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What top five i nterventions would you support to achieve the triple aim of better care, better health, lower cost?. Leveraging the Community Benefit Requirements of the Affordable Care Act for Collective Impact: The Atlanta Regional Collaborative for Health Improvement (ARCHI ).
Leveraging the Community Benefit Requirements of the Affordable Care Act for Collective Impact: The Atlanta Regional Collaborative for Health Improvement (ARCHI)
Grantmakers in Health
March 7, 2014
Changes in Private Coverage
Improving Health Care Quality
Led by United Way, ARC, and Georgia Health Policy Center
Funders (CDC, Kaiser, St. Joseph’s Healthcare, Grady, and the Lead Organizations)
Public Health, Hospitals, FQHCs, Physicians, Behavioral and Other Providers
Funders (CDC, Kaiser, etc.)
Business, Education, County Commissioners, Faith Leaders, Insurers, Philanthropy
How can we work together to solve complex problems in a complex world using technology that helps us see, understand & talk about the real problems and develop sustainable solutions…
Seeding Innovations in Health
1959 – We have long known that health care facilities should be adapted to the patients rather than the opposite.
1967 - To avoid becoming sick may be the greatest health and medical challenge to contemporary society.
1968 - Sooner or later some group will find out how to build, organize and operate a hospital which will be better and more flexible than at present, and at a lower cost.
1968 - The greatest opportunity people have to achieve and maintain good health and well-being, at the lowest possible cost, is by their own intelligent methods of daily living habits.
1969 - We need to develop a health care system which will be recognized as distinct from medical care. This is a real key to solving our “medical problem.”
1969 - We must have substantially new manners of thinking to enable mankind to bridge the gap between the things that have been and the things which will be.
A Collaborative Initiative of the Rippel Foundation
… work with leaders to demonstrate that sustainable redesign of regional health systems is possible and can improve health, care, costs, equity, ownership, productivity, regional economies, and communities vitality.
Better health, better care, lower costs and access for all
Collaboration by leaders across boundaries (in and out of health)
Whole system thinking
Redesign to meet health and care needs
National purpose, local action
Bring system stakeholders together in a way that builds trust, shared vision, and collaborative action.
Build purposeful and effective stewardship teams that can sustain efforts and achieve measurable results over time.
Assure that health resources are being spent to achieve the greatest impact.
Align community priorities with health system priorities.
Finance and sustain efforts long enough to see real results and avoid rebound experiences.
Support innovation, implementation, and system redesign in ways that achieve high impact goals and build critical interdependencies.
Educate leaders to have a whole system and collaborative perspective.
Engage in action-research
Develop and share lessons, tools, approaches
Stewardship Teams Exploring Simulated Scenarios
in Strategy LabsREDIRECTING HEALTH FUTURES
U.S. National Health Expenditures (1998-2020)
$ in Billions
Keehan SP, Cuckler GA, Sisko AM, et al. National Health Expenditure Projections: Modest Annual Growth Until Coverage Expands And Economic Growth Accelerates. Health Affairs 2012.
Heffler S, Smith S, Keehan S, Borger C, Clemens MK, Truffer C. U.S. health spending projections for 2004-2014. Health Affairs 2005:hlthaff.w5.74.
Hard to see the bigger system and where things/we fit
Stakeholders see different problems and solutions
Stakeholders speak different languages
Don’t recognize that not all solutions are equal – good / bad
Real conversations about money, priorities, strategy, etc. are difficult
Alignment from the community to policy levels is challenging
Pressure for short term results with limited evidence for better planning
System is complex and hard to predict
Consider Many Pathways
Engage in Deeper Dialogue
Anticipate Consequences and Plausible Futures
ReThink Health. Summary of the ReThink Health Dynamics model.
Available at http://rippelfoundation.org/docs/RTH-Dynamics-Model-Summary.pdf
Selected Geographic Focus
Productivity & Equity
Population tracked separately in 10 segments by age, insurance, and income
What can we do?
Are we doing the right things now?
What should commit to do?
Do we have the right partners engaged?
How do we pay for it?
How proud would we be to succeed?
What is our plan going forward?