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12/10/2013
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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)
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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
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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
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ICSI: Who We Are
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Land of 10,000 Lakes –
And Opportunities for the Triple Aim
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• Improve population health
• Improve patient experience of
care, including quality
• Improve affordability by
decreasing per capita costs
Targeting the Triple Aim*
*The Triple Aim: Care, Health, And Cost. Berwick DM,
Nolan TW and Whittington J., Health Affairs, May 2008,
Vol. 27, No. 3, 759-769.
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MN Health Care Spending
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“If State Health Care Costs Continue Their Current Trend, Spending on Other Services Can’t Grow”
3.9%
8.5%
0.2%
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
Revenue Health Care Education & AllOther
An
nu
al A
ve G
row
th 2
008
-203
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General Fund Spending Outlook, presentation to the Budget Trends Commission, August 2008, Dybdal, Reitan and Broat
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Must Address More than Health Care
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What Business Are We In?
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“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.”
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What Business Are We In?
Larry Schulz, CEO Lake Region HealthCare, Fergus Falls, MN
Building Accountable Health Communities
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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
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Community Reinforcing Loop
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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
ACO: Accountable
Care Organization AHCo: Accountable
Health Community
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Partnerships
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Partnerships
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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
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Partnerships
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• Locations:
–Bloomington, MN (pilot)
–Fergus Falls, MN
–North Minneapolis, MN
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Community Conversations
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How Do You Start the Conversation?
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Community Reviews Data
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Community Explores Shared Goals and Actions
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Audience Participation Exercises
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Community Conversations
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Value of 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
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Logistics for the Community Conversations
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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
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Expanding the Conversations
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• 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
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Critical Elements of AHCos
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Next Steps for This Work
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Envision a Sustainable Healthy Tomorrow!
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Thank You Questions?
www.icsi.org [email protected] [email protected]
