Connecting Community to the Delivery System

Healthier Washington is the state’s vision for transforming the health care system to achieve better health, better care and lower costs for the

people of Washington State.

The Healthier Washington Initiative

The goals of Healthier Washington are simple:• Healthier people and communities

• A transformed health care system that treats the whole person

• Affordable care

The Healthier Washington Initiative

• Healthier Washington is employing three overarching strategies to achieve its transformation goals:

• Supporting multi-sector engagement

• Integrating care and social supports

• Paying for value

We know that health is more than health care

Adapted from: Magnun et al. (2010). Achieving Accountability for Health and Health Care: A White Paper, State Quality Improvement Institute.. Minnesota.

The Practice Transformation Support Hub

Goals of the “The Hub”

• Engage providers to connect to and build an integrated system of care that addresses the needs of the whole person, including behavioral health needs

• Assist providers to respond to Value-based Payment Models

• Support providers to link to community resources for their patients

Components of The Hub

• Practice Coaching, Facilitation and Training Program• Negotiating contract with Qualis Health

• Regional Health Connectors, a Health Extension Network• Negotiating contract with Qualis Health

• Web-Based Resource Portal• Led by University of Washington Primary Care Innovation Lab

Role of the Regional Connectors

• How will Connectors improve community-clinical linkages?

• An ambassador from the Community to the Providers

• A voice to the community from the Providers

• Inventory and track local resources

• Refer and connect providers to resources

• Track provider requests and needs

• Share successes and gaps in resources with the community

An Accountable Community of Health &

The Plan for Improving Population Health

Gary Goldbaum, MD, MPH September 9, 2016

The Vision of the North Sound ACH

A coalition with the triple aim of transforming the health system:

to improve the health of our communities and our people

to improve the experience of care and access to care

and to lower per capita health care costs

in Snohomish, Skagit, San Juan, Island and Whatcom counties

We can accomplish more together than we can individually

Trust, respect, transparency, continuous learning, and data-driven decision-making

Collaboration between sectors is key

Communities must be engaged to shape strategies

The way care is currently organized and delivered will not be effective in achieving our shared aim

To improve overall community health we need to go upstream

The Guiding Principles of the North Sound ACH

The Process for the North Sound ACH

Build on existing strengths, experiences and successes

Align efforts with existing state, county or local priorities, outcomes, strategies and metrics.

Create measurable goals and ensure accountability towards outcomes

Ensure that our plan is clear, robust, well-researched, inclusive, and actionable, yet practical

North Sound ACH Governing Bodypage 1 of 2

Name Title Sector Geographic area

Carl Bruner, EdD Superintendent, Mt. Vernon School District Education Skagit

Bob Burden, RHU Marketing Development Director, Group Health Cooperative Health Plans Regional

Federico Cruz-Uribe, MD VP of Clinical Affairs, SeaMar Primary Care Regional

Connie Davis, MD Chief Medical Officer, Skagit Valley Hospital Specialty Care, also Hospitals Skagit

Regina Delahunt, MS Director, Whatcom County Health Dept. Public Health Whatcom

Robin Fenn, PhD, LSW Research Dir., Snohomish Human Serv. SS&S, also Behavioral Health Snohomish

Scott Forslund, MBA Dir., Sno. County Health Leadership Coal. At large, also Hospitals Snohomish

Linda Gipson, PhD, RN Chief Nursing Officer, Whidbey General Hospital Hospitals Island

Stephen Gockley, JD Senior. Attorney, Northwest Justice Project Consumers Whatcom

Gary Goldbaum, MD, MPH

Vice Chair Health Officer, Snohomish Health Dist. Public Health Snohomish

Erin Hafer

New Programs Integration Manager, Community Health Plan of

Washington Health Plans Regional

Keith Higman, MPH Director, Island County Health Department Public Health Island

Justin Iwasaki, MD, MPH Director, Lummi Tribal Health Center Lummi Nation Whatcom

Jennifer Johnson Health Director, Skagit County At large Skagit

Tim Key Everett Division Chief, EMS First Responders Snohomish

North Sound ACH Governing Bodypage 2 of 2Name Title Sector Geographic area

David Kincheloe, PhD Advisory Board Vice-Chair, North Sound Mental Health Administration Consumers, also Behavioral Health Regional

Barbara LaBrash Human Services Manager, San Juan County Gov. SS&S San Juan

Debra Lancaster, MEd Executive Director, United Way of Skagit Consumers, also Philanthropy Skagit

Linda McCarthy Executive Director, Mt. Baker Planned Parenthood Specialty Care Whatcom, Skagit & San Juan

John Miller Health Administrator, Samish Nation Samish Nation Skagit

Dan Murphy Executive Director, Northwest Regional Council Long Term Care Whatcom, Skagit, SJ & Island

Suzanne Pak Korean Women’s Association Small Employers Snohomish

Chris Phillips

Director for Community Affairs & Strategic Communications, Peace

Health Hospitals Whatcom, Skagit, San Juan

Glenn Puckett, MPA Senior Program Officer, Washington Dental Service Foundation Specialty Care, also Philanthropy Regional

Marilyn Scott Vice Chair, Upper Skagit Tribe Upper Skagit Tribe Skagit

Jason Smith, MA Dean of Health Sciences & Public Safety, Everett Community College Education Snohomish

John Stephens Programs Administrator, Swinomish Tribe Swinomish Tribe Skagit

Joe Valentine, MSW

Chair Executive Director, North Sound Mental Health Administration Behavioral Health Regional

Kim Williams, RN Chief Operating Officer, Providence Hospitals Snohomish

Greg Winter Homeless Svc Ctr. Dir. Opportunity Council SS&S, also Housing Whatcom

A population health resource for state and local partners

An evolving toolkit of curated strategies and resources

A source of current health status information

Information on current population health work in our state

The Plan for Improving Population Health

Available to all: www.doh.wa.gov/P4IPH

Three health focus areas:

Diabetes

Obesity

Tobacco

The Plan for Improving Population Health

Within each health focus areas:

Current work and initiatives

Emerging issues

Health equity concerns

Data and sources

Recommended strategies

The Plan for Improving Population Health

North Sound ACH – Early Win “Prevention” Project – LARC

Long Acting Reversible Contraception, reducing unintended pregnancy

Why LARC?Up to 50% of all pregnancies

are unintended; 78% for women under 20;

70% for women 20-24

Unintended pregnancy may be an indicator

of increased risk for some poor

birth and maternal outcomes

Slide courtesy of: Mark G. Martens, MD, FACOG

Rank Principal diagnosis

Total national

hospital bill

private ins.

% of

national bill

Number of hospital

stays (thousands)

1 Mother’s pregnancy

and delivery

$30 Billion 7.9% 4,664

2 Newborn care $21 Billion 5.6% 791

3 Osteoarthritis $16 Billion 4.3% 919

4 Coronary artery disease $16 Billion 4.2% 4,391

5 Back pain (spondylosis,

intervertebral disc

disorders, other back

problems)

$15 Billion 3.9% 911

Slide courtesy of: Mark G. Martens, MD, FACOG

Unintended Pregnancy is a Risk Factor for

• Inadequate prenatal care• Low birth-weights• Exposure of the fetus to tobacco, alcohol and other

substances• Neonatal death• Domestic violence• Child abuse• Economic hardship• Failure to achieve educational and career goals

North Sound ACH LARC Project Goals:1. Train Providers (first training on 9/15/16) on how to:

• Utilize client centered contraceptive counseling best practices

• Incorporate patient centered reproductive life planning

• Clarify pregnancy intentions

• And inserting/implanting LARC when patients choose

2. Reach out to women to:

• Increase awareness of these highly effective contraception options “get it and forget it”

Thank you!

Questions and discussion