An Update On Public Health: Integrating Public Health And .

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An Update on Public Health:Integrating Public Health andHealthcare from Planning toImplementationAndrew Wapner, DO, MPHDirector, Center for Public Health PracticeAssistant Professor – PracticeOSU College of Public Health2014 Update, Mirror, Mirror On The Wall: How the Performance of the U.S. Health Care SystemCompares Internationally. Commonwealth Fund, June 20141

What will the newly insured look like?“We cannot afford to perpetuate a systemthat pressures clinicians to chase outcomesfor problems that originate far beyond theirreach. We must pursue transformation thataligns public health and primary care”Brian Castrucci, Chief Program and Strategy Officer at the deBeaumont Foundation; from Primary Care and Public Health: APartnership to Change America's Health. Huffington Post,March 28, 20152

tions-Model-Testing-Round-Two/ Episodes ofCare Expansion ofPatientCenteredPrimary Caremodels AligningPopulationHealth Planning3

Episodes ofCare Expansion ofPatientCenteredPrimary CareModels AligningPopulationHealth Planning4

conduct a community health needsassessment (CHNA) and adopt an animplementation strategy at least onceevery three years. (These CHNArequirements are effective for tax yearsbeginning after March 23, 2012).5

HPIO Policy Brief: Makingthe most of communityhealth planning in Ohio.The role of hospitals andlocal health departments.May 20156

HPIO Policy Brief: Making the most of community health planning in Ohio. The role of hospitals and local healthdepartments. May 20157

Public healthfunding8

Regional variationin public healthservicesAn Update on Public Health:Integrating Public Health andHealthcare from Planning toImplementationTim IngramHealth CommissionerHamilton County Public Health9

Using Collaboration andthe Collective ImpactProcess to Achieve theTriple AimBetter Health, Better Care, and Lower CostsinGreater Cincinnati AreaWhat is the Practical Playbook?A cornerstone of the next transformation of health, inwhich health care and public health groups workcollaboratively to achieve population healthimprovement.www.practicalplaybook.org10

What Can Collaboration Offer?Public Health Data and AnalyticsReachImpact on Root Causes of HealthPromotionPolicy InfluenceHealth Care InformationAccess to PatientsCredibilityInnovationCommitmentStrengths Public Health Can Bring to thePartnershipData/AnalysisPromotionReachRoot CauseImpactPublic PolicyInfluence11

Strengths Health Systems Can Bring to thePartnershipElectronic MedicalRecordsCommunity VisibilityThe Patient-CenteredMedical HomePersonal Relationships& Patient AccessA Role for EveryoneHealth Care Clinical ProvidersBilling SystemData on PatientsData WarehousingPublic HealthOther Partners Insurance Portal to othercommunity agencies Providers Epidemiological data Social Services Health educators and Mental HealthnutritionistsServices CommunityAdvocates /Councils12

Principles of Collective ImpactCommon agenda reached thoughmulti-stakeholder consensusPartnerships with alignment ofmutually reinforcing activities ledby a Backbone OrganizationShared Measurement andAccountability for Improvement13

Small number of doable things that incombination have power to impact the triple-aim123IMPROVED POPULATIONHEALTHThe Value of the ReThink Model Shared Understanding of Possible initiatives Outcomes over time Cost of effort14

3 Action AreasHealthyBehaviorsCareDeliveryFinance &PaymentBold Goals 50% Reduction in Disparities Commitment to a Cost Goalof thecommunitywill reporthaving a usualandappropriateplace to go formedical care52%82%15

Health Status by theNumbersAll AdultAfricanAmericanAdultTotal Adultbelow 200%FPLCurrent767,00084,000180,000To goal52%* 266,00046% 37,00032% 129,00070%67%55%EX or VGHealth50% reductionin disparitiesBarriers to Excellent or Very Good Health (self reported) Chronic Disease Poor diet and exercise Weight Barriers to healthy choices attributable tosocioeconomic determinants of health*63% above 200%FPLAccess by the NumbersRegular andappropriatesource of careAll AdultAfricanAmericanAdultTotal Adultbelow 200%FPLCurrent1,210,000138,000393,000To goal82% 191,00076% 49,00070% 123,00095%92%89%50% reduction indisparitiesBarriers to Access (self reported) Insurance status Out of pocket expense Transportation1475,000 adults 182,000 African Americans 562,000 below 200%fpl16

3 Action AreasHealthyBehaviorsHealthyBehaviorsEmpowerpeople to: Eat Healthy Move More Smoke Less ManageStressCareDeliveryCare Delivery Address barriers toaccess Improve control andreduce prevalence of: Obesity Hypertension Diabetes COPD Improve clinical andcommunity linkagesFinance &PaymentFinance & PaymentRank in the lowest spendingquartile for comparablecommunities. Reduce unnecessary andwasted care Emphasize primary care basedcoordination of care Empower patients to choosebased on quality andaffordability17

Position StatementGood health empowers our humanpotential and improves our quality of life.When health is accompanied by sharedaccountability for efficient delivery andconsumption of health care, it driveseconomic prosperity for individuals and forour region.18

Director, Center for Public Health Practice Assistant Professor – Practice OSU College of Public Health An Update on Public Health: Integrating Public Health and Healthcare from Planning to Implementation 2014 Update, Mirror, Mirror On The Wall: How the Performance of the U.S. Health Care System Compares Internationally.

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