what community health planning offers to health care reform
Download
Skip this Video
Download Presentation
What Community Health Planning Offers to Health Care Reform

Loading in 2 Seconds...

play fullscreen
1 / 20

What Community Health Planning Offers to Health Care Reform - PowerPoint PPT Presentation


  • 84 Views
  • Uploaded on

What Community Health Planning Offers to Health Care Reform. Fran Weisberg Executive Director July 27, 2009. Presentation Overview . Health Care Reform & the States What is “Community Health Planning”? Elements of Community Health Planning Case Study: Community Health System 2020

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'What Community Health Planning Offers to Health Care Reform' - ivi


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
what community health planning offers to health care reform

What Community Health Planning Offers to Health Care Reform

Fran Weisberg

Executive Director

July 27, 2009

presentation overview
Presentation Overview
  • Health Care Reform & the States
  • What is “Community Health Planning”?
  • Elements of Community Health Planning
  • Case Study: Community Health System 2020
    • Finger Lakes Health Systems Agency
    • NYS Backdrop
    • The 2020 Commission
    • New York State Response to 2020 Commission
  • Community Health Planning & Health Care Reform
health care reform the states
Health Care Reform & The States
  • Federal Health Reform: Priorities
    • Increase health insurance coverage
    • Contain increasing costs
    • Increase access to high quality care
  • States’ Health Reform: Priorities
    • Increase health insurance coverage
    • Affordability of health coverage and services
    • Care that is of higher quality, greater value, and includes more preventive services
health care reform the states1
Health Care Reform & The States

Issues:

  • How, in a time of weak state revenues, to afford coverage for those who cannot afford coverage?
    • Massachusetts: Subsidized care at risk for legal immigrants
    • Maine: Tax for increased subsidies for Dirigo Care repealed by voter initiative, 11/08
    • BUT 13 states increase subsidies for children’s health coverage (NY Times, 7/19/09)
  • How to encourage the “right” mix of health services?
  • How to ensure health services are distributed to allow access to needed care?
health care reform the states2
Health Care Reform & the States

Additional State Health Reform Approaches

  • Improved public health initiatives to increase preventive services
  • Promoting evidence-based approaches
  • Realigning incentives with reimbursement reform
  • Constraining growth of health services and facilities

Examples from New York State to follow…

what is community health planning
What is Community Health Planning?

A structured approach to involving a

geographically defined community in an open public process designed to improve the availability, accessibility, and quality of healthcare services in their community as a means toward improving its health status.

  • Identify community needs
  • Assess capacity to meet those needs
  • Allocate resources
  • Resolve conflicts
elements of community health planning
Elements of Community Health Planning

Objective data

Structured analytics

Capacity analysis

Community engagement

Multiple stakeholders

Focus on community need over individual stakeholders’ priorities

Local input to state decision-making

case study community health system 2020
Case Study: Community Health System 2020
  • Finger Lakes Health Systems Agency
    • Birthplace of Community Health Planning
    • Prototype for NYS CON legislation in 1964-65, Federal legislation in 1966
    • Survived even when federal legislation expired in 1986, and when NY state funding ceased in 1995
    • Reinvigorated in 2006 with new emphasis on representing the community’s best interests
      • New model: Health Planning for the 21st Century
        • Data & Analytics
        • Capacity Analysis
        • Community Engagement
        • Reducing disparities
      • Strong relationship with NYS Dept. of Health
backdrop new york state
Backdrop: New York State
  • Berger Commission: Acknowledgement that market competition did not “right size” the health services system
  • New administration in Albany with mission to change “business as usual” in health care
  • Realigning incentives for primary and preventive care
  • Prevention Agenda: Improving community health and reducing disparities
backdrop new york state1
Backdrop: New York State
  • Increase coverage for vulnerable populations
    • Child Health Plus: Children in families up to 400% of Federal Poverty Level
    • Family Health Plus
  • Renewed emphasis on community health planning and rethinking approach to Certificate of Need
the 2020 commission
The 2020 Commission

Formed to review community need for new acute hospital beds in response to CON applications from 3 major health systems for 278 beds and facility modernization

Blue Ribbon Panel of Stakeholders: hospital trustees but not management, consumer, business, labor, regional representatives

The 3 CON applications reviewed as a “batch” rather than individually

Commission looked at the health care system regionally, not just from a single county perspective

Requested input from community, including providers, business, underserved, consumers

the 2020 commission1
The 2020 Commission

Recommendations:

  • 140 new acute beds (~50% of requested)
  • All modernization requests
  • Demand management initiatives to reduce use of inpatient care
    • Community Investment Initiatives
    • CON applicant hospitals participate with other community stakeholders
  • Trigger mechanism to fast track additional acute beds if demand management approaches fail to reduce need for inpatient care
community investment recommendations
Community Investment Recommendations
  • Decrease by 25%* preventable admissions for ambulatory sensitive conditions
  • Decrease by 15%* low acuity Emergency Department use
  • Decrease by 20%* low acuity admissions to CON applicant hospitals of residents from outlying counties
  • Establish goals that represent improvements in the metrics that quantify both health status and system effectiveness for the region, emphasizing reduction of health disparities among populations and increased overall system efficiency and quality
  • FLHSA to convene a new Task Force to provide leadership, guidance, and oversight for these initiatives, including developing the necessary funding mechanisms

* Preliminary Goals

new york state response to 2020 commission
New York State Response to 2020 Commission
  • Slight increase (+12) in the number of new acute beds approved within applicants’ CONs
  • Approved facilities’ modernization plans
  • Endorsed Commission’s Community Investment recommendations including linking hospital participation to CON approval
  • Promotes 2020 Commission as model of “new health planning”
    • Sees pairing of community investment with CON approval as an approach to ensuring health system meets community needs
2020 commission next steps
2020 Commission: Next Steps
  • 2020 Performance Commission convened by FLHSA to implement 2020 Commission’s Community Investment Recommendations
    • ED Use Work Group
    • Preventable Hospitalizations Work Group
    • Regional Community Health System Work Group
      • “2020 Commission” for the 6 counties in the region, including Monroe, but broader Finger Lakes focus
    • Other issues to include:
      • Workforce
      • Patient migration
      • Adequacy of primary and preventive care
community health planning health care reform
Community Health Planning & Health Care Reform
  • Ensures an independent entity that identifies community needs and objectively measures progress in meeting those needs
  • Ensures that all community stakeholders have a voice in determining need for health system resources
  • Since “health care is local”, ensures that local perspective will be heard at state and federal levels
  • Uses CON as a tool to shape the healthcare system to encourage better distribution of health care resources and thus reduce geographic disparities
community health planning health care reform1
Community Health Planning & Health Care Reform
  • Works to constrain unfettered growth of health system resources will aid in containing costs
  • Links health services capacity to community needs to promote investment in resources that will benefit community health
  • Bridges health system improvements with enhancing public health
is community health planning a realistic option in health reform
Is Community Health Planning a Realistic Option in Health Reform?
  • 38 States still have some form of Certificate of Need
  • Public health assessments are already closely linked with determination of community need
    • H1N1 Flu demonstrates the link between public health and health system resources
  • As cost savings are sought, community health planning may offer a credible way to “optimize” healthcare service system growth
is community health planning a realistic option in health reform1
Is Community Health Planning a Realistic Option in Health Reform?
  • Rochester, as the model, offers an example to those shaping federal health care reform:
    • Because health care is ultimately a local concern, ensures communities participation and input into their own health delivery system
    • Using CON as a tool in capacity planning
      • Promotes a delivery system designed to meet the needs of the community, especially the underserved
      • Emphasize the importance of primary and preventive care
      • Appropriately constrains health system costs by keeping health system capital costs in check
      • Saves on operating costs by designing a system without excess capacity to maintain
slide20

Finger Lakes Health Systems Agency

The triangle represents our agency’s role as a fulcrum—the point on which a lever pivots—boosting the community’s health by leveraging the strengths of all stakeholders. The fulcrum is also a point of equilibrium, reflecting our ability to balance the needs of consumers, providers and payers on complex health matters. The inner triangle also evokes the Greek letter delta—used in medical and mathematical contexts to represent change—with a forward lean as we work with our community to achieve positive changes in health care.

Give me a lever long enough and a fulcrum on which to place it,

and I shall move the world. —Archimedes

1150 University Avenue • Rochester, New York • 14607-1647

585.461.3520 • www.FLHSA.org

ad