Co-creating a Sustainable Healthy Tomorrow Sanne Magnan, MD, PhD-ICSI Joann Foreman, RN, BAN-ICSI Sean Kershaw-Citizens League (virtual) Bill Hanley-Twin Cities Public Television (virtual) 1 Objectives Identify strategies employed within select Minnesota conversations to engage clinicians, citizens, and community stakeholders to address the Triple Aim Identify proposed elements critical to success in building an Accountable Health Community 2 1
ICSI: Who We Are Independent, non-profit, collaborative of medical groups, nonprofit health plans, employers, purchasers and consumers 50+ medical group and hospital members representing 9,000 physicians Formed in 1993 by Mayo Clinic, HealthPartners and Park Nicollet Supported by Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, Security Health Plan of Wisconsin and UCare, as well as dues, grants and cooperative agreements 3 ICSI: Who We Are 4 2
Land of 10,000 Lakes And Opportunities for the Triple Aim 5 Targeting the Triple Aim* Improve population health Improve patient experience of care, including quality Improve affordability by decreasing per capita costs *The Triple Aim: Care, Health, And Cost. Berwick DM, Nolan TW and Whittington J., Health Affairs, May 2008, Vol. 27, No. 3, 759-769. 3
Annual Ave Growth 2008-2033 12/10/2013 MN Health Care Spending 7 If State Health Care Costs Continue Their Current Trend, Spending on Other Services Can t Grow 9% 8% 7% 6% 5% 4% 3% 2% 1% 0% 3.9% 8.5% 0.2% Revenue Health Care Education & All Other General Fund Spending Outlook, presentation to the Budget Trends Commission, August 2008, Dybdal, Reitan and Broat 4
Must Address More than Health Care 9 What Business Are We In? 10 5
What Business Are We In? We began changing our approach from just treating sick people to disease prevention and wellness...we had to go beyond our medical group and involve other community leaders to achieve better health in our region. Community leaders came together to define what we wanted our community to be in the future. Larry Schulz, CEO Lake Region HealthCare, Fergus Falls, MN 11 Building Accountable Health Communities 12 6
Building Accountable Health Communities Accountable Health Communities (AHCos): clinicians/citizens/community stakeholders in a geographic area work together to: Review local data on health, experience & quality of care, and costs of care (the Triple Aim) Create shared goals, actions and investments to meet the Triple Aim Involve citizens in local delivery system reform and stewardship of financial resources 13 Community Reinforcing Loop ACO: Accountable Care Organization AHCo: Accountable Health Community Source: Magnan S, Fisher E, Kindig D, Isham G, Wood D, Eustis M, Backstrom C and Leitz S. Achieving Accountability for Health and Health Care. A White Paper Developed from the State Quality Improvement Institute 2008-2012 in Minnesota. Found at www.icsi.org 14 7
Partnerships 15 Partnerships 16 8
Co-Creating a Sustainable Healthy Tomorrow Support from Bush Foundation to engage communities: Facilitated community conversations: health, cost, and care Infographic video Key stakeholder interviews Advisory committee ReThink Health linkage 17 Partnerships 18 9
Community Conversations Locations: Bloomington, MN (pilot) Fergus Falls, MN North Minneapolis, MN 19 How Do You Start the Conversation? 20 10
Community Reviews Data 21 Community Explores Shared Goals and Actions 22 11
Audience Participation Exercises 23 Community Conversations 24 12
Value of Community Conversations 25 Logistics for the Community Conversations Include citizens, clinicians, other community stakeholders in the planning Champion all aspects of the Triple Aim Be explicit about costs Employ a trusted facilitator Send personal invitations Ensure a balance of community stakeholders and clinicians at each table Choose a neutral location if possible 26 13
Co-Creating Support Bush Foundation grant to engage communities: Facilitated community conversations: health, cost, and care Infographic video Key stakeholder interviews Advisory committee ReThink Health linkage 27 Expanding the Conversations 28 14
Critical Elements of AHCos Leadership Grounding in population health (social determinants of health) A willingness to listen and to build new relationships trust Availability of data for review A focus on all aspects of the Triple Aim Discussion of priorities and goals Should they be linked to ACOs? More criteria.tbd 29 Next Steps for This Work 30 15
Envision a Sustainable Healthy Tomorrow! 31 Thank You Questions? www.icsi.org sanne.magnan@icsi.org joann.foreman@icsi.org 32 16