Transforming care delivery in Washington: A focus on children

Slides:



Advertisements
Similar presentations
World Health Organization
Advertisements

Life Course Theory Patricia J. Settle, MS RD
Healthy North Carolina 2020 Objective: Maternal and Infant Health
System Transformation in Texas: Agenda for Dave Wanser Ph.D. Deputy Commissioner for Behavioral and Community Health Department of State Health.
Jean Amoura, MD, MSc Marvin L.Stancil, MD.  Evaluate how fetal, infant, and childhood development is critical to understanding chronic diseases among.
JHU WCHPC 2004 Opportunities for Integrating Perinatal and Women’s Health A Multiple Determinants and Lifespan Approach Based on the Work of D Misra, B.
The Life Course Approach
Health Disparities for Hawaii County Health Conference August 13, 2010 Sharon H. Vitousek, M.D. North Hawaii Outcomes Project
Child Health Disparities Denice Cora-Bramble, MD, MBA Professor of Pediatrics, George Washington University Executive Director Goldberg Center for Community.
Interconception Education and Counseling: Strategies from Florida Presented by: Betsy Wood, BSN, MPH Infant, Maternal & Reproductive Health Unit Florida.
The Early Childhood Roots of Adult Health: Closing the Gap Between What We Know and What We Do JACK P. SHONKOFF, M.D. JULIUS B. RICHMOND FAMRI PROFESSOR.
FROM THEORY TO COMMUNITY PRACTICE The Life Course Approach Carol Brady, MA Executive Director Northeast Florida Healthy Start Coalition, Inc. Every Woman.
Public Health and Prevention M6920 September 18, 2001.
A Program Offered by the OU College of Nursing Funded by the George Kaiser Family Foundation Healthy Women, Healthy Futures.
1 NATIONAL ADVISORY COUNCIL ON HEALTHCARE RESEARCH AND QUALITY Subcommittee on Quality Measures for Children's Healthcare in Medicaid and CHIP Overview.
Picking Interventions and Strategies, Part I: Problem Analysis/Mapping South Side Families and Babies Community Team Meeting, January 21, 2014.
Future Research Agenda for MCH: Children with Special Health Care Needs November 10, 2004 Washington, DC Deborah Allen, ScD Boston University School of.
Integrated Framework for Reducing Racial and Ethnic Disparities in the Quality of Health Care Marshall H. Chin, MD, MPH, and Don Goldmann, MD University.
Human Capital Research Collaborative (HCRC) Fostering multidisciplinary research on human capital and well-being: Prenatal development through young adulthood.
Early Childhood Adversity
1 Community Health What is it? Why should I care?.
Coming Together for Young Children and Families.  What we know  Where we have been  Where we are today  Where we need to go.
Framework and Recommendations for a National Strategy to Reduce Infant Mortality July 9, 2012.
Mission: Protect the Vulnerable, Promote Strong and Economically Self- Sufficient Families, and Advance Personal and Family Recovery and Resiliency. Charlie.
Introduction to Nursing Care of the Childbearing Family
Triple Aim Goals  Improved health  Better health care & consumer experience  Lower Costs Tasks  Form a functional board and governance structure 
MICHIGAN'S INFANT MORTALITY REDUCTION PLAN Family Impact Seminar December 10, 2013 Melanie Brim Senior Deputy Director Public Health Administration Michigan.
MD’s State Health Improvement Process (SHIP) Healthy People 2020 Framework & Local Health Action Madeleine A. Shea, Ph.D. Director, Office of Population.
Padmini Parthasarathy, MPH Cheri Pies, MSW, DrPH Family, Maternal and Child Health Programs, Contra Costa Health Services Applying the Life Course Perspective.
Amy Fine Center for the Study of Social Policy
Changing Perceptions. Improving Reality. Reducing African American Infant Mortality in Racine Presented by: The Greater Racine Collaborative for Healthy.
HEALTHY KANSANS 2010 PROCESS OVERVIEW Encourage Change Improve the Health of all Kansans February 16 th, 2007.
Innovations and new initiatives to prevent obesity NSW Health Innovation & Health Symposium – November 2015 Louise A Baur University of Sydney: Discipline.
1 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 30 Major Health Issues.
Life-course Perspectives for Health Promotion and Obesity Prevention* Pan American Conference on Obesity III June 2013 Speakers/Facilitators Marcia Ory-Texas.
The Family Tree of “General Pediatrics” Where is it Going? Thomas F. Boat, MD Professor of Pulmonary Medicine Cincinnati Children’s Hospital Medical Center.
Chapter 7: Epidemiology of Chronic Diseases. “The Change You Like to See….” (1 of 3) Chronic diseases result from prolongation of acute illness. – With.
Pharmacy in Public Health: Determinants of Health Course, date, etc. info.
THE HEALTH CHALLENGE Sheila Shribman National Clinical Director Children, Young People & Maternity.
NUR 231 Pediatric Nursing Laura Salisbury RN, MSN/Ed.
Jolie A. Limon, MD, FAAP Valley Children’s Healthcare
South Dakota Department of Health
BUILDING INTEGRATED HEALTH SERVICE DELIVERY NETWORKS
INTEGRATED CLINICAL CARE ED
Berkshire County Health Needs Assessment
Mary Beth Sutter, MD Hannah Watson, MD Sherry Weitzen, MD PhD
Community-Clinical Linkages for Asthma Care
Chapter 41 Health Care Delivery Systems and Financing Issues
SNP Alliance Annual Leadership Forum Integrating Policy into Practice
Cascade Pacific Action Alliance
True Population Health in the Context of VBP
Prenatal & Perinatal Care & Pediatrics A Good Fit with the New Payment Systems VBP, P4P, Integrated MMC Elie Ward, MSW Director of Policy & Advocacy NYS.
Chapter 8 Adolescents, Young Adults, and Adults
Benton-Franklin Health District Board of Directors July 26, 2017
Greater Columbia ACH Board of Directors 4/19/17
Cascade Pacific Action Alliance
Project 3B: Reproductive, Maternal and Child Health – Logic Model 2018
Update on Integration: HCA’s Vision
Value-Based Payment Maternity, Delivery, and Infant Care
Welcome and Introductions: Tell Us About Yourself
Here are a several research articles that focus on the intersection between ACES and obesity These articles could be embedded into slide decks to underscore.
Although adverse childhood events may account for only a small proportion of the current obesity epidemic in the U.S. (Alvarez et al., 2007), risk of obesity.
Behavioral Health Committee Benton-Franklin Community Health Alliance
Advancing the Science of Transformation in Integrated Primary Care: Informing Options for Scaling-up Innovation   Session 3: Addressing health equity and.
The Nurse's Role in a Changing Child Health Care Environment
Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.
SAMPLE ONLY Dominion Health Center: Excellence in Medicaid Managed Care (or another defining message) Dominion Health Center is a community health center.
SAMPLE ONLY Dominion Health Center: Your Community Partner for Excellent Care (or another defining message) Dominion Health Center is a community health.
SAMPLE ONLY Dominion Health Center: Your Community Healthcare Home (or another defining message) Dominion Health Center is a community health center.
SAMPLE ONLY Dominion Health Center: Your Community Partner for Excellent Care (or another defining message) Dominion Health Center is a community health.
Presentation transcript:

Transforming care delivery in Washington: A focus on children Susan E. Birch, MBA, BSN, RN Director September 22, 2018

Today Who is covered by Apple Health (Medicaid) Influence of social determinants of health Role of team-based care Value-based purchasing to address disparities and determinants Maternal child health and oral health projects in Accountable Communities of Health

Learning Objectives Through the lens of the Life Stages Model, participants will gain a better understanding of the characteristics and needs of children covered by Medicaid Participants will learn how the Health Care Authority is using value based purchasing strategies to drive system transformation and improve the health of children Participants will consider how they as providers can work within their clinics and collaborate with external stakeholders to develop local strategies and support interventions that positively influence the health of children Maternal child health and oral health projects in Accountable Communities of Health Participants will leave with a better understanding of how Accountable Communities of Health are working with providers to promote the integration of behavioral health care with medical services and improve the health of children across the state

Apple Health (Medicaid) by payment plan as of 8/18

Apple Health clients by age

Apple Health clients by race/ethnicity

Apple Health clients by federal poverty level 2018 138% FPL Family of 4: $34,638 https://aspe.hhs.gov/poverty-guidelines

Apple Health clients by county

Flat trend for numbers of children living in poverty

Children living in poverty 2009-2013 https://datacenter.kidscount.org/data/bar/4748-children-in-poverty-by-race-and-ethnicity-state-level?loc=49&loct=2#2/any/false/1376/4684,172,133,12,4100,826,1673,13/11104 <100%FPL

Adult health outcomes related to childhood socioeconomic conditions All cause mortality Cause specific mortality Cirrhosis Smoking CV disease DM Respiratory Stomach cancer Cardiovascular disease Metabolic outcomes Insulin resistance Obesity Type 2 DM Behavioral outcomes Alcohol/drug abuse Depression Other health outcomes Braverman, P., Barclay, C. Health Disparities Beginning in Childhood: A Life-Course Perspective. Pediatrics Volume 124, Supplement 3, Nov 2009

Low birth rate <2500g by race 2016 https://datacenter.kidscount.org/data/bar/9817-low-birth-weight-babies-by-race?loc=49&loct=2#2/49/false/870/4038,4040,4039,2638,2597,1353,4758/19109

Adult health outcomes associated with low birth weight All cause mortality Cause specific mortality Cardiovascular Respiratory Coronary disease HTN Impaired glucose tolerance Metabolic syndrome Type 2 DM Chronic kidney disease Depression Braverman, P., Barclay, C. Health Disparities Beginning in Childhood: A Life-Course Perspective. Pediatrics Volume 124, Supplement 3, Nov 2009.

Social determinants of health

http://www. med. uottawa. ca/SIM/data/Models/Healthy_people_2020 http://www.med.uottawa.ca/SIM/data/Models/Healthy_people_2020.JPG">Uottawa.ca</a>

Team-based care: evidence suggests outcomes are improved

Team-based care Intermountain health care 51K patients over 4 years 51000 patients followed for 4 years. Team based care vs. usual practice. Boxes areas show significant changes in outcomes. Reiss-Brennan, B. et.al. Association of Integrated Team-Based Care With Health Care Quality, Utilization, and Cost. JAMA 2016;316(8):826-834

Pediatricians are uniquely positioned to address the social determinants of health and the complex environments in which children live

The basic science of pediatrics The basic science of pediatrics. An emerging, multidisciplinary science of development supports an EBD framework for understanding the evolution of human health and disease across the life span. In recent decades, epidemiology, developmental psychology, and longitudinal studies of early childhood interventions have demonstrated significant associations (hashed red arrow) between the ecology of childhood and a wide range of developmental outcomes and life course trajectories. Concurrently, advances in the biological sciences, particularly in developmental neuroscience and epigenetics, have made parallel progress in beginning to elucidate the biological mechanisms (solid arrows) underlying these important associations. The convergence of these diverse disciplines defines a promising new basic science of pediatrics. Jack P. Shonkoff et al. Pediatrics 2012;129:e232-e246

http://www.lcrn.net/wp-content/uploads/2015/05/LCHD_DiagramPrinciplesv2_PPTuse.png

State activities to transform the delivery system

Payment re-design and value-based purchasing strategies

Value-based purchasing https://www.hca.wa.gov/assets/program/vbp-roadmap-2017.pdf

State’s VBP standard https://www.hca.wa.gov/assets/program/vbp-roadmap-2017.pdf

2017 measures with 0.75% withhold for managed care plan performance

Provide actionable data: Healthier Washington dashboard https://fortress.wa.gov/hca/tableau/t/51/views/HealthierWashingtonDashboard/StatewideMeasureBrowser?:embed=y&:linktarget=_parent

Focusing interventions at a regional level

Accountable Communities of Health Promote health equity Create, support and collaborate on local health improvement plans Support local and statewide initiatives such as the Medicaid Transformation, practice transformation and value based purchasing Align resource and activities that improve whole person health and wellness

Medicaid transformation projects with a pediatric focus Reproductive and maternal/child health Pre-conception health/intentional pregnancies Evidence-based visiting model for high risk or first time mothers Evidence-based model or promising practice to improve childhood well child visit and immunization rates Access to oral health services Oral health in primary care Access to mobile

Discussion

Sue Birch, director sue.birch@hca.wa.gov Tel: 360-725-2104 Questions? Sue Birch, director sue.birch@hca.wa.gov Tel: 360-725-2104