Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.

1. Children’s Hospitals and the Impact on the
Social Determinants of Health
The Opportunity for Integrated Health Systems to Lead
Tamarah Duperval-Brownlee, MD, MPH, MBA
Senior Vice President, Chief Community Impact Officer, Ascension Healthcare
President and CEO, Ascension Providence Health System, Washington, DC
@DrTamSpeaks @Ascensionorg

2. 2
Objectives
Children’s Hospitals and Impact on Social Determinants of Health
• About Ascension
• Commitment to Health Equity
• Ascension’s Children’s Hospitals
• Examples of Impact
• Dell Children’s Medical Center
• Considerations for Action

3. 3
About Ascension
Children’s Hospitals and Impact on Social Determinants of Health
• Ascension is a faith-based healthcare organization dedicated to transformation through
innovation across the continuum of care.
• A unified Mission and identity – Caring for all persons, with special attention to persons living in
poverty and those most vulnerable.
• One of the largest non-profit health system in the U.S. and the second largest Catholic health
system founded by the Daughters of Charity in 1999.
• Integrated Healthcare Delivery System since 2012
• Provided nearly $2 billion in care of persons living in poverty and other community benefit
programs
• $38.5 billion in total assets and total operating revenue of $23.2 billion
• 151 Hospitals
• 5 Children’s Hospitals

4. Ascension’s Care Delivery Map
2,600
Sites of
Care
Caring for
Patients in
21 states
Ascension Children’s Hospitals

5. 5
One Ascension
Commitment to Health Equity
• A unified Mission and identity – Caring for all persons, with special attention to
persons living in poverty and those most vulnerable
• Ascension is committed to identifying and eliminating disparities in healthcare outcomes
and achieving health equity
• Personalized and compassionate care – Health services that are
redesigned around the person
• National leadership in quality and safety – our Ascension Way
• National advocacy leadership for a compassionate and just society
• Population-based economic models that reward value

6. 6
What we’re looking at
SDOH in Ascension Communities

7. 7
SDOH Questions (10 total)
SDOH in Ascension Communities

8. 8
SDOH Assessment
SDOH in Ascension Communities
• Launched in a Quarter of markets Across Ascension to date; full deployment through FY20
• >95% response rate
• Nearly 1/3 of patients with positive responses
• Responses collected (through registration process) are recorded in the Ambulatory electronic
health record

9. 9
• Chicago Suburban Hospital
• New to market
• Focus on Population Health
• SDOH theme: focus on meeting affordable
housing needs and medication access (Dispensary
of Hope)
AMITA Health Women and
Children’s Hospital
Ascension’s Children’s Hospital

10. 10
• Children’s Hospital Designation in SE
Michigan
• ~20 % of Market Share
• Medicaid ~60% inpatient discharges, ED
Visits, and Outpatient Visits
• High Population and utilization
• SDOH theme: Bridges to HOPE (Helping
Others Prosper through Empowerment)
program – a partnership between St. John
Community Health Investment Corporation
(a division of Ascension SE Michigan),
Catholic Charities of Southeast Michigan
and the Society of St. Vincent de Paul
St. John Hospital and Medical
Center
Ascension’s Children’s Hospital
52 licensed beds

11. 11
• Serves 7 Florida counties and 4
Alabama counties
• Geographic span of 250 miles, mostly
rural
• Medicaid ~55% inpatient discharges, ED
Visits, and Outpatient Visits
• SDOH theme: Access to primary care is
a unique challenge – high subspecialty
saturation in the market; Medicaid
reimbursement
Studer Family Children’s Hospital
Ascension’s Children’s Hospital

12. 12
• 2 locations: Indianapolis and Evansville
• Indiana State Department of Health
Level of Care IV
• Medicaid ~57% inpatient discharges, ED
Visits, and Outpatient Visits
• SDOH theme: screening and referral;
Subspecialty access and education;
Medicaid reimbursement
Peyton Manning Children’s Hospital
Ascension’s Children’s Hospital

13. 13
• 11 counties PSA; 46 total counties
served
• CMS ~52% inpatient discharges, ED
Visits, and Outpatient Visits; 4% self-pay
• Partner with Dell Medical School
(University of Texas)
• SDOH theme: Screening and referral –
Austin specific, Access to primary care
Dell Children’s Medical Center
(DCMC)
Ascension’s Children’s Hospital

14. 14
• Children’s Health Express (CHE) –
Mobile Unit
• Development from a Stop Gap clinical to a
primary medical home (pre-schoolers, WIC)
• Dell Children’s Medical Center Social
Determinants of Health Project
• SDoH Screening Tool (FQHC, Dell Medical
School, Dell Children’s)
• Goal to address needs in person specific
and geo-specific accuracy
• Community Resource Toolkit Created and
specific referrals emailed to
patients/caregivers
Dell Children’s Medical Center
Ascension’s Children’s Hospital Children’s Health Express

15. 15
• 93% of CHE families reported a need
• 3+ needs per positive survey for CHE families
• 2+ needs per positive survey for DCMC
families
• Largest needs
• Groceriesà Referrals
• Utilitiesà Referrals
• Transportation to medical appointments (Lyft
Partnership)
• College financial aidà Financial Counseling
• Next steps
• Addition of Case Work/Social Work support
• Enhancing collection of data
Dell Children’s Medical Center -
Social Determinants of Health
Project
Ascension’s Children’s Hospital

16. 16
Considerations for Action
Children’s Hospitals and Impact on Social Determinants of Health
• Screening is important and we are not accurate at identifying patients with out the
tools
• Communities are important
• You may have to walk with people for a while
• Hospital systems have resources for the community they have not thought about