Rural Health Initiative

Transcription

1 Rural Health Initiative 1

2 Our Vision For Rural Health To facilitate best in class health care in rural areas and reduce rural health care in Idaho as a disparity. To facilitate equity in health in rural areas by the reduction of health care disparities in Idaho. To become a major influencer to transformational changes in rural health delivery in Idaho. To become a major player and well known leader in rural health initiatives in Idaho

3 Health Equity and Disparity Health equity means that everyone has a fair and just opportunity to be healthier. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care. Healthcare disparities refer to differences in access to or availability of facilities and services. Health status disparities refer to the variation in rates of disease occurrence, treatment outcomes and disabilities between socioeconomic and/or geographically defined population groups Working Definition

4 IDAHO HEALTH DISPARITIES

5 Prenatal/Pregnancy Care

6 Percent With Heart Disease Idaho rates of reporting heart disease has been lower but percent in 2016 is equal to national rate. No significant difference in rates by region. 6

7 Heart Disease Deaths Idaho has a lower rate of cardiac related deaths. Disparity in heart disease is noted in regions 1, 3 and 7. 7

8 Adults Who Do Not Have a Usual Provider Higher percentage of Idahoans who do not have a usual healthcare provider. No significant difference across the districts. 8

9 Blue Cross of Idaho Foundation Core Tenets CONVENE AND FOCUS CATALYTIC ENGAGEMENT

10 Blue Cross of Idaho Foundation Functional Tenets The Foundation brings various capabilities as investments into initiatives, tailoring them to the specific needs: Advisory provide access and engagement of subject matter experts, and other skill sets. Connecting facilitate connections of relevant organizations and influencers in specific areas. Convening/Facilitation bring together different factions for brain storming, informative forums or teams to work through complex and wicked problems. Monetary Support issuing solo grants or through a collaborative partnership with other funders for sustainable initiatives. Active Engagement/Leadership assume full direct or indirect accountability of project leadership for an initiative.

11 Initial Discoveries Through preliminary discovery, many themes surfaced as issues unique to rural health care in Idaho: Insufficient provider coverage/workforce. Limited and/or unaligned community resources. Attritions of physicians from rural areas is high (e.g. lost 40% of Idaho trained physicians from rural settings). Need to maintain a high patient office visit level in a transportation challenged area to sustain practice. Different practice style and expectations from the community. Practice isolation/high risk for out of date practice. Effects of value based contracting will challenge the existence of local critical access hospitals, rural providers and other related community resources. Need to increase graduate medical training sites and continue to build ancillary workforce. Need a new model of medical services delivery that is low cost and in alignment with the culture of rural communities. Social determinants of health are major factors that impact the effectiveness of medical services in rural communities.

12 Rural Health Initiative: Early Directional Focus Pillars Personalized Community Health Care Practice/Financial Redesign Access to Quality Care Workforce Subcategory Personalized Rural Community Health Profile Address Social Determinates Facilitation of Community Engagement / Ownership Practice Change Alternative Reimbursement Innovative Practice Tools Infusion of Progressive and Evidenced Base DX and Trt Access to Best SMEs Rural Provider Shortage Residency Training Gaps Maintenance 1 st Draft Deliverable(s) Identify rural community profile parameters. Collect and analyze data on rural health delivery systems and outcomes. Create personalized rural community profiles. Field test the CHM Hub as a tool for compiling and displaying Idaho specific SDOHs Facilitate the identification of practice and financial models suited for rural health care delivery system, (starting with CAH crisis and redesign care delivery using free medical clinical s operational models as a base. Create access t to innovative practice tools as needed Facilitate access to clinical practice improvements and SME subspecialist. Identify early pilot opportunities that have potential for impact and provide proof of concept. Identify specific rural areas with critical provider shortages, ( beyond physicians nurse practitioners, nurses, PA, Emergency Medical Technicians, Community Health Workers)

13 Initial Projects Personalize Rural Community Profile Create a digital and non digital profile made from multiple data sources to identify disparities factors that can or have effected health Profile Indices (examples) Provider shortage by county examining age factor Social Determinants of Health Environmental factors Voice of the providers and community Digital Component Community Health Management (CHM) Hub project Piloting a geo-mapping tool Collect and install additional community based data on a zip code or county level into tool Offer access to key community stakeholders Non-Digital Component Compilation of Idaho specific stats, factoids and perceptions by community stakeholders and providers Goal to create profiles that differentiate and distinguish communities for initiative planning Open source to the community

14 Initial Projects Practice/Financial Redesign Support sustainability strategy and plan Areas of focus Behavioral Health Crisis Center Rural model design Innovative Tools and approaches to enhance health care in rural areas Telemedicine exploratory telemedicine initiative to support implementation(s) and uniformity Enhancing community self-care capability - exploratory Access to Quality Care Support the advancement of Project ECHO as a major tool for enhancing the capabilities of rural providers Advisory Panel Sustainability Plan Product design Integration into P4P/VBC Establish linkages to Subject Matter Expert consultation - exploratory

15 Planned Events Convening Events Idaho Health Summit Plenary on Rural Health Rural Health Forum TBD for 2019 Community Tour Voice of the Providers and Community Goals Tour several rural communities Collect data via interviews and focus groups Conduct surveys where possible Create video storybook Building Partnerships Idaho Rural Health Association Rural Health Institute ISU Idaho Rural Partnership McClure Center U of I Bureau of Rural Health and Primary Care Idaho Policy Institute - BSU

16 Project Timeline Jan 1, 2018 Foundation allocation of funds for Rural Health Initiative Identified initial focus areas Start rural community profile project Idaho Health Summit Hosted Rural Health Session Identify indices and draft model Start community based listening tours Launch Advisory Panel(s) Jan. Feb. Mar. April May Jun. Jul. Aug. Sept. Initial listening sessions with stakeholders Start exploration for practice reform and access to quality CHM Hub demos and Hub Master recruitments Completion on Phase one community profiles Launch initial grant RFPs Rural Health Forum Oct.. Nov. Dec. Jan Feb. 2019

17 Appendix

18 RURAL HEALTH STRATEGY ROAD MAP

19 Strategy Road Map for Rural Health Phase 1 - Catalytic Engagement Using data and research as key tools to understand and identify issues. Use information to help prioritize key rural health initiatives for action. Communicate and convene in a meaningful way the findings to help level set the issues in the community, facilitate stakeholder engagement and/or mobilize action. KEY OUTCOME: CREATION AND DISSEMINATION OF EVIDENCED-BASED INFORMATION Phase 2 - Building Meaningful Collaborations and Relationships Establish key collaborations, relationships, partner(s), and consultants to help advise, engage and support development of initiatives. Identify needed capabilities and resources needed to move forward. KEY OUTCOME: ESTABLISH KEY RELATIONSHIPS & COLLABORATIONS

20 Strategic Road Map for Rural Health Phase 3 Prioritizing and Focusing Resources Rank order initiatives based on the potential of achieving an impact and being transformational and sustainable. Comprehensive assessment of resource needs to achieve outcome. Clear grant specifications that encourage the inclusion of success factors in submissions. KEY OUTCOME: FOCUSED FUNDING & RESOURCE ALLOCATIONS TO FACILIATE SUCCESSFUL START UP AND LONGER TERM INITIATIVES Phase 4 Implementing Change that is Transformational and Sustainable Build sustainable models/protocols and infrastructure that assure transformation and sustainability to rural Idaho. Facilitate the infusion of innovative approaches to bring transformation and sustainability. KEY OUTCOME: EVIDENCE-BASED MODEL(S)/ PROTOCOLS AND NOVAL APPROACHES

21 COMMUNITY HEALTH MANAGEMENT HUB PROJECT

22 Community Health Management Hub When it comes to health outcomes and utilization patterns, the zip code is more impactful than the genetic code. BCBS Idaho and the Community Health Management Hub Community Health Management Hub (CHM Hub ) is a proprietary software application. Value is its ability to integrate diverse information to display healthcare related factors on a community level. Provides geo-spacial visualization of certain health conditions (Asthma, Coronary Artery Disease, Diabetes, Hyperlipidemia, Hypertension and Obesity). local resources a comparison between communities on a zip code, county and state-wide basis. CHM Hub offers general information on a community level that gives a finger print view of resources as identified from several different sources. Compiles many views and rankings of geo, social and clinical determinants to support the identification of issues and hypotheses for deeper research. Previously siloed clinical, social, environmental and behavioral data across 45,000+ zip codes in the USA in order to produce a visual that aids in the planning and deployment of health resources. The CHM Hub has a growing list of over 68,000 community resources that fill short term health gaps. As a customizable enabling platform, the CHM Hub enables targeting strategic deployment of solutions and resources to address local, social and access barriers correlated with key health outcomes and utilization patterns.

23 Community Health Management Hub When it comes to health outcomes and utilization patterns, the zip code is more impactful than the genetic code. Data resources

24 Community Health Management Hub When it comes to health outcomes and utilization patterns, the zip code is more impactful than the genetic code. Data resources