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Hennepin Health. People.Care.Respect July 2013 Nancy Garrett, Ph.D. Hennepin County, MN. What is Hennepin Health?. Minnesota Department of Human Services (DHS) & Hennepin County Collaborative for Healthcare Innovation Hennepin County Partners: - PowerPoint PPT Presentation

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  • Hennepin HealthPeople.Care.Respect

    July 2013Nancy Garrett, Ph.D.

    Hennepin County, MN

  • What is Hennepin Health?Minnesota Department of Human Services (DHS) & Hennepin County Collaborative for Healthcare Innovation

    Hennepin County Partners:Hennepin County Medical Center (HCMC)NorthPoint Health & WellnessHuman Services and Public Health Department (HSPHD)Metropolitan Health Plan (MHP)

  • Population ServedMA Expansion in Hennepin County 21 - 64 year-old Adults, without dependent children in the homeAt or below 75% federal poverty level ($677/month for one person)Targeting ~10,000 members/monthStart date: January 2012 (two year demonstration project)

  • PremiseNeed to meet individuals basic needs before you can impact healthSocial disparities often result in poor health management and costly revolving door careBy coordinating systems and services, we can improve health outcomes and reduce costs

  • The Business CaseProblem:High need population Top 5% utilizing 64% of dollarsCrisis driven careSystem fragmentationSafety net - cost shiftingNeed:Address social disparitiesImprove patient outcomesIncrease system efficienciesIncrease preventive care

  • Population Characteristics~68% Minority status~45% Chemical Use~42% Mental health needs~30% Chronic Pain Management~32% Unstable housing~30% 1+ Chronic diseases

  • Goals: Years 1 and 2Decrease admissions/readmits by >10%Reduce emergency department visits by >10%Increase primary care touches by >5%Reduce churn. Maintain coverage by >95%

    Improve Residents Health Outcomes, Reduce Overall Costs

  • Finance model 100% at risk contract Partners share risk/gains Tiering approach Fee for Service pmpm with outcome contracts

  • System Opportunities (sample)5% utilizing 64% of health care fundsIndividuals stuck in hospital bedsIndividuals failing transitions between programsIndividuals misusing crisis care venuesSystem fragmentation and duplicationLow medical literacy

  • System Investments Year 1 (sample)

    InitiativeSame day dental care Care CoordinationData WarehousePatient Radar Reports

    Outcome>30% average cost reductions>50% hospital reduction - Tier 3Ability to see across systems Work prioritization

  • System Investments Year 1 (sample)InitiativePharmacy MTMHealth Plan/Provider recordSame day access to primary care

    OutcomeReduce medication costs >50%Near real time data, reduced duplication of effortsReduction of ED - crisis care

  • System Investments Year 2ProjectSobering Center Transitional HousingBehavioral Health ContinuumPsychiatric Consult modelIntensive primary care - clinic expansionVocational servicesReturn on Investment80% cost reduction ED to sobering centerOne month of housing < 2 days of hospitalization30 - 50% cost reduction expected

  • Where do we need to be?*

  • SIM and Health Care ReformSignificant opportunity in managing care

    Significant benefit in Systems (health plans, providers, public health) being on level playing field

    Systems motivated to shared outcomes - create huge opportunities (both health and savings)

  • ACO Models-ACOSingle PayerHospital(s)Provider System(s)

    ACOSingle PayerHospital(s)Provider System(s)

    Risks:

    Larger silos

    System fragmentation

    Competition vs. transparency/collaboration

  • DHS

    Geographic-Community model

    Risk:StandardizationComplexityGeographic Health GovernanceArea Providers ResidentsArea Hospitals

    Area Health PlansCommunity PartnersShared risk/gain partnership across systemsPublic Health

  • Health ReadinessCreation of collaborations who are your critical partnersEmphasis on tool box educationAssess current environment (position to fill the need)Services expandingServices shrinkingGaps in servicesReduction in duplication of effort

  • Existing Health CareFee-for-Service (do more, get more)Payer driven interventionsSystem response - we provide what they pay forSuccess = Structure, Workflows, standardization, program approach*

  • Future Health CareConsumer driven (choice and competition - quality matters/access matters)Payer - High Quality and Low Cost demandsSystem Response - smart health care- we provide what patients needSuccess = Innovation ~(non-traditional health care)Net clinics, E-Visits, Virtual teaming-consults Data driven, with return on investment (low cost, high health outcomes)Adaptive/Decisive leadershipMajor system changes, incremental/planned, nimble decision making Flexibility to meet patient needs (not program needs) in order to get quality outcomes at low costLean Processing Reduce waste (paperwork, interventions without value-add to patient outcomes)Streamline systems/Align leaders*

  • Hennepin Health Bringing systems and people togetherwww.hennepin.us/healthcareVideo and more information: www.hennepin.us/healthcare

    ************

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