1. Making Connections
How RHCs are supporting practice transformation and clinic-community linkages
October 26, 2018

2. The project described was supported by Funding Opportunity Number CMS-1G from the U.S. Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), and by grant number 1R18HS from the U.S. Department of Health and Human Services (HHS), Agency for Healthcare Research and Quality (AHRQ). The Colorado State Innovation Model (SIM), a four-year initiative, is funded by up to $65 million from CMS. EvidenceNOW Southwest (ENSW), a four-year initiative, is funded by up to $14.8 million from AHRQ. The content provided is solely the responsibility of the authors and does not necessarily represent the official views of HHS or any of its agencies.

3. It’s December – which means it’s time for two things: order new calendars and start thinking about new year’s resolutions.
If you hate resolutions, raise your hand.
If you made a resolution for 2018 or plan to make one for 2019, please raise your hand
Please keep your hand raised if your resolution has something to do with your health
Please keep your hand raised if your health-related resolution has something to do with your behavior – eating better, exercising more
Thank you! You can put your hands down. Would anyone like to share their resolutions?
We didn’t see very many hands go down. What does that tell us?
Intuitively, we know that our behaviors influence our health.
We also know that it’s hard to change our behaviors – hence the resolutions!
And if you’re in this room, it’s probably because you know that both of those things are having a real impact on our health care system.

4. Resolutions for this Session
Go outside the clinic to address the parts of our lives that determine our health
Hear from Regional Health Connectors who are connecting clinics and communities
Gather ideas for addressing community needs

5. Researchers have estimated how much of our health is determined by those answers and assigned a percentage of our health to each of these four categories.
Does anyone want to guess what percentage of our health outcomes are determined by clinical care?
Health behaviors?
Physical environment?
And that leaves 40% to socioeconomic factors.
Estimates vary, but we know that most of what affects our health — as much as 80 percent — happens outside the doctor’s office. So addressing those non-clinical factors can make a huge difference in our health.
This means that health care providers are increasingly looking outside their clinics to address these factors, often referred to as the social determinants of health.
The research suggests that building clinical-community linkages holds promise for better care, better health and reduced health care spending over time.18, 19 But up front, they can be an expensive proposition. That’s because the cost savings for an insurer — like Medicaid or a private commercial plan — are tricky to calculate.
But this is changing. With the movement toward value-based payments — or paying for health rather than for individual services — insurers are more likely to invest in those connections to support their patients outside of the clinic.

6. RHCs connect the existing work of different systems
PF – Practice Facilitator
CHITA – Clinical Health Information Technology Advisor

7. The RHC Roadmap
Local relationships and priorities in each region will drive the work of each RHC, throughout the following steps:
Review existing initiatives and data
Align local priorities with statewide target areas
Develop a roadmap for RHC work on local priorities
Make connections and implement the roadmap

9. RHCs Connect Your Practice with Community
What’s an example of a connection you’ve made for a practice?
What upcoming community event do you want practices to know about?
What is the resource you share most often, or find most valuable?

10. Southwestern Colorado Area Health Education Center
Mary
Dengler-Frey
Southwestern Colorado Area Health Education Center
What’s an example of a connection you’ve made for a practice?
What upcoming community event do you want practices to know about?
What is the resource you share most often, or find most valuable?

11. Alexis Klein Tri-County Health Network
What’s an example of a connection you’ve made for a practice?
What upcoming community event do you want practices to know about?
What is the resource you share most often, or find most valuable?

12. Charity Weir Mesa County Public Health
What’s an example of a connection you’ve made for a practice?
What upcoming community event do you want practices to know about?
What is the resource you share most often, or find most valuable?

13. West Mountain Regional Health Alliance
Namrata Shrestha
West Mountain Regional Health Alliance
What’s an example of a connection you’ve made for a practice?
What upcoming community event do you want practices to know about?
What is the resource you share most often, or find most valuable?

14. Your Western Slope Regional Health Connectors
Namrata Shrestha, Region 12, West Mountain Regional Health Alliance
Charity Weir, Region 19, Mesa County Public Health
Alexis Klein, Region 10, Tri-County Health Network
Mary Dengler-Frey, Region 9, Southwestern Area Health Education Center
Take questions from the audience

15. Resource Sharing BrainBloom

16. Take out a piece of paper and write down:
Resources you currently share
Gaps in resources

18. Want more information? Check out our Interactive Map!

19. Read more about RHCs and Clinical-Community Linkages!
North Colorado Health Alliance (NCHA) is offering a one year full scholarship to Regional Health Connectors to use the Thriving Colorado Dashboard, a community health data tracking tool
Regional Health Connectors can use the Thriving Colorado Dashboard to:
Track SMART goals and report on the progress made by partnerships
Share data for patients, community members, and partners to view
See what other RHCs and public health organizations are working on
Identify evidence-based practices from around the state

20. And, more success stories and RHC Profiles!
Namrata coming soon!

21. Thank you!
@RHConnectors