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Different Strokes for Different Folks Matching Program to Community

Comments for Frontier Partners Meeting Washington, DC April 16, 2013. Different Strokes for Different Folks Matching Program to Community. Keith J. Mueller, Ph.D.

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Different Strokes for Different Folks Matching Program to Community

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  1. Comments for Frontier Partners Meeting Washington, DC April 16, 2013 Different Strokes for Different Folks Matching Program to Community Keith J. Mueller, Ph.D. Director, RUPRI Center for Rural Health Policy AnalysisHead, Department of Health Management and PolicyCollege of Public HealthUniversity of Iowa

  2. General Considerations • Population and Patient Payment • Elderly and disabled: Medicare • Low income: Medicaid • Veterans, American Indians and other systems • Privately insured • Uninsured • Could be trade-offs across payment policies

  3. General Considerations • Degree of isolation • Availability of health care workers of all types • Sources of non-patient revenue • Other?

  4. System Considerations • Capital investment: sources and repayment • Potential for system partners • Existing infrastructures and variability therein (two state examples)

  5. Alaska Healthcare Facility Locations Boroughs and Census Areas Legend PPS Hospital CAH Hospital Rural Health Clinic FQHC - Full time North Slope FQHC - Part time Northwest Arctic Indian Health Service Clinic Nome Census Other MD/DO Wade Hampton Census Dillingham Census Yukon-Koyukuk Census Fairbanks North Star Southeast Fairbanks Census Denali Matanuska-Susitna Valdez-Cordova Census Bethel Census Bristol Bay Anchorage Lake and Peninsula Kenai Peninsula Aleutians East Kodiak Island Aleutians West Census Yakutat Haines Juneau Sitka Wrangell-Petersburg Census Ketchikan Gateway Prince of Wales-Outer Ketchikan Census Produced by: RUPRI Center for Rural Health Policy Analysis, 2013

  6. Scale (miles) 100 0 200

  7. Scale (miles) 100 0 200

  8. Scale (miles) 100 0 200

  9. Additional Alternatives • Critical Access Hospitals • Rural Community Hospital Demonstration • Free-standing Emergency Departments • State Innovation Models Initiative • And more?

  10. Framework for Developing Alternatives • Inform: to help leaders create awareness of the need to change care delivery to deliver value to all stakeholders, and make that case locally • Assess: to understand strengths, needs, and capacity to build value in local health care environment

  11. Framework for Developing Alternatives • Prepare: to identify action steps based on organizational and community needs and capacity • Act: to select activities based on synthesis of assessments and discussion and then implement organizational and community change that creates value

  12. Actions • Improve: changes to current activities that optimize effectiveness • Enhance: modest changes to broaden and improve care delivery (one foot still on the dock) characterized by focused, limited, tactical, and low risk activities • Innovate: transformational changes with new structures and models characterized by broad, enterprise-wide, bold, and experimental activities

  13. For Further Information The RUPRI Center for Rural Health Policy Analysis http://cph.uiowa.edu/rupri The RUPRI Health Panel http://www.rupri.org

  14. Dr. Keith J. Mueller Department of Health Management and PolicyCollege of Public Health105 River Street, N232A, CPHB Iowa City, IA 52242319-384-3832keith-mueller@uiowa.edu

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