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Sharon Moffatt RN MSN Acting Commissioner of Health November 6, 2006. The Vermont Blueprint for Health…. … gives people with chronic conditions the information, tools and encouragement they need to be successfully to manage their health. Why is change needed?. Growing health care costs

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sharon moffatt rn msn acting commissioner of health november 6 2006
Sharon Moffatt RN MSN

Acting Commissioner of Health

November 6, 2006

the vermont blueprint for health
The Vermont Blueprint for Health…
  • … gives people with chronic conditions the information, tools and encouragement they need to be successfully to manage their health
why is change needed
Why is change needed?
  • Growing health care costs
  • Vermont health care costs  11.5%
  • from 2001
  • Vermont Medicaid expenditures 13.4 %
  • since 1997
  • All insurers expenditures  9.2%
  • since 1997
cost of chronic conditions is both personal and financial
Cost of Chronic Conditions is both Personal and Financial

Care for people with chronic conditions accounts for:

83% of health care spending

81% of hospital admissions

76% of all physician visits

91% of all prescriptions filled

the cost of obesity
The Cost of Obesity
  • One-third of total direct health care costs in the U.S. are related to
  • 15 Diseases Associated with Obesity
  • Medical expenses attributable to
  • Adult Obesity inVermont
  • 141 Million Annually
vermont obesity trends
Vermont Obesity Trends
  • 53% of Vermont Adults are
  • obese or overweight

OR

226,615 Vermonters are

above

a healthy weight

reducing diabetes deaths options
Reducingdiabetes deaths: options

Deaths Per Thousand Adults

2.50

No Change

Better Care

2.25

Obesity

Prevention

2.00

1.75

1.50

1.25

1980

1990

2000

2010

2020

2030

2040

2050

Time (Year)

reducing diabetes deaths comprehensive approach

2.50

2.25

2.00

1.75

1.50

1.25

Reducing diabetes deaths: comprehensive approach

No Change

No major changes – status quo

Obesity Prevention and Better Care

Care and reduction in caloric intake

1980

1990

2000

2010

2020

2030

2040

2050

Time (Year)

Deaths from complications–per thousand Adults

vermont blueprint
Vermont Blueprint
  • A system of care that enables Vermonters to lead healthier lives
  • A system of care that is financially sustainable
  • inable;and,
  • A public-private partnership
  • that sustains
  • the new system of care
social ecological model
Social Ecological Model

Public Policy

  • Behavior change influenced at all levels

Community

Organizational

Interpersonal

Individual

vermont blueprint model for health

Blueprint Partnership

Vermont Blueprint Model for Health

Community

Public Policy

Public Health

  • Built Environment
  • Health Services
  • Health Awareness
  • Healthy Options
  • Information
  • Systems

Patients and

Families

Healthy

Vermonters

  • Policies
  • Infrastructure
  • Financing
  • Resources
  • Advocacy
  • Regulation
  • Information
  • Systems
  • Health
  • knowledge
  • Self-manage-
  • ment skills
  • Supportive
  • home
  • environment
  • Information
  • Systems

Health

Systems

  • System policy
  • Quality care
  • Reimbursement
  • Financing
  • Continuity
  • Coordination
  • Information
  • Systems

Health

Provider Team

  • Practice standards
  • Office Systems
  • Support
  • Information
  • Systems
blueprint for health fy 06

Self Management

  • 6 Master Trainers
  • 45 Instructors
  • 200 participants
  • (200 more by 6/30)
  • 15 towns
  • 5 VDH staff
  • Community Services
  • 5 Communities
  • 10 District offices
  • 18 towns-physical activity
  • VT-211 in 2 pilot communities
  • 28 VDH staff participate
Blueprint for Health—FY 06
  • Information
  • Systems
  • VHR to practices
  • Registry Selected
  • Practice needs
  • Analysis
  • 4 VDH staff
  • Provider Practice
  • Pilots:
    • 19 Practices
    • 45 Providers
    • 1200 patients
  • Others: 20 practices
  • 1VDH staff (PT)
  • Health Systems
  • Disease Management
  • Report
  • Pay 4 Performance
  • (study started)
  • 1 VDH staff (PT)
healthy living participants medical care
Healthy Living ParticipantsMedical Care

Both visits to a doctor’s office and visits to the ED went down significantly at six and 12 months

MD Visits

ED Visits

daily activities
Daily Activities
  • For many participants, after 12 months, their health condition does not interfere with their daily activities such as social activities with friends, hobbies, recreational activities and household chores.
physical activities and abilities
Physical Activities And Abilities
  • There is an increase in the number of participants who are able to walk at least 30-60 minutes a week.
  • Many report having no difficulty walking outdoors, dressing themselves, and picking up clothes from the floor
resources references
Resources/References
  • The Chronic Care Model: Improving chronic illness care a national program of The Robert Wood Johnson Foundation, www.improvingchroniccare.org
  • Wagner, E.H. Chronic Disease Management: What will it take to improve care for chronic illness? Effective Clinical Practice 1998;
  • 12-4.
resources references23
Resources/References
  • The Model for Improvement by the Institute for Health Improvement www.ihi.org
  • The Quality of Health Care Delivered to Adults in the United States. New England Journal of Medicine 2003, 348:26.
best practice guidelines
Best Practice Guidelines
  • Agency for Healthcare Research and Quality www.guidelines.gov
  • Institute for Clinical Systems Integration www.icsi.org
  • American Diabetes Association www.diabetes.org
  • American Heart Association www.americanheart.org
vermont blueprint for health
Vermont Blueprint for Health
  • www.healthvermont.gov