• Social barriers to care are addressed
• Partnerships reduce likelihood of high-cost in-patient care
Reducing Health Disparities: The Journey of Brightpoint Health
Health Home

13. Reducing Health Disparities: The Journey of Brightpoint Health
Expanded Reach: 24 Sites

14. • Brightpoint Merger with Community
Health Action of Staten Island (CHASI)
• Brightpoint gets: New services and service area
• CHASI gets: Financial and infrastructure support,
and scale from a larger organization
• How it happened and why it worked
• Merger was based on shared vision, culture,
strategy and commitment to quality.
• CHASI leadership integrated with Brightpoint. CEO
key addition to our team
Solution:
Growth Through Affiliations and Mergers
Reducing Health Disparities: The Journey of Brightpoint Health

15. • Brightpoint Health affiliated with a
hospital partner
• Took over the operations of the
hospital’s outpatient clinic
• Continues the hospital's residency
programs
• Expands scope of services
• Introduces an integrated care
model
Reducing Health Disparities: The Journey of Brightpoint Health
Hospital System Partnerships

16. Better Care
• Over 85% of our primary care patients are
satisfied with their care, provider access and
engagement. Almost all would recommend
Brightpoint Health to a friend.
These Solutions Allow Us to Meet Our Overriding Objective:
The Triple Aim
Lower Costs
Lower Costs
• Identify high risk/high cost patients.
• Provide more intensive care
management and intervention toward
reducing costly Emergency
Department visits and inpatient care.
Better Health
• Our clinical results meet or
exceed national and state
benchmarks despite patients
representing a less stable
population than Medicaid
recipients overall.
Reducing Health Disparities: The Journey of Brightpoint Health

17. Our
nursing
home was
our legacy.
Not our
future.
Our nursing home was
our legacy.
Not our future.
Solution: Making Tough Decisions
In 2015, we made
the very tough decision
to sell our nursing
home license to a
proprietary group
Heartbreaking but necessary for
our long term success and
ability to serve more
patients, including those
living with HIV.
New care models
and Value Based
Payments discouraged
inpatient Care.
Patients were getting the same
services and the
same quality care on
an outpatient basis.
Reducing Health Disparities: The Journey of Brightpoint Health

18. Reducing Health Disparities: The Journey of Brightpoint Health
Organizational Chart

19. Since 2012, Brightpoint Health has gone
Result: Internal Growth and Adjusting to Change
From four
locations to
sixteen
From 300
employees to
almost 800
From 90,000
health care
visits to over
130,000
Reducing Health Disparities: The Journey of Brightpoint Health

20. We maintain our ten Core Values:
Result: Internal Growth and Adjusting to Change
Reducing Health Disparities: The Journey of Brightpoint Health

21. How?
• Invested in quality
• Invested in culture
• Continuity in executive leadership
• Brand ownership
Result: Internal Growth and Adjusting to Change
Reducing Health Disparities: The Journey of Brightpoint Health

22. Reducing Health Disparities: The Journey of Brightpoint Health
WOW! Quality Service