Building Healthier Communities Through Innovative, Public-Private Models

21 June 2012 | William O’Leary, Executive Director, Policy, Health and Human Services at Microsoft
​In a struggling economy, health costs have somewhat of a domino effect spanning people, education and business. For citizens and communities, health costs impact quality, access to care and preventive efforts. For education, government spending is reduced as healthcare costs take up more and more of the overall budget. And, for business, both America’s economic health and global competitiveness are hurt by the increasing percentage of GNP and employer’s income spent on healthcare.
 
Achieving healthier communities, therefore, is a concern that goes beyond health-focused organizations. It involves both the government and private sector, and has spurred a new era of public-private partnerships and innovative models that extend to education, workforce, nonprofit organizations and foundations.
 
Toward that end, Microsoft, in partnership with government and business leaders and foundations, has facilitated forums in Miami, San Diego and Chicago to focus on cross-cutting approaches that contribute to building healthy communities. We have heard from leaders including U.S. Surgeon General Regina Benjamin, and have discussed successful models of public-private collaboration from the county of San Diego, Walgreens, Scotts Miracle-Gro, and many other organizations.
 
Today, nearly 50 of these participating thought leaders will convene in Washington, D.C. to review multiple models of collaboration that fall under three key themes: Community to Business (C-B), Health to Education (H-E), and Business to Community (B-C).
 
These themes have resonated throughout each of the previous forums. In advance of the final event, I’ve asked leaders from the Health and Human Services Agency in San Diego, Miami’s Single Stop USA and Health Choice Network programs, and General Electric to share more about their models, including areas of success and lessons learned.
 
First up is Nick Macchione, director of the Health and Human Services Agency in San Diego County. He will speak to San Diego’s Community to Business (C-B) Model: implementing an Accountable Care Community.
 
Bill: Nick, describe the scope of the Accountable Care Community, and how it requires collaboration and new models of care across multiple government, health, community and business stakeholders.
 
Nick: Through the San Diego County Accountable Care Community, public, private and nonprofit entities--including health and social service providers, schools, hospitals, faith-based agencies, military and veterans, community providers, and residents—establish community-wide health goals together and measure their performance against those shared goals.
 
At the core of this model is the basic question of, how do we organize and deliver services for the maximum benefit of clients and communities? It’s looking at the whole person in the context of their community—the factors that influence their ability to live well. It’s looking at wellness as being more than just health—it is, of course, physical and mental health, but it is also, how safe is their home and community? Do they have the skills and resources to be economically prosperous, does their community environment support their health and wellbeing, and are they able to thrive in their community?
We’re pursuing a real paradigm shift in how we define and deliver health services in the most beneficial ways to support our residents. We need to move past ‘sick care’ and focus on prevention and integrated health care systems—in other words, focus on population-based quality and cost performance and population-based health outcomes, and create system integration with community health resources.
 
To truly harness the power and efficiencies of Accountable Care Communities, you need to have strong leadership and a robust IT architecture that is person-centric and supports the exchange of key data among systems. In San Diego County we have the advantage of being one of the Beacon Collaborative Communities. We are among the 17 communities selected by the federal government to pioneer an effort to establish comprehensive local health information exchanges. We’re also developing a Community Information Exchange (CIE) focused on the interoperability of social services information. Connecting the Beacon and CIE, along with the enterprise data solutions we’re making in the Health and Human Services Agency, will be highly instrumental in achieving the vision of Accountable Care Communities.
 
Bill: Thank you, Nick. In addition to these Community to Business (C-B) collaboration models, we are also seeing cutting edge collaborations occur at the intersection of health and education (H-E). Miami’s Single Stop USA and Health Choice Network programs are both great examples.
 
Elisabeth Mason is the CEO of Single Stop USA, a national nonprofit that is focused on increasing retention and graduation rates at Miami Dade College through a health and social services benefit coordination model. This work is scaling nationally.
 
Elisabeth, your goal is to measurably improve economic opportunity. How does your model achieve this?
 
Elisabeth: Community colleges serve more than 12 million people each year, with the goal of higher lifetime earnings and greater economic mobility. Unfortunately, fewer than half of those who set out to earn a degree will actually achieve their goal. The reason most drop-out is simple - they can't afford to stay in.
 
At the same time, billions earmarked to alleviate poverty and help students succeed go unused every year. Segmented service delivery, complex eligibility requirements, and antiquated financial aid and student support systems make it nearly impossible for students to access all of the benefits and services for which they are eligible. The problem is one of logistics, and solving it means moving millions towards long term economic security, which is good news for students, and for the communities where these students live, work and pay taxes. And it’s good news for the employers who will hire these students once they graduate.
 
Single Stop USA is working with community colleges in Miami and across the country to increase persistence and completion by leveraging technology and human service capital to connect existing resources to the students who need them most. In 2011 alone, Single Stop provided services to nearly 20,000 students, helping them access resources worth almost $45 million. But demand far exceeds supply. We now have sites in seven states with strong initial impact data. We have received direct solicitation for assistance from more than 10 percent of community colleges nationally. Now, we are looking to replication and scale.
 
Bill: Health Choice Network (HCN) is a Miami-based company that also scales nationally. It provides comprehensive health IT services to a wide network of health centers.
 
Kevin Kearns is the president and CEO. Kevin, can you describe your Network, the collaborations involved, and how you are focusing on improving health and care models at a lower cost in community settings such as schools, and in health markets such as managed care?
 
Kevin: Consistent with the Triple Aim objectives from CMS, Health Choice Network’s goal is to support our member Community Health and Behavioral Health Centers to improve population health, the patient’s experience of care, and to reduce health costs. We have implemented a successful nationwide collaboration among Community Health Centers, Community Mental Health Centers, Health Center Controlled Networks and other partners, including a centralized electronic health and oral heath record with strong clinical analytical tools. By providing key business services, strategic initiatives and the latest in health information technology, our members can improve patient outcomes through increased efficiencies and more accessible care. We support 45 health centers in thirteen states, serving more than 800,000 consumers.
 
Improving health outcomes requires collaborations and business models that cross payer, provider and community services such as education. HCN runs the South Florida Regional Extension Center for Health Information Technology to support more than 2,500 priority primary care providers with the adoption of electronic health records and the path to meaningful use. We provide key infrastructure to our member health centers as they achieve certification for patient centered medical homes, including 15 Federally Qualified Health Centers in 45 service locations. We focus on chronic condition prevention and management.
 
With the support of the GE Foundation, we are leveraging HIT to provide a care management / planned visit model for 10,000 diabetics in Miami-Dade County. HCN and our Florida member centers are the founders of Prestige Health Choice, the 6th largest Medicaid Managed Plan in Florida with 75,000 members across 27 counties. And, through Health Connect in Our Schools, we provide medical home school-based health services in 93 Public Schools in Miami, leveraging telemedicine and technology tools to serve 73,000 students.
 
Bill: Businesses are also focusing on the economics of health, and improving health outcomes. At our forum, John Kahle, senior vice president, Intercare Insurance Solutions, will speak to the reality that employee wellness is no longer an option. Rather, it is a strategic driver for businesses.
 
In a previous blog interview, Dr. James M. Galloway, Assistant U.S. Surgeon General for the United States Public Health Services, spoke to new models of social entrepreneurship emanating from business. Today, Dr. Galloway will speak to this topic with Attorney Marc J. Lane.
 
Attorney Lane is Chairman of the State of Illinois' Task Force on Social Innovation, Entrepreneurship, and Enterprise. He is nationally renowned for developing a socially responsible investing approach, and for his work on Low-Profit Limited Liability Companies (LC3’s), a new hybrid structure aimed at for-profit ventures that have a primary goal of achieving a socially beneficial purpose.
Alan Gilbert, director of GE’s healthymagination Global Government and NGO Strategy, will speak to GE’s Business to Community (B-C) approach to improve health and reduce costs through community collaborations.
 
Alan, how is GE looking at collaborations with communities to improve health outcomes?
 
Alan: At GE, we realize that impacting health is complex. Collaboration is essential in identifying the best ideas and driving innovation that results in meaningful change. Inside GE, we are creating a healthy work environment that helps employees make healthy choices at work and at home while keeping healthcare costs low. In our communities, such as Cincinnati, Ohio, we are collaborating with community leaders and other local corporations to catalyze citywide, comprehensive approaches to reducing costs and improving quality of and access to care. We are committed to building lasting success that leads to better health for more people.
 
Bill: Models of collaboration including Community to Business (C-B), Business to Community (B-C), and Health to Education (H-E) are driving innovation and improved outcomes. During the Washington, D.C. forum we will hear from other leaders supporting models of innovation, thought leadership and research that contribute to healthier communities, including Kaiser Permanente, Johnson & Johnson, HealthyYouNow, the National Minority Quality Forum, and the Robert Wood Johnson Foundation. We will discuss their efforts in more detail in future blog postings.
 
If you’re interested in joining us for the forum, register for the live streaming at http://msft.it/DCHealthForum.
 
William O’Leary
Executive Director, Policy, Health and Human Services at Microsoft