National Health Policy Forum December 7, 2012

Transcription

1 Center for Health Innovation National Health Policy Forum December 7, 2012 Integrated Health Services

2 What is CHI? Our Mission Develop and implement strategies and models to improve quality of life and health status locally, at the state level and nationally Through By Program Development Planning and Policy Development / Improvement Advocacy Technical Assistance / Resource Development Supporting HMS strategies and our Partners Modeling Innovation Leadership Development and Integrating community needs and direct services

3 Session Goals Integrating care in a Frontier FQHC with partners Hidalgo Plan Concepts and Practice Frontier Workforce Training Issues for Policy Makers related to service integration in rural and frontier communities

4 Frontier SW NM: No Extra Charge for the View!

5 Before HMS Access After HMS. Before HMS, 70% of the two-county population lived within thirty minutes of primary care with limited financial accessibility. Now, with eleven HMS clinics, over 96% of the population lives within thirty minutes of accessible primary care services You Can t Integrate Services Where None Exist!

6 Census 2010 Population / % served: Grant County: 29,514 / 55.4% Hidalgo County: 4,894 / 74.4% Total Svc. Area: 34,408 / 60% Pop. Per Sq. Mile = 4.6 Patient Origin Map

7 The Health Systems Pyramid V E R T I C A L M a n a g e m e n t Tertiary and LTC Secondary and Subspecialty Care Integrated Primary Care Service Integration Social Support Policy and Systems

8 Core Primary Care Provision Medical Dental Behavioral Family Support Vertical Management Subspecialty In/Outpatient Hospital Long Term Care Ancillary Services 4 Core Services Context for a Health(y) System Model Articulation EMR Integration Internal Pt. Systems Integration External Referral Management Workforce Training Integration of Core Services Prevention Diagnosis Treatment Management Support Systems Health Equity Income / Poverty Education / Social Services Community Health Policy

9 Spectrum of Core Health Services Model Articulation Management and Team Interventions Prevention Diagnosis & Treatment Cost % Population

10 Spectrum of Core Health Services Model Articulation POPULATION FOCUS INDIVIDUAL / FAMILY FACILITATION/EDUCATION INTENSIVE INTERVENTION Community Health Early Intervention and Patient Support Care Coordination Cost % Population

11 Building the Model 2012

12 Center for Health Innovation Workforce Development Building an Integrated Rural Health Workforce

13 Rural Training One Community s Approach

14 Who Are We? We are a Network of Healthcare Partners addressing primary care shortages in New Mexico.

15 More specifically - A Community Health Center A Regional Hospital The State Academic Teaching Hospital A Family Medicine Residency Program A Dental School ARIZONA SCHOOL OF DENTISTRY & ORAL HEALTH

16 The Model Policy Support: Training, Distribution and Supply Encourage rural Students from middle school on to enter health careers Residencies and Rotations Support Primary Care Integration Support students through undergraduate education Rural Training Hub & Rural Residency Program Development

17 How we Integrate Training Maintain a Rural Training Hub with Partners = 70 Student and Resident Rotation Months at HMS Trainees Rotate through all Core PC Services and CHI Build a FM Residency Program and Rural PC Residency Rotations ORHP Support Develop Longitudinal Partnerships with Common Interests in Quality Primary Care Access and Training (12 disciplines, 8 sponsoring institutions, local providers) Engage the Public Schools and local University (clubs, curriculum, internships) AHEC - FY 12 = 1,408 Students Effectuate Systems Change Consortium Development and Model Dissemination State Funds

18 Goals for Integrated Rural and Frontier Health Services Primary Care Foundation Adjust for Volume Based / Fee For Service Payments Incentives for improved care, not more care Risk /Severity Adjusted Payments Care Coordination Models Chronic Disease Management Processes Early Diagnosis and Family Support Community Health Promotion Incentives Local Health Professional Development Models Teaching Health Centers On-Going or Non-Hospital Primary Care IME Payments Residency Consortia Development Rural Track Incentives No Cap on Family Medicine Training

19 Goals for Integrated Rural and Frontier Health Services Ensure Appropriate Secondary Care Population Size- Appropriate Models (FESC / CAH) Capitated or other Patient Management Incentives Primary Care Integration Reduce ER Use Pre-Hospital and Discharge Care Coordination Health Improvement / Cost Reduction Incentives Stop Leakage to Urban / Sub-Urban Systems for Patient Management Reduce Incentives for Expensive Transfers Care Coordination Manage Referrals Locally Tele-Health Support (Project ECHO)

20 Downtown Historic Silver City at Dawn

21 Charlie Alfero, Executive Director HMS- Center for Health Innovation 709 Santa Rita Street Silver City, NM (c)