Improving Hunger & Health Outcomes in Minnesota. For Hunger Free Communities Summit March 1, 2014

Transcription

1 Improving Hunger & Health Outcomes in Minnesota For Hunger Free Communities Summit March 1, 2014

2 Introduction to Hunger-Free Minnesota Statewide, cross-sector campaign working reach a quantified finish line for hunger in Minnesota Business process and datadriven approaches Invested $6M+ into 120+ projects that are designed to add 100 million meals by

3 Hunger-Free Minnesota Statewide Leadership Ken Powell, Chairman & CEO Terry Scully, President, Financial Services Greg Page, Chairman & CEO Pat Donovan, President & CEO Jack Larsen, CEO, Medicare & Retirement Sarah Caruso, President & CEO Jeff Ettinger, Chairman & CEO Rob Zeaske, CEO 3

4 Partnership 3-YEAR ACTION PLAN BIG DATA HUNGER & HEALTH 4

5 ~$1.6B in costs incurred in Minnesota each year due to missing meals Costs to Minnesota Physical & Mental Healthcare Costs ~ $1.4 billion Educational Program Costs ~ $0.24 billion Opportunity Costs: Foregone Wages & Economic Productivity Total Cost of Hunger = $1.62 billion Source: Hunger-Free Minnesota "Cost/Benefit Hunger Impact Study" (2010), University of Minnesota analysis 5

6 Child: Health Impacts of Food Insecurity Poor health status & chronic diseases more prevalent in foodinsecure (<200% FPL) populations Relative prevalence in US children < Food Insecure Food Secure 2.2X 14-20% 1.3X 9% 8-9% 7% 0.9X 32-38% 42% Poorer health & higher rates of hospitalization in foodinsecure children 0 Fair/Poor health Hospitali zation in past year 3 Well-Child Status 6

7 Adult: Health Impacts of Food Insecurity Poor health status & chronic diseases more prevalent in foodinsecure (<200% FPL) populations Relative prevalence in US adults <100% FPL 1.4X 15% 13% 11% Cardiovascul ar Disease % FPL 4% 2X 4% Stroke 2% >200% FPL 1.7X 12% 11% 7% Diabetes CVD, stroke & diabetes more prevalent among food-insecure adults 7

8 Hypothesis Health systems bring four distinct advantages due to the high intersection between health needs and food insecurity A Improved Coverage Leveraging health system ubiquity to bridge "coverage gaps" B Greater Effectivenes s Addressing barriers to participation (e.g., awareness, stigma, transportation, registration, etc.) given their unique position as trusted advisor C Higher Efficiency Using large scale, professional staff, access to volunteers and existing infrastructure and capabilities D Better Health Outcomes Reinforcing the positive connection between improved nutrition and outcomes, especially for chronic diseases 8

9 Missing Meals Gap Number of Meals Needed After Assistance Supply: Calculated supply of emergency food and government programs Demand: Calculated the number of meals needed annually by food insecure people Net: Calculated net missing meals gap for each Neighborhood neighborhood (St. Paul) Supply : Food shelves Meal programs SNAP NSLP/SBP WIC CACFP SFSP Demand : Meals needed annually by food insecure people Main Street Housing Partnership The Family Place Health Care for the Homeless Dorothy Day Center Emergency Food Shelf Safe Zone Face to Face Health Downtown St. Paul (Census tract # ) Net missing meals gap 9

10 Two Problems Drive the Missing Meals Gap Coverage and Participation 100 Million Missing Meals Low Food Shelf Coverage Medium/High Food Shelf Coverage High missing meals Low missing meals Coverage gap areas Participation gap Other 42M meal gap 42M meal gap 21M meal gap Areas with low existing coverage by food shelves Areas with high food shelf coverage but low participation Note: Coverage gap areas defined as census tracts with low or no coverage by EFS agencies; Participation gap areas defined as census tracts with medium to high EFS agency coverage that still show high missing meals (top 2 quintiles of missing meals); Other defined as census tracts that have high to medium coverage and lower missing meals (Bottom 3 quintiles of missing meals) Source: Hunger-Free Minnesota Community Close-Up Data with analysis from partner Boston Consulting Group (2012) 10

11 Improved Coverage Health systems cover ~80% of Minnesota food-insecure population living in low coverage areas Hospitals within coverage gap areas % of F-I covered by a health system FQHC Hospital Coverage Gap % of F-I population % 42% 30% # Hospitals & FQHCs covering to 5 >5 0 7% Low Coverage areas 2 1. No Coverage is not mutually exclusive from Coverage & Combo, e.g. No Coverage is included in Coverage & Combo. 2. Total = Coverage + Combo. 3. FQHC means Federally Qualified Health Center Note: Health system coverage defined based on a radius of service for a health system that is consistent with the radius of service for an EFS agency. A radius is assigned for each geographic segment.radius of service defined as 13 miles for rural segment, 11 miles for non-metro urban, 9 miles for metro suburban,4 miles for metro urban; No Coverage is defined as census tracts with 0 agencies and a missing meal gap in Quintiles 1-5; Coverage Gap is defined as census tracts with No Coverage or Low Coverage by EFS agencies (Quintiles 1 & 2) and a low missing meals gap (Quintiles 1-3); Combination Gap is defined as census tracts with No or Low Coverage & a high missing meals gap (Quintiles 4&5). 11 Source: HFMN Building Blocks Data_2010

12 Outcomes Health systems could decrease hospitalizations & increase the health status of food-insecure children... Each year... 56K food-insecure children in MN < 6 years old 1.2k low birth weight infants are born By increasing food security 30-50% fewer low birth weight infants 32-38% have wellchild status you could achieve % increase in well-child status 1 4-5k foodinsecure kids are hospitalized 9% fewer child hospitalizations Resulting in fewer low birth weight infants each year $20-37M in direct cost savings each year add'l children with well-child status each year $17-56M in lifetime net benefit each year fewer child hospitalizations each year $ M in direct cost savings each 12

13 Outcomes Broad health system partnerships in MN could decrease the 100M meal gap by 30-45M meals 20-29M meal impact Missing meals (M) due to patient enrollment into government programs Meal gap EFS M meals by mix of food shelf referrals and onsite food distribution within health systems SNAP 2-3 WIC 2 Other Gov t Remaining Gap 30-45M

14 What s In It for Healthcare Providers? 14

15 Beyond being "the right thing to do," there are benefits to health systems in addressing patients' hunger relief needs Healthcare trends Population health - beyond the acute care episode New regulations and reporting requirements Consumer-driven healthcare Bundled payment and clinical quality Benefits from tackling food security Food insecure populations are a logical starting point for testing population health and medical home approaches Addressing food security is a high ROI community benefit--a clear need with well developed solutions and a measurable impact Increase patient satisfaction by demonstrating a focus on "treating the individual, not just the disease" Improve avoidable readmissions and ER overutilization by addressing food security in high risk patients 15

16 Interventions 16

17 Multiple models are required given variable agency coverage & differing population needs in Minnesota Hunger relief system Services Client needs assessments + referrals Government program enrollment Distribution Food shelves Gov't programs (SNAP, WIC, etc) Prepared meals + Health system infrastructure Community hospital (including critical access hospitals) Primary care clinic Home Health agency Retail pharmacy / clinic 17

18 Distribution options Services Interventions 1: Serviceonly 2: Svc+ distr. Screening / identification Identify food insecure in a clinical setting Required Required Referral Registration / enrollment Refer to food shelves and to enrollment locations Assist enrollment in gov't programs e.g, SNAP Required Required Set of services may vary depending on partner Nutritional counseling "Starter kit" Variable packaging Provide nutritional and dietary counseling Uniform, prepackaged kits Same few items for every bag. Pre-packaged kit; Variable foods based on season Select best distributi on model for the partner Self-select Grocery store-like Clients select food Focused on participation gap areas Focused on Coverage gap areas 18

19 Current Distribution Investment Therapeutic Food Pharmacy to do 1.1MM lbs. in 2014 In 2013, provided over 850k lbs of food, serving ~6.2k people & 2k households/month 41% YOY distribution growth over 2012 Food distributed by 22 clinics within HCMC network Primarily funded through philanthropy and contribution from Medicine / Senior clinic Source: Boston Consulting Group Interviews with Dr. Diana Cutts, Joni Geppert (HCMC) and Dr. Deborah Frank, Hirallal Latchman(Boston Medical Center) 19

20 Current Service Investments NorthPoint Health & Wellness Mobile program with health worker/dietician Open Door Health Center Public benefits screening Fairview Health Clinics Care coordinator screening, prescription pad for SNAP outreach specialists Hunger Solutions Minnesota - Developing SNAP education and web materials intended for Minnesota health care professionals 20

21 THANK YOU