Promoting health, improving lives

GROUP HEALTH REPORT TO THE COMMUNITY 2013 Promoting health, improving lives Group Health. It s such a simple name. Yet it conveys a much larger purpose, a singular goal to improve the health of everyone in our community. We do this by offering affordable health coverage and providing evidence-based health care and research. We also do this by giving of our time, talent, and resources to benefit our members and neighbors, their friends and families, and those underserved in areas where we live and work. This report highlights a few examples of our commitment to the community by the Group Health family including Group Health Research Institute, Group Health Foundation, Group Health Physicians, and staff. The ways we give back are many and varied, but, as you ll read, all reflect caring and heart. 2013: STRATEGIC PLANNING Sharpening our focus on community involvement One of the outcomes of the Affordable Care Act has been a requirement for hospital nonprofits to have a Community Health Needs Assessment (CHNA) and an Implementation Strategy. That s a mouthful that simply asks, how can we best connect with, engage, and improve the health of our communities? It s a question Group Health wholeheartedly embraced since it aligns so closely with our mission. More than 50 Group Health senior leaders including members of our Board of Trustees, Executive Leadership Team, Senior Leadership Team, and more examined all the ways we might impact the health of our community. Our overriding criterion became, given all the things we do well, where can we make the most difference with the most people in the most communities we serve? Group Health Report to the Community 2013 Page 1

COMMUNITY HEALTH NEEDS ASSESSMENT 3 strategies that make the largest impact GROUP HEALTH S MISSION 1 2 3 Promotion of physical activity, improved fitness, and healthy eating Access to care for underserved populations Diabetes and cardiovascular disease prevention and management Through multiple venues, three strategies rose to the top, each designed to have maximum impact on the health of individuals in our communities now and in the years to come. Our mission is to improve lives by improving health, says Diana Rakow, executive vice president, Marketing & Public Affairs, and president, Group Health Foundation. What this more focused approach does is allow us to be much more strategic with our resources, deliberate with our actions, and to ultimately have a greater impact on health. The needs assessment, which took up much of 2013, is only the first part of the overall initiative. Part two concerns the implementation of our strategies. Adds Rakow, We re quite excited about the prospects, having already forged partnerships with a number of community-minded organizations in the area. These include the Juvenile Diabetes Research Foundation, YMCA, Pronto Cycle Share, Cascade Bicycle Club s Major Taylor Project, Seattle King County/Remote Area Medical roving free clinic, and more. What these groups have in common with Group Health is a commitment to improve health and prevent disease for more members of our communities. 2013: SUPPORTING COMMUNITY ACCESS TO CARE Medicaid and Group Health Health outcomes are out of our hands at times, says Janice, a longtime Seattle resident. Emergencies happen and as we become older our parts just don t function as well as we hope. Nearing 60 and living under the federal poverty level, Janice recently found herself beset with a debilitating and painful digestive infection. Fortunately, she had qualified for Apple Health (as Medicaid is now called in Washington state). Even better, she was able to choose Group Health as her provider. My pain was so high that walking, sitting, and sleeping were difficult, Janice explains. Commuting on the bus caused greater pain from jarring and bumps in the road. Her Group Health primary care doctor has been instrumental in managing Janice s care, from arranging for lab tests and scans to coordinating diagnostic day procedures and prescribing multiple antibiotics. Group Health Report to the Community 2013 Page 2

20,000 Number of Medicaid patients Group Health cared for each month in 2013 My primary care doctor and care team checked in with me many times to hear about my concerns and monitor my symptoms, she says. I m so grateful to have Group Health. Without them, I m not sure how I would have been able to care for myself. And without Apple Health (Medicaid), I wouldn t have been able to get the appropriate care when needed. Group Health Medical Centers provides health care for thousands of low-income adults and children. In fact, Janice was one of more than 20,000 Medicaid patients Group Health cared for each month in 2013. The Olympia Free Clinic Despite the success of the Affordable Care Act to enroll people in health care plans, there are thousands in Thurston County who remain uninsured. Fortunately, there s The Olympia Free Clinic a valuable resource for low-income, uninsured people of the county to receive access to cost-effective, quality, acute health care, as well as links to appropriate community services. My most satisfying encounters are with patients who have a relatively straightforward problem that I m able to solve for them completely that evening, says Julia Sokoloff, MD, one of a number of Group Health doctors who volunteer at the clinic. They re so grateful, and everyone is happy to have prevented an expensive and time-consuming ER visit. Because of the connections that our doctors have with the community and this safety net organization we began the process of providing lab tests for any patient of the clinic through our own Olympia Medical Center lab. There s a refreshing purity to these encounters, adds Dr. Sokoloff, No meetings or paperwork. Just me with my knowledge and prescription pad, and a fellow human in need. Project Access Northwest Project Access Northwest screens referrals for uninsured and underinsured patients to ensure that appropriate tests and paperwork are completed before the patient sees a specialist. By arranging for the necessary laboratory and imaging services as well as providing qualified interpreters, we remove the barriers that prevent patients from keeping their appointments with medical or dental specialists. More than 95 percent of Project Access Northwest patients keep their appointments, compared to fewer than 70 percent in typical uninsured populations. In 2013, Group Health supported over 1,400 visits. Group Health Sponsored Care Programs Keeping specialty appointments: a comparison 95% PROJECT ACCESS NW PATIENTS Rebecca knows what it s like to take care of people. After all, she was a caregiver for more than 15 years until vision and knee problems kept her at home. Unemployed and also suffering from diabetes, Rebecca found herself unable to pay for the many medications required for her well-being. That s when Group Health took care of her. Her Group Health family physician, Tania Rose Posa, MD, put Rebecca in touch with the Health Care Assistance (HCA) program, which allowed her to forgo the copay on her many prescriptions. Said the Lakewood grandmother, I have so many tablets I have to take for diabetes, high-blood pressure, a heart condition that without Group Health s help, there s no way I d be able to care for myself. 70% TYPICAL UNDERINSURED PATIENT Group Health Report to the Community 2013 Page 3

HCA helps qualifying Group Health Cooperative members pay their bills for medically necessary care. The program aids members in resolving temporary financial difficulties by providing short-term help with deductible, copayments, and fees for services provided at Group Health Medical Centers. Through Health Care Assistance and Charity Care, Sponsored Care provides a temporary financial safety net for patients struggling in the aftermath of a catastrophic accident, dealing with major surgery, or coping with a serious chronic disease or life-threatening illness. In 2013, through Sponsored Care, Group Health provided financial assistance to more than 2,300 members, totaling more than $2.3 million. $2.3 million Financial assistance provided to members in 2013 2013: DISEASE MANAGEMENT Practical research leads to better health worldwide For more than 30 years Group Health Research Institute (GHRI) has been conducting practical research to help people find ways to stay healthy and enrich their everyday lives from wearing bike helmets to quitting smoking. Among the many ground-breaking projects over the years was the development of the Chronic Care Model, a redesign of medical practices to help patients with chronic diseases including heart disease, diabetes, asthma, and depression receive more effective care. The model has proven so effective it s been adopted by such notable health organizations as The Mayo Clinic and the World Health Organization. In 2013, GHRI was once again hard at work, managing 292 active grants and publishing 353 articles in peer-reviewed journals. Noteworthy studies included: See the video by going to grouphealthresearch.org and search nurse navigators Nurse navigators and cancer care. In this trial, when Group Health patients received support from a nurse navigator soon after a cancer diagnosis, they had better experiences and fewer problems with their care particularly in getting health information, care coordination, and psychological and social care. The study was so effective that Group Health has already incorporated an oncology nurse navigator into usual care at its Capitol Hill campus for women newly diagnosed with breast cancer. Colorectal cancer screenings. Group Health researchers used electronic health records to identify and contact patients who weren t screened regularly for cancer of the colon and rectum. Taking a centralized, automated approach to patient notification doubled the rates of on-time screening and reduced operational costs over two years. Saving health care costs is just one part of the equation. Saving lives is the other. More than one in 20 Americans will develop colorectal cancer, which is second only in morbidity rates to lung cancer. Screening can save lives, says study leader and Group Health physician Beverly Green, MD, MPH. But screening can t help if you don t do it and do it regularly. I ve seen people die from cancer, so I was thrilled to find that our intervention doubled screening rates and kept them up to date. This project has influenced care at Group Health and, now through a grant from the National Institutes of Health, is being adapted in other settings, including community health centers. Blood sugar and dementia risk. A joint Group Health University of Washington study in the New England Journal of Medicine found that higher blood sugar levels are Group Health Report to the Community 2013 Page 4

associated with higher dementia risk, even among people who do not have diabetes. Our research implies that lowering blood sugar levels would help reduce rates of late-life dementia. ABC News counted this among their top-15 diet and weight loss stories of 2013. 2013: PUTTING OUR STRATEGIES INTO PRACTICE Promotion of physical activity, improved fitness, and healthy eating Miles of cycling. Group Health, in association with the Cascade Bicycle Club, sponsored the Major Taylor Project. This joint effort ensures that any middle- or high-school student in underserved areas who wants to learn to ride and care for their own bike, can. Summer found approximately 10,000 bicyclists including 25 Major Taylor kids participating in the Group Health STP, the 203-mile, Seattle-to-Portland bicycle ride. Over in Spokane, the popular Spokefest drew 2,000 cyclists. Other Group-Health sponsored rides in the region included the Whidbey General Hospital Tour de Whidbey, the Cystic Fibrosis Cycle for Life in Seattle, and the NW Tulip Pedal in La Conner. Let s go for a run. Group Health supported more than 25 running events in 2013, including the Rock n Roll Marathon and Half Marathon with 20,000 runners competing. A record-setting 11,000 runners supported type 1 diabetes research in the Juvenile Diabetes Research Foundation (JDRF) Beat the Bridge race. Running clinics for the Bloomsday Run in Spokane and sponsorship of the Poulsbo Marathon, the MS Relay for Life, and the March of Dimes March for Babies allowed runners from around the state to put in some serious miles. Healthy kids. Together with the YMCA, Group Health gave out more than 1,000 jump ropes to promote physical activity as part of Healthy Kids Day at 11 YMCA branches statewide. The effort was part of a national initiative aimed at improving the health and well-being of kids. Group Health was also one of the primary sponsors for youth camps put on by the Seattle Sounders (soccer) and Seattle Storm (basketball). 2013: GROUP HEALTH COMMUNITY CONTRIBUTIONS Research $45,380,000 Care and coverage for low income populations Community health initiatives and services $33,881,100 $6,324,200 Research Care and coverage for low income populations Health professions education $10,135,700 Total Value $95,721,000 Community health initiatives and services Health professions education 14-CB-1251 2014-10 Group Health Report to the Community 2013 Page 5