1. A NEW CONTINUUM CONVERSATION

2. 2 CEO Meeting Presentation and Take Aways What We Are Doing Setting parameters within which we will test and discover breakthrough approaches to integration What We Are Not Doing Solving all challenges linked to behavioral health or chronic disease

3. 3 Overarching Approach To Initiative We will test our collaborative capacity and identify potential breakthrough opportunities in two principal focus areas Design Team Focus Areas Chronic Disease: Prevention & Management Behavioral Health Charge for Design Teams 1.Analyze the current landscape in the focus area 2.Identify shared goals that could foster the vision 3.Propose specific initiatives in which we might pilot breakthroughs in collaboration that would improve our work across the continuum and the resulting outcomes Core Grou p

4. 4 What We Are Aiming For Mutually Reinforcing Activities Inputs -Landscape briefs in Behavioral Health and Chronic Disease -User/Provider dialogue and design needs -Economic analysis relating to costs of fragmentation -Scan of success factors, barriers and applicability of other complex integration efforts Outputs -Design teams recommend one or more breakthrough integration opportunities -New design simulation, implementation, study and adaptations -Design team identifies policy enablers and barriers to change -Innovations impact environment to make healthy choices easier and recognize that people live in families and are not just individuals -Learnings report (using stories) Impact -Increased collaborative capacity and effectiveness -Paths to scalable, spreadable system reforms -Measureable change for people living in community

5. A NEW CONTINUUM CONVERSATION "Leaders who can build partnerships for seeing larger systems...must cultivate open-mindedness in order to challenge continually their own favored views and to learn how to embrace multiple points of view in the service of building shared understanding and commitment. This work will require a set of deep capacities: systems intelligence, building partnership across boundaries, and openness of mind, heart, and will." - Peter Senge, Systems Citizenship: The Leadership Mandate for This Millennium

6. Refine Initiati ves Recommend/ Simulate One or More Initiatives that Would Foster Vision Desig n Teams Core Group Set Vision + Mission + Design Team Scope + Charge Jan-May 2015June-Aug 2015 Implemen t or Not Create Shared Goals & Explore Possible Approaches Assess Current Landscape Sept-Dec 2015 System User/ Provide r Issues Briefs Shared Learning Scanning Economic Analysis

7. Issues Briefs and User/Provider Dialogue  Description of process  Conveners and output (stories) Are the issues briefs directionally on target?  Issues briefs and related resources  Case studies on transformation systems change Are the user/provider dialogues directionally on target?

8. Economic Analysis Mapping/Scanning: A first step in economic analysis will be to conduct a literature search on the costs of fragmentation in the arenas of chronic conditions and behavioral health. Focus on the costs of siloing care and support services and related reimbursement. Broader cost implications of transitions issues in the health care system and cost implications regarding the social determinants of health will not be the focus of the initial analysis but could be addressed later. Does the work to date on economic analysis of costs of fragmentation provide guidance for next steps?

9. Environmental Scan Environmental Scan Scope: pursue an effort that will produce an environmental scan and sense-making of current cross-sector initiatives. This work will likely support multiple efforts in the community, but could provide valuable information for Silos to Circles Design Teams and the Core Group as they shape potential integration initiatives. Limit the studied initiatives to those that: 1) test barriers and facilitators in the field; and 2) bring together elements that were not previously working together in order to achieve better outcomes. Is the focus of our environmental scan still appropriate?

10. Other Emerging Work What do we do with related work that is emerging in the field ?  Post Acute  Aging Colloquim Proposal

11. Next Steps

12. 12 Design Team Guidance and Charges Design Team Role, Process and Timeline April-May 2015  Establish the charge and key questions that the design teams will answer  Articulate terms and realities of work (e.g. answer key questions, suggest breakthroughs, share with core group, work may or may not go forward)  Core group members invite design team participants (using template language)  Lab support finalizes team list and coordinates development of issues paper Setting System ContextSetting Person-Centered Context June-September 2015  White Paper/Issues Briefing  Synthesis of Critical Data Sets  Focus groups  Observation leveraging design principles  Design Team Output: o Fill in gaps, develop and learn from use-case o Identify and answer the big questions, including the following:  What are the greatest needs in navigating the system  What gets in the way of achieving right levels and use of care  How do life stages impact the discussion  Propose potential breakthroughs* that could be achieved in this area to foster the vision and outline how the breakthrough could be modeled or tested in a pilot, demonstration or initiative  Include in the proposal how any successful pilot could be scaled and spread *Breakthrough could include: - Scrapping and redesigning all or part of the system - Putting existing components of system together differently to create new whole and achieve desired results *Breakthrough is NOT tinkering with broken parts of system or adding new broken parts

13. Essential Functions of the Lab 13 Helps a collaboration: Hold guiding vision and strategy through neutral/shared forum and process Support aligned activities Gauge and share progress Build public will Advance policy Mobilize funding