Improving Health Care Outcomes for East African Communities

Transcription

1 Improving Health Care Outcomes for East African Communities Community Partnership Models to Improve Access, Satisfaction, and Outcomes 2013 Diversity RX: Achieving Equity in an Era of Innovation and Health System Transformation March 11-14

2 UCare Mission 2 UCare will improve the health of our members through innovative services and partnerships across communities.

3 Member Demographics 3 UCare serves a culturally diverse mix of nearly 300,000 members. State Public Programs 206,000 White 46% African origin 28% Asian origin 14% Hispanic (all origins) 8% Native American 2% Other 3%

4 UCare s Approach to Member Care 4 Programs are flexible. Support services are tailored to individual needs. Board of Directors: 40% consumer representation. Three advisory committees that include members. Focus on cooperation with federal, state, and local governments, and community partners. Innovative risk and service partnerships with care systems and providers.

5 Addressing Health Disparities Affecting East African Population Somali emergency room, primary care education program using community health workers. Pill boxes for Somali elders. Sport shoes to reduce obesity and diabetes. Health risk assessments in multiple languages, including Somali. Culture Care Connection website a UCare/ Stratis Health partnership to advance culturally competent care by informed providers statewide. Health Commons UCare Fund Grant to support health of local East Africans. 5

6 Emergency Room Education WellShare partnership Your Health : Community Health Workers engage members Education about levels of care in the western health care system: Primary care Urgent care Emergency room care 140 home visits in

7 Emergency Room Education ED VISITS PER 1,000 52% decrease Pre-Period Post-Period PARTICIPANTS NON-PARTICIPANTS Based on claims. WellShare participants compared to general membership.

8 Medication Management 8 Hennepin County Medical Center partnership. Started in January 2012; has served 1, 000 elders. Addresses medication adherence and chronic health perception in Somali community. Somali pharmacy technician distributes pill boxes and carrying bag, created just for this initiative. Education about the importance of taking medication consistently.

9 Sport Shoes: Obesity and Diabetes Prevention 9 Program aimed at reducing obesity, diabetes. UCare staff delivered and fit 200 pairs of shoes at Somali and East African Adult Day Care Centers. In our home country, we walked everywhere, to the market, our children s schools, to see our friends - everywhere. Now that we are in this country, we aren t walking. The shoes have helped me get back to walking to the grocery store and take walks with other adults at the center. We walk every day now which makes me feel better.

10 East African Customer, Clinical Services Targeted Approaches 10 Somali: Health risk assessments, provider listening session, health promotion materials Somali customer service representatives 24-hour access to East African interpreters in multiple languages: Djibouti, Ethiopia, Amharic, Kenya, Malawi, Somalia, Tanzania Welcome calls to new members in primary language. Process for bilingual complaints, grievances, and appeals. Language line available to all staff and providers including transportation. Child & teen checkup incentives, MOMS prenatal and post partum checkup incentives.

11 Culture Care Connection Resources for East African Community Culture Care Connection a UCare-funded online resource with demographic and cultural information to help providers deliver culturally competent care. Specific East African resources: Somali Ethiopian Targeted clinic education sessions. 11 UCare Fund awards grants to organizations that strive to improve the health of our community.

12 History of Health Commons 12 Partners: University of Minnesota Medical Center, Fairview, Augsburg College, East Africa Health Funds: UCare NIH-funded community-based research by St. Catherine University Nursing Faculty Community input meetings Located in Cedar Riverside community in Minneapolis, MN

13 Cedar Riverside Community Needs Index (CNI) 13 Cedar Riverside has CNI scores above 4.2 (highest level of need). Thompson Reuters and Catholic Healthcare West developed CNI methodology. Established causation between high score and inappropriate ED admissions for ASCs based on underlying socio-economic indicators of health status. Highest Community Need (5) Lowest Community Need (1)

14 Health Commons Model 14 Basic Supplies Community Connection Education & Literacy Vision: To improve the health of the community through Relationships Hospitality A safe and friendly environment Recreation Wellness Services Information Envisioned outcomes: Increase community connections and recreational activities Increase access to health services and resources Improve the health and sense of well being in the community Provide space for spirituality and mind-body healing

15 Health Commons Site 15

16 Health Commons Programs 16 Medication review Healthy eating/cooking demonstrations Exercise classes Parenting classes Wellness sessions 1:1 consultations with nurse Healing Touch Massage therapy Group education Special topics Massage, Healing Touch, Reiki Parenting Classes Say no to yes

17 Role of Public Health Nurses 17 One-on-one health consultations Screenings Complementary therapies Chair massage Healing touch Reiki Medication review Group education

18 Health Commons Drop-In Center and Class Data Average attendance per month 2011 = 57/month 2012 = 103/month 18 Overall feelings about health? In pain or worried 57% Well 36% Visitor characteristics Elderly and adults 7:2 women to men Reasons for visit Primarily for blood pressure check or health education; also for massage, general questions, healing touch, medical review What was taught/learned? Exercise, healthy eating, selfcare and relaxation What is participant going to do differently? Exercise, eat better, follow up with primary care center, take meds regularly

19 Making a Difference 19 $ $ PMPM DIFFERENCE 43% decrease $ $ $ High member satisfaction and cost effective. $ $ Pre-Period Post-Period $0.00 PARTICIPANTS NON-PARTICIPANTS Based on claims. WellShare participants compared to general membership.

20 Thank you Mama Alwa Health Commons story I came here when I was really, really sick. I was on a few medications, some were for my depression, and sleep medication without it I couldn t go to sleep. I had a body ache all over and I was taking medicine three to four times a day just to have the pain go away. I was really overweight, I had a heart palpitation and I had a lot of muscle aches. The three days that I come here I m surrounded with people. I talk, I laugh, I m not as depressed as I used to be. They also work with my muscles, all over my body I do a lot of muscle exercise so they give me strength. They also changed my diet, what I was on before. Now I m eating a lot healthier food. I really appreciate everything they do for me. I like the Center. 20

21 For More Information 21 Russ Kuzel, M.D, M.M.M. Senior Vice President and Chief Medical Officer UCare 500 Stinson Blvd NE, Minneapolis, MN Sahra Noor, R.N., M.A. Director Of Language Services & Community Health At University Of Minnesota Medical Center, Fairview 2450 Riverside Avenue Minneapolis, MN Katie Clark RN, MA Nursing Instructor And Coordinator Of Augsburg Central Health Commons And Health Commons At Dar Ul-quba Augsburg College CB Riverside Avenue South Minneapolis MN