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“Building Collaborative Health Networks: Pat Terrell”
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“Building Collaborative Health Networks: Pat Terrell”

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PPT on Building Collaborative Partnerships for the the Regional Health Care Safety Net in Northeastern Illinois. Presented at the Safety Net Summit, June 23, 2009, hosted by Health & Medicine Policy …

PPT on Building Collaborative Partnerships for the the Regional Health Care Safety Net in Northeastern Illinois. Presented at the Safety Net Summit, June 23, 2009, hosted by Health & Medicine Policy Research Group (HMPRG) and the U.S. Health Resources and Services Administration (HRSA)

Published in: Health & Medicine, Technology

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  • 1. Community- and Population-Based Health Care Delivery Systems: Building Collaborative Networks Regional Health Care Safety Net Summit Health and Medicine Policy Research Group Pat Terrell June, 2009
  • 2. Building Regional, Collaborative Health Care Networks
    • Why?
      • Pressure will mount on local communities and governments to meet growing need
      • Publics can’t meet need alone
      • Providers motivated to come to the table to bring new ideas
      • National—and state--reform will require new delivery system models
  • 3. Local Communities Have Unique Opportunities
    • Rising numbers of uninsured likely
    • State is just trying to get through the day in face of growing deficits (Medicaid)
    • Federal government will be immersed in reform deliberation (looking models for addressing both access and cost)
    • Any new approach will require new delivery models (“Coverage” is not the same as “Access”)
    • Local communities can become learning laboratories for new delivery systems with local government as “honest broker”
  • 4. Elements of Developing Effective Delivery Systems
    • Know the population.
    • Understand need and current health utilization of all levels of care.
    • Find gaps/duplications in continuum.
    • Align mission, financial sustainability, competencies of individual providers.
    • Create systems to manage network.
  • 5. Who is the focus of a safety net system? Hospitals? Doctors? Unions? County Supervisors? Population!
  • 6. Targeting Population
    • Underserved, not just uninsured
      • Medicaid
      • Multiple morbidities (including pysch)
      • Geographically isolated
      • Under-insured
      • Immigration/cultural issues
    • Where do they live now and where are they moving?
    • What care are they getting now and from which providers (FQHCs, EDs, hospitals, doctors, nursing homes, etc.)?
  • 7. Population: What do they need?
    • Must assume what demand should be, not just what is.
    • Population focus to determine volume of:
      • Primary Care
      • Specialty Outpatient Care
      • Inpatient acute
      • Lower levels of acute
      • LTC
    • Translate into provider requirements.
  • 8. Different Approaches to Determining Need
  • 9. Building a System: Filling Gaps, Eliminating Duplication
    • After mapping out need and current resources, identify:
      • Current gaps and duplications
      • Inappropriate utilization
      • Project future concerns about delivery system ability to meet need.
    • Begin fitting providers to system design, based on:
      • Individual institutional mission
      • Financial rationality (i.e., primary care in FQHCs)
      • Community benefit leverage
      • Not wanting to be “left out”
  • 10. Bringing Players to the Table
    • Start with individual discussions (even if within public system only)
    • Propose roles, assure that others are included
    • Key issues: predictability, sustainability, equitability
    • Stress role of local government bodies as “honest brokers”
    • Bring all together when there is general agreement to endorse broader plan
  • 11. Managing the Network
    • Network management will be key – takes beyond a puzzle of different components
    • IT, referral systems, common disease management approach are essential
    • Connections with non-acute services
    • Evaluating what works and what doesn’t (and changing it) on an ongoing basis is critical
  • 12. Formalizing the Network
    • Can be internal system oversight or multi-provider “governance”
    • Accountability of all elements of the system to each other is important
    • Planning for continual changes in the patient population and service needs to be key function
    • Resource sharing and cost-saving is a standing agenda item
    • Coordinated advocacy at state and national level is a significant benefit
  • 13. Network Development Focused on Underserved Populations: Examples
    • California Counties (unique requirement for local responsibility for indigent care)
    • - San Mateo
    • - Orange
    • New Orleans (4 parishes)
    • Austin, Texas (greater Travis County)
    • Chicago/South Suburbs (Comer Plan/CHNU)
    • Miami/Dade County
    • Cincinnati/Hamilton County Plan

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