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1 w w w. w i s e h e a l t h s y s t e m. c o m / c h i

2 Our Secret Projects TEAM Started in

3 Project Description Baseline Reported DY5 Reported Telemedicine Renal Disease 30-day Readmission Rate 17.91% 11.76% 3 Year Telemedicine COPD 30-day Readmission Rate 7.89% 4.35% What we accomplished: Extraordinary Results Lowered Preventable Admissions Lowered Preventable Readmissions Lower Diabetic HbA1c Improved Reported Behavioral Health Increased Patient Satisfaction Pediatrics Pediatric ED Visits per 100,000 19,891 21,775 BH IOP Behavioral Health/ Substance Abuse Admission Rate per 100,000 10,523 9,158 BH IOP RAND Short Form 36[1] (SF-36) Health Survey Diabetes Hypertension (HTN) Admission Rate per 100k Diabetes COPD Admission Rate per 100k Child Obesity Child Obesity Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents Reduce Pediatric ED visits for Ambulatory Care Sensitive Conditions 3.25% 36.63% 11.35% 8.44% Care Transitions Risk Adjusted All-Cause Readmissions Care Transitions Congestive Heart Failure (CHF) Admission Rate per 100k 3,345 2,273 CHC Flu and Pneumonia Admission Rate per 100k 4,018 2,954 CHC Reduce ED visits for Ambulatory Care Sensitive Conditions 22.90% 22.00% PCMH Diabetes Care: HbA1c poor control (>9.0%) 49.70% 38.46% PCMH Patient Satisfaction Survey CG-CAHPS 92%-DY %

4 Blue Zones Characteristics Move Naturally Know Your Purpose Down Shift Right Tribe Belong Family First 80% Rule Plant Slant Wine At 5

5

6 Survey was made available between June 13 th and August 15 th, 2017 The Community Health Needs Assessment 291 responses collected from 76 Question survey Gathered social and demographic data from multiple sources Included face-to-face Stakeholder Interviews with 21 individuals % This page needs some sort of statistic or graphic.

7 Survey Responses What is the biggest barrier to receiving health care in in our community (check one): 45.00% 40.00% 35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% Doctor's Office Hours Transportation Knowing Where To Go In A Healthcare Facility Cost or Expense Health Knowledge Insurance Issues Stigma Culture and Language Medicaid Rules % 2.29% 5.34% 38.93% 11.83% 12.98% 10.31% 0.00% 0.76% % 2.76% 5.86% 34.14% 13.79% 13.45% 5.52% 0.34% 1.72%

8 Improved Unemployment Rates 8.0% 7.0% 6.0% 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% Wise County 5.1% 3.0% 4.5% 4.3% 4.1% Texas 6.3% 5.0% 4.4% 4.6% 4.8% United States 6.7% 5.6% 5.0% 4.7% 4.3% Wise County Texas United States Source: U.S. Bureau of Labor Statistics

9 Improved Health Insurance Status County Under 65 Uninsured Wise County Texas (1000s) Health Insurance Status by Age Percent Uninsured Under 65 Insured Percent Insured 9, % 43, % 4, % 19, % Wise County % 39, % Source: DHG Healthcare, 2017 The Claritas Company, 2017 Truven Health Analytics LLC

10 Slight Increase in Poverty 20.0% 18.0% 16.0% 14.0% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% All Persons Wise 10.0% 12.1% 12.0% Texas 17.2% 15.9% 15.6% United States 15.5% 14.7% 14.0% Under Age % 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Wise 15.3% 17.4% 18.1% Texas 24.5% 22.9% 22.4% United States 21.7% 20.7% 19.5% Median Household Income $62,000 $60,000 $58,000 $56,000 $54,000 $52,000 $50,000 $48, Wise $59,904 $58,367 $57,609 Texas $53,067 $55,668 $56,583 United States $53,657 $55,775 $57,617 Source: U.S. Census Bureau, Small Areas Estimates Branch

11 County Health Ranking Changes 2014 Ranking 2017 Ranking Ranking Change Healthy Behaviors Clinical Care Quality of Life Socioeconomic Physical Environment Length of Life Out of 243 ranked counties in Texas, Wise County ranked 42 nd overall in 2017.

12 County Health Ranking Changes Texas Average (2017) % Change Premature Death 7,486 7,800 6,700 4% Adult Smoking 18% 15% 15% -3% Adult Obesity 32% 31% 28% -1% Physical Inactivity 30% 21% 23% -9% Motor Vehicle Crash Rate % Sexually Transmitted Infections % Teen Birth Rate % Uninsured Adult Rate 26% 20% 21% -6% Primary Care Physicians 2,463:1 1,990:1 1,670:1-19% Preventable Hospital Stays % Mammography Screening 50% 50% 58% - Some College 50% 47% 60% 3% Violent Crime Rate % Source: countyhealthrankings.org

13 Let s Invest in Our Community

14 Step 1: Reflect and Strategize Community Health Improvement Model Step 8: Implement Strategies Step 9: Evaluate Process Step 2: Identify and Engage Stakeholders Step 3: Define the Community Step 7: Plan Implementation Strategies Step 4: Collect and Analyze Data Step 6: Document and Communicate Results Step 5: Prioritize Community Health Issues

15 Why is this good for WHS? Our Mission Provide compassionate and innovative care to our community and patients with transparency and excellence. Community Benefit Uncompensated Care $29,587, $21,456,322 Our Vision Transformed and improved lives through better health and extraordinary outcomes. Charity/ Indigent Care $21,546,000 $35,492,095 Total Benefit: $51,133,000 $56,948,417 Source: Wise Health System

16 W H Y I S C O M M U N I T Y H E A L T H GOOD FOR YOU? Economic Impact Social Impact Educational Impact

17 Williamson County Community Health Improvement Plan Williamson County established their CHIP in response to their 2016 CHNA. The WWA is the county s health and wellness coalition and oversees health improvement activities, recommends direction and priorities, and promotes ways for groups to rally around health issues. HealthyWilliamsonCounty.org

18 2017 CHNA Summary of Needs 1) Obesity (#2) 2) Primary Care Physicians (#4) 3) Lack of Mental Health Services (#6) 4) Uninsured / Lack of Access to Services (Cost)(#1) 5) Diseases of the Heart (#5) 6) Physical Inactivity (#8) 7) Diabetes (#3) 8) Poor Nutrition (#7) 9) Utilization of Emergency Room for Episodic Care (new) 10) Lack of Health Education (#9)

19 Health Priority Committees TEAM The needs assigned to each committee will not be the only subjects that can be improved upon. Each committee with established a goal, metric, timeline and strategy for each need listed. Healthy Behaviors Committee Needs Addressed: (1) Obesity (7) Diabetes (5) Diseases of the Heart (8) Poor Nutrition (6) Physical Inactivity Mental Health and Substance Abuse Committee Needs Addressed: (3) Lack of Mental Health Services (11) Alcohol/ Drug Abuse (17) Adult Smoking Healthcare Resource Awareness Committee Needs Addressed: (4) Uninsured/ Lack of Access (9) Utilization of ED for Episodic Care (10) Lack of Health Education (12) Transportation

20 Health Priority Action PlansA M

21

22 How to Participate In Community Health Improvement How Can We All Participate in Community Health Improvement? Implement the CHI by joining the Wise CHI and participating in one or multiple committees How Can Local Government Participate? Incorporate CHI into strategic and future planning Advocate for policies and resources that improve the health priorities How Can Health Care Systems, Insurers, and Clinicians Participate? Work to increase insurance coverage and access to healthcare to Medicaid, low income, and uninsured individuals, especially for mental health How Can Community, Non-Profit, and Faith-Based Organizations Participate? Align health improvement efforts with the CHIP Leverage additional resources by referencing the CHIP How Can Businesses and Employers Participate? Promote worksite wellness policies and resources that focus on the health priorities Encourage employees to participate in a committee How Can Early Learning Centers, Schools, Colleges Participate? Share CHI plan with fellow educators Equip educators with skills to promote and improve health How Can Individuals and Families Participate? Practice and Promote health behaviors in the community Advocate for community health improvement in the places where you live, work, worship, play, and learn

23 Our Ask Join committee(s) in areas you would like to influence Help in development of a working written plan by March 31, 2018 Sign a commitment letter to partner with the Wise CHI and adopt its principles Participate in and promote activities identified to influence a healthier Wise community Participate in the next CHNA in 2020 and celebrate your success

24 Resources

25 Questions? Jordan Holzbog Paul Aslin

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