Collective Impact in Health

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Collective Impact in Health A conversation with: John Kania, Managing Director, FSG Karen Ordinans, Executive Director, Children's Health Alliance of Wisconsin Christy Reeves, Director, Blue Cross and Blue Shield of Louisiana Foundation Dr. Victoria Rogers, Director, Let's Go! (Maine) December 11, 2013 Boston Geneva San Francisco Seattle Washington

Agenda for Today s Webinar Opening Remarks and Overview of Collective Impact in Health John Kania, FSG Panel Discussion Karen Ordinans, Executive Director, Children's Health Alliance of Wisconsin Christy Reeves, Director, Blue Cross and Blue Shield of Louisiana Foundation Dr. Victoria Rogers, Director, Let's Go! (Maine) Audience Q&A Closing Comments John Kania, FSG Tweet along using the hashtags #collectiveimpact and #health 2 2013 FSG

FSG and Collective Impact Collective Impact Has Gained Momentum in the Social Sector as a Disciplined Approach to Solving Large-Scale Social Problems Field-Wide Interest in Collective Impact FSG articles have paved the way for CI: Original CI article is #1 most downloaded on SSIR, even 1.5 years after publication Subsequent CI articles downloaded thousands of times Webinars: Up to 500 practitioners joining recent webinars on funder role, opportunity youth & emergence Media Coverage: 360+ references (print, blogs, online articles) Conferences: 2012: 300 attendees + 800 live-stream participants from 35 countries Two National backbone workshops in 2013 with a total of 220 participants CI Initiatives: FSG has been engaged to help launch more than 25 CI initiatives around the world Speaking Engagements: Hundreds around the world, including: Social Media: More than 20,000 CI Blog views in 2012 Twitter: Significant usage of CI hashtag 3 2012 FSG

Five Conditions of Collective Impact Five Conditions for Collective Impact Common Agenda Shared Measurement Mutually Reinforcing Activities Continuous Communication Backbone Organization 4 2013 FSG

Collective Impact in Health The Healthcare Landscape is Changing Nationwide, Creating New Opportunities for Collective Impact to Improve Health Shifting Market Conditions for Providers and Payers Shifting Funder Priorities Rewards for Producing Health, not Healthcare Increase in value-based payment models Hospitals will need to work with new groups as they are held accountable for health beyond the hospital Financial Pressures from Shifting Payer Mix Decrease in commercially-insured patients and increase in patients covered by Medicaid, Medicare, and exchanges Providers will need to deliver better care to support decreased reimbursement Changing Role of Community Benefit Decrease in the size of the uninsured population, making charity care a less substantial component Opportunities for non-profit hospitals to demonstrate a new approaches Community Health Preventing Unnecessary Acute Care Strengthening the Safety Net Improving Accountable / Coordinated Care Patient Engagement Source: FSG analysis, interview with leading healthcare foundations and providers 5 2013 FSG

Collective Impact in Health Addressing Social Determinants of Health Upstream Requires Collaboration Between Diverse Actors Collective Impact is a way that communities can organize themselves to improve system-level factors that influence social determinants of health Example Partners Public health departments Governments Doctors and hospitals Payers Non-profit organizations Pharmaceutical or medical device companies Employers Primary and secondary schools Medical professional associations Medical education providers Faith-based organizations Universities and researchers 6 2013 FSG

Collective Impact in Health Collective Impact in Health: Unique Challenges Competition Payers, providers, and others often compete for patients and funding. These are the same groups needed to create a common agenda. Partners can come together to define a problem and set a goal to solve that problem based on mutual benefits. Sharing the Savings Improved health leads to financial savings. Who accrues these saving, and how they are distributed, can be a source of tension among groups needed to align activities to achieve the common agenda. These issues can be addressed up front by inclusion of various players (e.g., payers, providers, government, pharmaceutical companies) in creating a common agenda that speaks to individual interests. Patient Privacy Patient privacy laws (i.e., HIPPA) can prevent partners from sharing data. This data is necessary to track progress, set strategies, and learn. Partners can share de-identified data, potentially via hospital councils or other data sharing entities Source: FSG research and interviews 7 2013 FSG

Panel Discussion Panel Discussion Karen Ordinans, Children's Health Alliance of Wisconsin Christy Reeves, BCBS of Louisiana Foundation Dr. Victoria Rogers, Let's Go! (Maine) 8 2013 FSG

Children s Health Alliance of Wisconsin www.chawisconsin.org www.chawisconsin.org 7/13

Children s Health Alliance of Wisconsin www.chawisconsin.org www.chawisconsin.org 7/13

Building collective impact WI Department of Health Services Local public health departments FQHC and free clinics Professional dental associations Private dental organization-delta Dental School administrators Children s Health Alliance of Wisconsin www.chawisconsin.org www.chawisconsin.org 7/13

Results: Wisconsin Seal-A-Smile 2002 2012 SAS Funding $60,000 $608,000 # of kids screened/sealed 3,919 / 2,918 34,157 / 21,640 # of sealants placed 10,701 79,792 # of schools served 102 613 % of Wisconsin 3 rd graders with untreated decay 31% 18% Children s Health Alliance of Wisconsin www.chawisconsin.org www.chawisconsin.org 7/13

Innovative projects that address the root causes of obesity through integrated changes in policies, norms, practices, social supports, and the physical environment. Projects should have multiple-collaborators, address the specific needs and settings of the community incorporate a variety of obesity prevention efforts across multiple levels Comprehensive evaluation Our Response to Louisiana s Declining Health: Challenge for a Healthier Louisiana A presentation of the Blue Cross and Blue Shield Association. All rights reserved. 13 110311

1.4M 2.4M Results 112 organizations submitted Letters of Intent 49 submitted full applications 2M 12 projects were awarded representing 200 organizations totaling nearly $30M in healthy living initiatives across Louisiana 1M Project Activities: 2M 2.5M 4.8M 4.5M 6.4M policy councils parks/recreational units community gardens farmers markets food trucks educational programs cooking classes A presentation of the Blue Cross and Blue Shield Association. All rights reserved. 14 2013 FSG

Victoria W. Rogers, MD Barbara Bush Children s Hospital at Maine Medical Center (207) 662-4982 www.letsgo.org

What has worked? Strategies for Success 1. Provide healthy choices for snacks and celebrations 2. Provide water and low fat milk, limit sugary drinks 3. Provide Non-food rewards 4. Provide opportunities for physical activity every day 5. Limit screen time www.letsgo.org

What has been challenging? Words and Frameworks Letting go our of own work Accountability and credit Real and perceived barriers from grants www.letsgo.org

Q&A Audience Q&A with Our Panel Karen Ordinans, Children's Health Alliance of Wisconsin Christy Reeves, BCBS of Louisiana Foundation Dr. Victoria Rogers, Let's Go! (Maine) John Kania, FSG Moderator 18 2013 FSG

Collective Impact Forum Goals of the Collective Impact Forum: Create the knowledge, networks and tools that accelerate the adoption and increase the rigor of collective impact Activities Develop a field-wide digital forum to create and disseminate effective knowledge, tools and practices that support collective impact Support communities of practice, convenings and other events across the country that enable practitioners and funders of collective impact to increase their effectiveness The first two communities of practice are for funders of collective impact, and collective impact backbone organizations Partners Co-Catalysts Go here (www.collectiveimpactforum.org) to sign up for updates! 19 2013 FSG

Thank You for Joining Today s Conversation! Please fill in the brief electronic survey that you ll receive after today s event to share your feedback with us. For more information on Collective Impact visit: http://www.fsg.org/ourapproach/collectiveimpact.aspx Sign up for Collective Impact Forum updates: http://collectiveimpactforum.org To access the recording and to download the slides from today s webinar, visit http://www.fsg.org/collectiveimpactinhealth 20 2013 FSG