Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. Vision To influence the improvement of health and well-being for all Ohioans. Mission To provide the independent and nonpartisan analysis needed to create evidence-informed state health policy. TM Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. Medicaid eligibility in Ohio CFC=Children, Pregnant Women and Parents ABD=Disabled Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

2016 Federal Poverty Level (FPL) Guidelines (by household size) Source: Federal Register, January 25, 2016 Note: Annual guidelines for all states except Alaska, Hawaii and DC. For each additional person, add $4,140 Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. Ohio Medicaid enrollment trend Average monthly enrollment update Source: Ohio Department of Medicaid monthly caseload report Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

Group VIII Enrollment by Month Update Source: Ohio Department of Medicaid monthly caseload report, August 2016 Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

Ohio Medicaid enrollment Update Copyright © 2016, 2015 Health Policy Institute of Ohio. All rights reserved.

57.4 percent of Ohioans had private health insurance coverage in 2015 Uninsured rate decreased by half from 2013 to 2015

Non-group coverage accounted for less than six percent of insured Ohioans in 2015

More than 90 percent of Ohioans with private health insurance coverage had employer-sponsored health insurance

Access to quality health care is necessary, but not sufficient, for good health. But we spend most of our healthcare dollars on clinical “sick care” instead of prevention. Copyright © 2015, 2016 Health Policy Institute of Ohio. All rights reserved.

Going upstream to improve population health Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. 12

Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. These are just a few examples of the many rankings and scorecards that have proliferated as data has become more accessible. There generally seems to be receptivity to the idea of comparing states to one another in many areas. Doing so provides a way to view data in context. Because of this, a couple of years ago staff at the Health Policy Institute of Ohio began to wonder if there was a comprehensive way to look at how the health of Ohioans compares to other states. Given our mission….. Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

Pathway to improved health value Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. 14

How does Ohio do? Analysis of the 106 metrics included in the Health Value Dashboard is sobering: 15

The state of health in Ohio Ohio ranks 47th on health value Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. 16

State comparison on health value Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. 17

Highest- and lowest-value states Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. 18

Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. Snapshot of health challenges and strengths The Dashboard highlights Ohio’s strengths and challenges. This page has been particularly useful in engaging Ohio’s policymakers. Senator Shannon Jones… Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. 19

Pathway to improved health value Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. 20

Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. Vision Ohio is a model of health and economic vitality. Mission Improve the health of Ohioans by implementing a strategic set of evidence-based population health activities at the scale needed to measurably improve population health outcomes and achieve health equity. Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

What is the state health assessment (SHA)? A comprehensive and actionable picture of health and wellbeing in Ohio Informs identification of priorities for the State Health Improvement Plan Provides template for state agencies and local partners (uniform set of categories and metrics) Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. 22

Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. 23

SHA sources of information Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

What is the state health improvement plan (SHIP)? An actionable plan to improve health and control healthcare costs Provides state agency leaders, local health departments, hospitals and other state and local partners with strategic menu of priorities, objectives and evidence-based strategies Signals opportunities for partnership with sectors beyond health Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. 25

SHIP priority outcomes

Outcome: Reduce diabetes prevalence

Outcome: Reduce diabetes prevalence Complete glide path

Diabetes prevention example

Center for Medicare & Medicaid Innovation Purpose: to support the development and testing of innovative healthcare payment and service delivery models. Ohio received a $3 million planning grant in 2013 to design new payment models and a $75 million dollar implementation grant that began in 2015. Accountable Care Organization models (ACO) Episode-based payment initiatives Primary Care Transformation Initiatives focused on the Medicaid and CHIP populations Initiative focused on the Medicare-Medicaid enrollees Initiatives to accelerate the development and testing of new payment and service delivery models Initiatives to speed the adoption of best practices Focus on SIM and grant and how it is being used. Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

“Glide path” framework to connect primary care with upstream population health activities Source: Developed by HPIO as part of a population health planning project commissioned by the Governor’s Office of Health Transformation, Ohio Department of Health and Ohio Department of Medicaid.

State Health Assessment (SHA) State Health Improvement Plan (SHIP) Local health departments Community Health Assessment (CHA) and Community Health Improvement Plan (CHIP) Hospitals Community Health Needs Assessment (CHNA) and Implementation Strategy (IS) Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.

Coordinate the implementation of evidence-based population health strategies

Copyright © 2016 Health Policy Institute of Ohio. All rights reserved. HPIO core funders Interact for Health Mt. Sinai Health Care Foundation The George Gund Foundation Saint Luke’s Foundation of Cleveland The Cleveland Foundation HealthPath Foundation of Ohio Sisters of Charity Foundation of Canton Sisters of Charity Foundation of Cleveland Cardinal Health Foundation United Way of Greater Cincinnati Mercy Health CareSource Foundation SC Ministry Foundation United Way of Central Ohio Copyright © 2016 Health Policy Institute of Ohio. All rights reserved.