Health Care Reform in the Northwest: Part Two Wendy Braund, MD, MPH Jacquie Watson, MHS Melissa Carico John Wiesman, DrPH, MPH www.nwcphp.org/hot-topics
Public Health-Clinical Partnerships in WY Wendy Braund, MD, MPH, MSEd, FACPM State Health Officer and Senior Administrator, Public Health Division, Wyoming Department of Health
Health Information Exchange: Wyoming Total Health Record Current Features Electronic Health Records at no cost to Medicaid providers Links to immunization registry and Medicaid claims data Tools and Uses Provider reminders Quality Improvement initiative on Diabetes care/control Planned Links to MyWYHealth Wyoming s health information exchange Other public health databases
Wyoming Immunization Registry (WyIR) Shows which immunization rates are low and where Medicaid providers and public health nurses receive information for follow-up Targeted interventions based on issue(s) driving low rate
Maternal and Child Health Public Health Nursing (PHN) Weekly list of newly pregnant Medicaid clients Clients enrolled in Home Visitation Program Improving birth outcomes Safety, tobacco use, nutrition information Screening Brief Intervention and Referral to Treatment (SBIRT) Due Date Plus
Office of Rural Health Partner with Institute for Population Health Provide seed money for CHIPs Top issues across 16 communities: 1) Overweight/obesity 2) Prevention services 3) Suicide prevention Collaborating with other programs
Primary Care Office Primary Care Support Grant Funds Van for mobile primary care Co-located mental health and primary care services Start-up funds for Community Health Centers Support and collaboration on expansion and creation of Health Centers Consultant to Community Health Center start-ups Partnerships with providers and specialty societies
Additional Collaborations Community Oral Health Coordinators Infectious Disease Epidemiology County Health Officers
Medical Home for Children with Special Health Care Needs in Rural Idaho Jacquie Watson, MHS Program Manager Melissa Carico Project Manager, Idaho Department of Health and Welfare
Program Objective Introduce the patient-centered medical home model to care providers who work with children and youth with special health care needs in rural parts of Idaho. Evidence-based quality improvement strategies Prevention, education, data and evaluation through public health Triple Aim
Partnership Children s Healthcare Improvement Collaboration Funding Expertise in PCMH Training Quality Improvement / Learning Collaboratives Maternal and Child Health Program Health education and prevention Data and evaluation support Plans for replication and sustainability Funding Local Public Health Connection to community resources
Medicaid and Public Health Collaboration Eastern Idaho Public Health District Teton Valley Medical Clinic (Driggs) Brown Family Medicine (Idaho Falls) Southeastern Idaho Public Health District Caribou Medical Clinic (Soda Springs) Caribou Medical Clinic (Grace) Lost River Medical Clinic (Mackay) Lost River Medical Clinic (Arco)
Goals Short-Term Introduce patient centered medical home (PCMH) concepts and strategies Medical home coordinator training Improved care for children and youth with special health care needs (CYSHCN) in rural Idaho Long-Term PCMH transformation Replicate PCMH for CYSHCN to all health district regions Continued measure of outcomes
Successes Registries (e.g., ADD, ADHD, autism, asthma, chronic, complex) Care coordination (e.g., family support, connecting to resources) Systems building (e.g., care coordinator network, education on quality improvement)
Outcomes Introduced validated tools Provided education on prevention strategies Provided care coordination to allow for appropriate services and tests Allowed staff to work at the top of their expertise and licensure Connected patients/families with appropriate resources and support services Improved family-centered quality outcomes Identified patient populations (registries) to manage patient care
Stories from Washington John Wiesman, DrPH, MPH Secretary of Health, Washington State
Priority Areas and Strategies Healthy Eating More convenient healthful foods and beverages by creating easy access in communities and work places. Fewer obese people. Active Living More safe and walkable streets, especially for students. People getting more physical activity. Preventive Healthcare Services Tobacco Free Living More technical assistance for health care providers to strengthen preventive services. Fewer people with high blood pressure, high cholesterol, and late-stage cancer. Strengthen link between clinic and community. Increase number of trained Community Health Workers. Protect people from secondhand smoke. Access to smokefree housing, parks, and campuses. More availability of cessation services and treatments. Local control on tobacco marketing. People living tobacco free.
Washington Health Improvement Network Support primary care teams to: Develop health/medical homes Integrate behavioral health Develop care management for patients with multiple chronic conditions Reduce care transitions
Washington Health Improvement Network Strategy Regional collaboratives Statewide, self-paced online modules Teams focus on: Increasing rates of clinical preventive services Improving care for chronic conditions, with measurable improvements to population health for hypertension, diabetes and asthma Increasing developmental screening rates for children
Community Health Worker Training Eight-week core curriculum (in-person and online) Additional health-specific courses (and more to come) Breast, Cervical, Colorectal, & Prostate Cancer Screening Diabetes Navigating Health Insurance
Training By the Numbers Delivered four times per year in seven regions Community-based and clinical providers 332 students Core Competency Training 195 students One or more health-specific modules 150+ students enrolled for 1 st quarter 2014
Looking Ahead: State Health Care Innovation Plan Three Strategies Pay for outcomes, not visits and tests Integration of physical and behavioral health Building healthy communities and people through prevention
Building Healthy Communities and People Through Prevention Set a Prevention Framework Begin a Health in All Policies approach Innovation investment Create Accountable Communities of Health Use data to drive community decisions Apply a regional context for Medicaid
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