2017 & 2018 – new member employers• +20 outreach and enrollment events • “crowd...
TRANSCRIPT
2017 & 2018 –
New Member Employers 2017 2018
• Almon, Inc. • American Metal Technologies • Bemis Manufacturing Company • Inlanta Mortgage, Inc. • Krones, Inc. • Nordco, Inc. • Oldenburg Group, Inc. • Wisconsin Aluminum Foundry
Company
• Associated Banc-Corp. • The Bon-Ton Stores, Inc. • Goodwill Industries of North
Central Wisconsin, Inc. • Goodwill Industries of
Southeastern Wisconsin, Inc. • Kohler Co. • Reinhart Partners, Inc. • Sendik’s Food Markets
And significant growth expected throughout 2018 and for 1/1/19
Today’s Agenda
2:30-2:35 Welcome 2:35-2:40 Mary Ellen Stanek, Baird – Opening Remarks 2:40-3:30 Julie Schuller, M.D., Sixteenth Street Community Health Centers Joy Tapper, Milwaukee Health Care Partnership 3:30-4:10 John Prince, OptumRx 4:10-5:00 Peer-to-Peer Networking
Business Health Care Group
March 21, 2018
Mission
The Milwaukee Health Care Partnership is a
public/private consortium dedicated to improving
health care for low-income, underserved populations
in Milwaukee County, with the aim of improving -
– health, – reducing disparities, – and lowering the total cost of care.
Members 4 Health Systems
• Ascension WI • Aurora Healthcare • Children’s Hospital & Health System • Froedtert Health
5 Federally Qualified Health Centers (FQHCs/Community Health Centers)
• Gerald Ignace Indian Health Center • Milwaukee Health Services, Inc. • Outreach Community Health Centers • Progressive Community Health Centers • Sixteenth Street Community Health Centers
Public Health Agencies
• City of Milwaukee Health Dept. • Milwaukee County Dept. Health & Human Services • WI Dept. of Health Services and Medicaid Office
Academic
• Medical College of Wisconsin Affiliates: Wisconsin Hospital Association, Wisconsin Primary Health Care Association, Medical Society of Milwaukee County, Wisconsin Statewide Health Information Network (WISHIN), Free Community Clinic Collaborative (FC3), Others
Milwaukee County Population Profile
2017County Health Rankings Who is Vulnerable? Milwaukee County’s rank among 72 Counties
Quality of Life 72
Overall Health 71
Health Behaviors 71
Socioeconomic Factors 71
Length of Life 66
Clinical Care 45
Milwaukee County Population 957,735 Nearly 20% of residents live at or
below the federal poverty level
33% are enrolled in a Medicaid program
46% of children are covered by Medicaid
Between ~7% of the population is uninsured at any point in time
Health Disparities
50
55
60
65
70
75
80
2012 2013 2014
Age
in y
ears
Milwaukee County Average Age of Death by Race/Ethnicity
White
Black
Hispanic
American Indian
Asian
Secondary Data Report: Wisconsin Interactive Statistics on Health (WISH) dhs.wisconsin.gov/wish/ mortality
Core Functions
1. Assess & build awareness of community health needs
2. Implement a community wide plan and policy agenda*
3. Secure and align public and private funding and invest in high- impact initiatives
4. Monitor and report outcomes
5. Serve as a clearing house for new initiatives
*Improve efficiency and effectiveness by reducing duplication, fragmentation of efforts and cost
Goals
1. Secure adequate and affordable health insurance coverage for all
2. Increase the availability and accessibility to health care programs and services
3. Enhance care coordination and navigation within and across health and social care delivery systems
4. Address targeted community health issues via cross-sector collaboration
ACTIVITES & ACCOMPLISHMENTS
• +75 Organizations
• >160 Enrollment Assisters and Insurance Navigators
• +20 Outreach and Enrollment Events
• “Crowd Funding” for Community Marketing Campaign
Sources of Insurance in Milwaukee County 2017
Nationally Recognized Enrollment Coalition
Milwaukee Enrollment Network
Uninsured in Milwaukee County
17,769
41,820
22,202
39,422
24,913
15,861
33,802
Quarterly Coverage Report October 2017
55,667
23,768
22,202
11,512
39,442
28,058
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
2013 2016
≥ 2.00 FPL 1.38 to 1.99 FPL < 1.38 FPL
Post - ACA 6.8%
117,311
63,338
46% Reduction in the Uninsured Rate
Pre- ACA 12.6%
13
Primary Care Access Study Highest Poverty Zip Codes accounted for: • 45% of total county population
• 71% of the county’s Medicaid
and uninsured population
• 27% of total primary care physicians
• 60% of primary care treatable ER visits
Primary Care Access
FQHC Growth Plan Build the capacity and
capabilities of Milwaukee’s Community Health Centers
Invest in New Access Points
Support operational improvements, efficiencies, collaboration and shared services
Access Organized and Supported Other Safety-Net Clinics
+25 Free Medical Clinics; 38 other Safety Net Clinics reported 510,472 patient visits in 2016.
Specialty Access for Uninsured Program
ACCESS Behavioral Health • Advancing MKE County BHD Redesign • Investments and Expansion in
Outpatient Care • Expansion to Psychiatric
Teleconsultation Services Expansion
Oral Health • Embed Hygienists in Primary Care
Settings • Expand Seal-A-Smile program in high risk
schools • Improve access for Special-Needs
Dentistry
Goal: Decrease avoidable ED visits and connect to Primary Care and other health resources.
Care Coordination Emergency Department Care Coordination
ED to Health Home Program • +55,000 referrals since
2009; ~500 patients per month
• 45% show rate; 55% stick rate
• 44% decrease in ED visits once connected
Collaborative Community Health Improvement Priorities
Leveraging Investments
Shared Community Investment Fund (SCIF) Health Systems’ Strategic Funding Pool
Total Investments: $26.6 million
MHCP/ United Way Health Improvement Fund (HIF) “Challenge Grant” Total Investments: $2 million
Other Extramural Funding Total Raised: $5.9 million
More than $32 million in aligned funding to improve access, reduce disparities and slow the rate of increase in the cost of care in Milwaukee.
Greater Milwaukee Business Foundation on Health Medication Access • $185,832 in GMBFH grant funding over 7 yrs. to support prescription assistance program:
Served 5,717 unique patients
Filled 30,943 prescriptions
Provided medications at an average wholesale value of $37,285,106
ROI = $201 in Rx cost savings for every $1 contributed Health Information Exchange • $164,000 grant enabling the connection of 8 largest safety-net clinics to WISHIN Coverage • $300,000 commitment from 2018 – 2020 to strengthen and sustain insurance enrollment assistance
Impact on Payers and Employers Supporting enrollment, ensuring timely access to the “right” care and improving overall population health benefits payers and employers Securing Coverage and Access to Care for Working Poor
– Estimate > 50% uninsured are employed – 78% of Medicaid beneficiaries live in a family with at least one working family
member; 60% of adult Medicaid enrollees are employed full or part time
Reducing Cost-Shifting – Reducing charity pass- through – Reducing Medicaid uncompensated care – “Hidden Tax” – Medicaid Tax-Payer Value
Building a Safer, More Productive, and Prosperous Community – Preventing and addressing illness, chronic disease and disabilities – Supporting the development of a healthier workforce
Sixteenth Street Community Health Centers Over 45 years of quality, patient-centered, family- based
healthcare and supportive services
What is a Community Health Center (CHC)?
For over 50 years, HRSA-supported community health centers have provided comprehensive primary and preventative health care services – which means • Medical • Dental • Behavioral health • Substance use care • Connections to social services
Community Health Center Requirements
• Have a 51% patient-majority board of directors
• Be located in/serve a medically underserved area or population
• Apply for and receive competitive HRSA grants for continuation
• Comply with HRSA 19 program requirements • Demonstrate compliance through routine
HRSA operational site visits
To improve the health and well-being of Milwaukee and surrounding communities by providing quality, family-based health care, health education and social services, free from linguistic, cultural and economic barriers.
Our Mission
Our History • Since 1969, Sixteenth Street Community Health
Centers has been a community leader in primary health services for our city’s most vulnerable residents
• Our reputation for compassion, innovation and quality is both locally and nationally recognized
• An independent non-profit agency, Sixteenth Street now operates at six locations, including three full-service medical clinics and a Women, Infants & Children (WIC) nutrition program
• Since 1969, Sixteenth Street Community Health Centers has been a community leader in primary health services for our city’s most vulnerable residents
• Our reputation for compassion, innovation and quality is both locally and nationally recognized
• An independent non-profit agency, Sixteenth Street now operates at six locations, including three full-service medical clinics and a Women, Infants & Children (WIC) nutrition program
Our Board of Directors Rick Walters Board Chairman Wells Fargo Advisors LLC
Lauren Lopez Milwaukee Public Schools
Laura Arnow, CPA Treasurer Arnow & Associates
Teresa C. Mercado Mexican Fiesta/WHSF
José Avila, MSN, FNP Ellen K. Murphy, J.D. UWM School of Nursing
Thomas M. Gazzana Vice President
Juan Ruiz Secretary United Community Center
Wayne F. Heidenreich, MD Northwestern Mutual
Suzanne Sanicola, CPA Ascension Wisconsin
Kathryn Hein Les Aspin Center for Government
Levi Sosa
Steven K. Kulick, MD ProHealth Care, Inc.
Rick Walters Board Chairman Sixteenth Street Patient
8 of our 13 members are patients
Our Practice Sites Milwaukee
• Chavez (full service clinic) • Parkway (full service clinic) • Layton (full service clinic – focus on
behavioral health and AODA) • United Community Center – Senior
Center (geriatric care) • St. Anthony in-school clinics • St. Augustine Prep in-school clinic • Greenfield Building (WIC location among
other services)
Waukesha
• Sixteenth Street – Waukesha (full service clinic)
Our Patients
Our patient population is extremely diverse, representing many cultures, ethnicities and economic backgrounds.
Our Patients
85%
24% 13% 8%
5% 4%
65%
12%
3%
71%
29%
Our Impact In 2016 Sixteenth Street served nearly 38,000 people,
in more than 160,000 individual visits.
Our Impact
Our Quality Story • Sixteenth Street has been accredited by the Joint Commission
since 2010, and passed our last two unannounced Joint Commission audits in 2012 and 2015
• In 2013 we received recognition as a Level 3 Patient Centered Medical Home (PCMH) by the National Committee on Quality Assurance
• In 2016 we were accredited as a Joint Commission Primary Care Medical Home
• We are part of the Wisconsin Collaborative for Healthcare Quality, an organization that aggregates and publishes health care quality information
Key Quality of Care Indicators
Trimester of Entry into Prenatal Care 74% of patients entered prenatal care in the first trimester Childhood Immunizations 92% of children under age two were up-to-date with immunizations Cervical Cancer Screening 71% of women were screened for cervical cancer
Hypertension under Control 74% of patients had their hypertension under control
Diabetes under Control 74% of patients with diabetes had A1c levels under 9
Low Birth Weight 93% of babies delivered by Sixteenth Street providers were at or above normal birth weight
Operations | Coordinated Care for the Whole Person
• We operate within a fully integrated model of primary care, behavioral healthcare, social services and supplemental services all on-site.
• Every added service requires an in depth discussion about cost and sustainability.
• We have to be very disciplined about what is and isn’t within our cost model.
Primary Care | Team-Based Care On site collaboration between providers, case managers, outreach workers, social workers, support staff, within and across medical and behavioral health departments. Staff of all levels work to the top of their license creating cost efficiencies.
Primary Care | Medical and Behavioral Health Services Medical Services • Pediatrics • Family Medicine • Internal Medicine • Midwifery • Women’s Wellness (Prenatal and
Pediatric Nurse Case Management) • Chronic Care Education
Outpatient Behavioral Health Services • Psychology • Psychiatry • Psychotherapy • Marriage & Family Therapy • AODA (Waukesha and Layton only) • MAT (Waukesha and Layton only) • Child and Adolescent Day Treatment (Layton
Only) • ADHD Testing (Waukesha only)
Primary Care | Pediatrics
We offer the highest quality care and treatment of infants, children, and adolescents. With 49% of our patients being under the age of 18, we care for over 18,000 pediatric patients per year.
Primary Care | Internal Medicine
We provide long-term, comprehensive care managing both common and complex diseases.
Primary Care | Family Practice
We offer continuing and comprehensive health care for individuals and families of all ages.
Primary Care | Midwifery & Women’s Wellness
We provide a personalized focus on women’s health issues including disease prevention, reproductive health, birth and delivery services, support groups, case management, parenting classes and child enrichment activities.
Behavioral Health
Psychiatrists, psychologists and family therapists provide individual and group therapy sessions and medical management for adults and children. They also help clients better manage stress, chronic illness and pain, abuse, neglect issues and depression.
Integration of Medical and BH Services • Collocation of behavioral health providers on the same floor • Behavioral Health providers able to immediately address mental health concerns
during primary care visit • Short sessions focus on intervention and relief • Reach patients early Collaboration and immediate care is key for preventing behavioral health
issues and giving our patients the coordinated care needed to put them in control of their health.
Primary Care | Supplemental Services • WIC (Women, Infants & Children
Program) • Social Services • Parenting Resource Center • Environmental Health Department • HIV Services • Healthy Choices (obesity prevention
program) • Women’s Wellness (prenatal and pediatric
case management, Obstetric Medical Home Initiative)
Support Services| WIC (Women, Infant & Children) Nutrition Program
We ensure the health and wellbeing of children and families by providing nutrition education, health screenings, breast feeding counseling, food vouchers and other support services.
Support Services| Healthy Choices
Through family education and community advocacy, Healthy Choices strives to improve the home and neighborhood environment for adults and children in Milwaukee’s Southside, so they can enjoy a healthier life.
Support Services| HIV
Sixteenth Street’s HIV program provides a comprehensive approach, including medical care and treatment, supportive case management and prevention education for Milwaukee’s Latino population.
Support Services| Parenting Resource Center
We offer proper car seat usage classes, parenting classes, the child enrichment program and the Stork’s Nest (Wisconsin Chapter of the March of Dimes) to our Sixteenth Street parents.
Support Services| Social Services
Our Social Services department provides crisis intervention, counseling, advocacy, education, health insurance enrollment assistance, referral to community resources and case management services to our patients, their families and the community at large.
Support Services| Environmental Health
The Department of Environmental Health promotes education, community activities and advocacy for neighborhood development and sustainability, in addition to comprehensive lead outreach and testing. It helps families live safe from lead poisoning, contaminated waters and other hazards.
Support Services| Chronic Condition Health Education
We provide prevention, intervention and support for patients managing asthma, diabetes and hypertension. Offering individual and group education, support groups and outcome- based care management.
Outreach Many departments within Sixteenth Street are actively out in the community to connect with and educate residents around prevention and maintenance to care.
• HIV outreach, education and prevention efforts
• Chronic Conditions (Diabetes and Asthma) outreach, education and prevention efforts
• Healthy Choices outreach, community advocacy, obesity education and prevention efforts and maintenance
• Prenatal and pediatric case management
• HIV case management
Enrollment Eligibility and Enrollment Into Coverage • Every patient is evaluated for eligibility
• Specialists help determine if a client may be eligible and assist with enrollment into Badger Care Plus including coverage for children, families, childless adults and express enrollment for qualifying pregnant and child cases
• Sixteenth Street submits applications to the state and the state makes determinations on the case
CHCs| Community Value
Large financial contribution to the health care system as a whole Cost effective care – saving the health care system millions Stimulate local economy
In 2016, the five CHCs in Milwaukee received $13.3 million in federal grants to care for un- or under-insured patients and wraparound services
CHCs| Financial Contribution
Source: Wisconsin Primary Health Association
CHCs| ED and Cost Effective Care ED and UC Visits • Keep people out of ED and UC for non-acute issues
– Nationally, 69% of ED visits among the general population are primary care sensitive in nature and therefore preventable
– Average expense for an ED visit= $978 – Average expense for a health center visit = $150 – Average TOTAL ANNUAL EXPENSE for a health center patient = $687
Cost effective care • Health centers’ average cost runs a dollar less per patient per day compared to all physician
settings (while typically serving more complex patients that are more likely to have chronic conditions)
• Health centers save over $24 billion for the healthcare system annually
CHCs| Stimulate Local Economy
FTEs at health centers in Milwaukee Operating expenditures directly into local economies
* 2015 UDS
707
$75 MILLION
Community health centers are economic engines. • Create jobs • Increase business for surrounding
companies • Take an active part in improving
their surrounding environment
Sixteenth Street Community Health Centers Over 45 years of quality, patient-centered, family- based
healthcare and supportive services