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Partnering with States and Communities to
Redesign Care Delivery: Implications for Family
Medicine Departments
ADFM 2016 Winter Meeting
San Antonio, Texas
February 18, 2016
Lloyd Michener, MD
Department of Community & Family Medicine, Duke University Medical Center, Durham, NC
Lauren Hughes, MD, MPH, MSc
Deputy Secretary for Health Innovation, Pennsylvania Department of Health, Harrisburg, PA
Kate Neuhausen, MD, MPH
Associate Director, VCU Office of Health Innovation, Richmond, VA
No Disclosures
While I have been a participant in the discussions
cited, the conclusion and summaries are mine,
and have not been endorsed by the sponsoring
organizations.
There IS a plan…
Moving Forward the National Strategic Imperative of Health
“From Health Care to Health”
Drivers:
1. Cost
2. Chronic Disease
3. Data
4. Policy
What is needed: Leadership
(McGinnison, The Practical Playbook, pg 11)
Signs of Change
Accountable Health Communities —
Addressing Social Needs
through Medicare and Medicaid
Dawn E. Alley, Ph.D., Chisara N. Asomugha, M.D., Patrick
H. Conway, M.D., and Darshak M. Sanghavi, M.D.
Road Ends
All Traffic
Exit Here
“we see CMS as playing a catalytic role. By embedding population-
based strategies in our programs and policies, CMS can help drive
transformation that aligns health care systems with public health
and social service systems and thereby accelerate progress to-
ward improved health for our whole country.”
Payors are paying attention – especially CMS:
Accountable Health Communities – Addressing Social Needs
Through Medicare and Medicaid
Dawn E. Alley, Ph.D., Chisara N. Asomugha, M.D., Patrick H. Conway, M.D.,
and Darshak M. Sanghavi, M.D.
Facilitating
Percent Difference Between Medicaid Recipients Enrolled in CCNC
and Those Not Enrolled in CCNC, for Rates of Asthma-Related
Emergency Department Visits and Inpatient Admissions, 2008–2012
Note. CCNC, Community Care of North Carolina. NCMJ
September/October 2013, Volume 74, Number 5
460
480
500
520
540
560
580
600
InpatientAdmissionsper1,000
Beneficiaries
Inpatient Admissions Per 1,000 MCC
Beneficiaries per Year
Inpatient Admission Trends among NC Medicaid Beneficiaries
with Multiple Chronic Conditions,
2008-FY2014
This means
>8,000 fewer
inpatient
admissions in
SFY2014
compared to
2008
performance
The State of State Health Policy: Governors’
State of the State Addresses
ADFM’s Role
Leadership
Community of Learning
www.practicalplaybook.org
Users: 38,759 Pageviews: 187,185

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Partnering with States and Communities to Redesign Care Delivery: Implications for Family Medicine Departments

  • 1. Partnering with States and Communities to Redesign Care Delivery: Implications for Family Medicine Departments ADFM 2016 Winter Meeting San Antonio, Texas February 18, 2016 Lloyd Michener, MD Department of Community & Family Medicine, Duke University Medical Center, Durham, NC Lauren Hughes, MD, MPH, MSc Deputy Secretary for Health Innovation, Pennsylvania Department of Health, Harrisburg, PA Kate Neuhausen, MD, MPH Associate Director, VCU Office of Health Innovation, Richmond, VA
  • 2. No Disclosures While I have been a participant in the discussions cited, the conclusion and summaries are mine, and have not been endorsed by the sponsoring organizations.
  • 3. There IS a plan… Moving Forward the National Strategic Imperative of Health
  • 4. “From Health Care to Health”
  • 5. Drivers: 1. Cost 2. Chronic Disease 3. Data 4. Policy What is needed: Leadership (McGinnison, The Practical Playbook, pg 11)
  • 6. Signs of Change Accountable Health Communities — Addressing Social Needs through Medicare and Medicaid Dawn E. Alley, Ph.D., Chisara N. Asomugha, M.D., Patrick H. Conway, M.D., and Darshak M. Sanghavi, M.D. Road Ends All Traffic Exit Here
  • 7. “we see CMS as playing a catalytic role. By embedding population- based strategies in our programs and policies, CMS can help drive transformation that aligns health care systems with public health and social service systems and thereby accelerate progress to- ward improved health for our whole country.” Payors are paying attention – especially CMS:
  • 8. Accountable Health Communities – Addressing Social Needs Through Medicare and Medicaid Dawn E. Alley, Ph.D., Chisara N. Asomugha, M.D., Patrick H. Conway, M.D., and Darshak M. Sanghavi, M.D.
  • 9.
  • 11.
  • 12.
  • 13.
  • 14. Percent Difference Between Medicaid Recipients Enrolled in CCNC and Those Not Enrolled in CCNC, for Rates of Asthma-Related Emergency Department Visits and Inpatient Admissions, 2008–2012 Note. CCNC, Community Care of North Carolina. NCMJ September/October 2013, Volume 74, Number 5
  • 15.
  • 16. 460 480 500 520 540 560 580 600 InpatientAdmissionsper1,000 Beneficiaries Inpatient Admissions Per 1,000 MCC Beneficiaries per Year Inpatient Admission Trends among NC Medicaid Beneficiaries with Multiple Chronic Conditions, 2008-FY2014 This means >8,000 fewer inpatient admissions in SFY2014 compared to 2008 performance
  • 17.
  • 18. The State of State Health Policy: Governors’ State of the State Addresses

Editor's Notes

  1. Lloyd – brief (Denise in depth later)
  2. = >$65 million savings