snohomish co. health leadership coalition

UW Foster School of Business / Premera

Economic Disruption in Healthcare II

Anatomy of a Crisis…

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30

25

20

15

10

5

0

Perc

en

t o

f

GD

P

1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080

Year Projected Tax

Revenues

Actual Projected

Interest on the debt

All other non-interest spending

Social Security

Medicare, Medicaid, CHIP, Exchange Subsidies

Source: CBO and George Mason University © 2012 Premera / Scott Forslund (425) 918-5070

Our Challenges

Health Threat

Healthcare Cost Threat

Economic Threat

Growing Faster in

Snohomish County

Coalition Steering Committee

Status Review: 2013-15 Strategic Plan

Strategic Goals

Form coalition, set direction, create organizational structure and

formally launch

Build awareness, interest and appetite for support through

coordinated communication and outreach

Successfully execute first two proof-of-concept initiatives: youth

activity and palliative care

Set stage for expansion into new initiatives and replication of model

across state and region

Palliative Care

Initiative

Coalition Palliative Initiative: 3-Pronged Approach

2. Integrate existing community efforts (local, multi-state collaboration)

3. “Sector” strategy – community-based, self-sustaining models

1. Combined consumer and physician/ARNP education

2013-14 Measurable Objectives

First Focus on Advanced Planning

Convene organizations around a mutual goal to educate 1,500

Consumers

20% (300) advanced directives generated

CME-education for 130 Physicians (plus ARNPs, etc.)

23% of physicians in relevant specialties

Create a 1:4 scale model – community-based, self-sustaining

Integrate diverse efforts of multiple players

Demonstration models in >2 sectors: faith community & senior services orgs

Community-Set Desired Outcomes

• Identify relevant personal values & goals if facing

a life threatening illness

• Understand common life-sustaining treatments,

palliative care, hospice

• Identify your preferences for medical care

• Understand this requires communication,

documentation, and advocacy

• Take specific actions to ensure EOL care will

reflect personal valuesDemographics, contact information

• Received opportunities to address questions in class and supplemental

support (including spiritual assistance) as needed following the class.

Youth Activity

Initiative

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Strategic Objectives

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What This Initiative Aims to DeliverH

YS

Activity/H

ea

lth

Me

tric

s

Grade 5 Grade 6

Current path

Desired results

Partnering Organizations

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What the kids see…

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Fifth Graders’ View

“Grown-up” view of engagement, variation

A closer look…

Multi-channel Engagement Strategy:

• Gear Up & Go! Community

Collaboration

• Sqord platform expansion

Feature roll-outs

Real-time feedback integration

Participation…Engagement…Potential!

Avg Daily Activity Points

• School district activity levels vary by up to 30%• Classroom activity: top quartile has 2-3x the activity of bottom quartile

Early data shows promise – strong overall activity levels AND significant variation suggesting many ‘best practices’ to share

2013-14 Approach and Timeline

Oct 2013 June 2014Jan 2014

Participation

Insights & Collaboration

Engagement

Wave 1: 7,000 students, 900 staff

Wave 2: 2,300 students, 300 staff

Oct 2014

Wave 3: Summer/Community

HYS 2014

Feb 2014 Dec

Build community

My school My districtMe, my class

Evaluation PartnershipAllen Cheadle, Director

Center for Community Health Evaluation

Group Health Research Institute

Tao Kwan-Gett, MD, MPH, Director

Northwest Center for Public Health Practice

UW School of Public Health

Coalition Analytics Committee co-chairsGary Goldbaum, MD, Director, Snohomish Health District

Oscar Lucas, Strategic Programs Director, Premera Blue Cross

Premera Corporate Informatics group

Collective Impact Framework

Key Indicators

Personal Health indicator(s) Physical, mental

Lifestyle, behavioral

Healthcare cost / trend indicator(s) Relative to income

Individual, employer, community

Economic indicator(s) Individual, employer, community

Civic Health indicator(s) Social determinants of health

Other e.g., civic health TBD