BUILDING A THRIVING COMMUNITY · 2019. 12. 21. · BUILDING A THRIVING COMMUNITY . 2014 NACo...
Transcript of BUILDING A THRIVING COMMUNITY · 2019. 12. 21. · BUILDING A THRIVING COMMUNITY . 2014 NACo...
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BUILDING A THRIVING COMMUNITY
2014 NACo Healthy Counties Forum San Diego, CA January 30, 2014
T H E C A S E O F L I V E W E L L S A N D I E G O
Nick Macchione, FACHE Agency Director Health and Human Services Agency County of San Diego, CA
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WHAT THE HEALTH IS GOING ON IN SAN DIEGO?
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GAME CHANGERS IN HEALTH CARE Laws & Policies: PPACA, State Realignments
Demographics: Aging, Diversity/Latinization
Epidemiology: Chronic Diseases, Health Inequity
Technology: Information Technology, Biotech
Consumer Value = Price + Outcome + Experience
Globalization: New emerging markets
Cost: Health GDP and National Deficit
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TRADITIONAL BUDGET BALANCING APPROACH
Cut people from care Cut provider rates Cut services
Meanwhile…
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THE FOURTH PATH Change how care is delivered to improve health and wellness: Optimize existing healthcare, public health and social
service resources to innovate new service delivery, reduce waste and improve outcomes Create local accountability by all, not some
₋ Health (and Safety) In-All-Policies ₋ Promote individual responsibility
Achieve fiscal sustainability thru new payment reforms Connect the Unconnected thru modernized IT Advance evidence-based policy making and planning
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WELLNESS TRIPLE AIM
Improved Health and Social Well Being for the
Population
Lower Cost per Capita
Better Services for Individuals
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Building Better Health
Living Safely Thriving
Building Better Health
Living Safely Thriving
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Building Better Health
Pursuing policy and environmental changes
Improving the culture from within
Building a better service delivery system
Supporting positive healthy choices
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Population Health Leadership
Admin
Neighborhood
Patient-Centered Health Home
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10 March 19, 2008 Team San Diego GMU Module 1 Draft 10 10
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Inpatient/ Outpatient
Care Public Health
Behavioral Health
Military/Veteran Services
Social Services
Accountable Care Community
Individual
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White Space (No Network)
“Love-Fest”
“Rumble in the Jungle”
“Co-opetition” (San Diego County)
THE
LEVE
L O
F CO
MPE
TITI
ON
THE LEVEL OF COOPERATION
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Meet Donald
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His wish is simple, NOT to sleep in any more hospital beds!
What’s at stake?
One Person Many Facets
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0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
Within 30Days
Within 60Days
Within 90Days
12.6% 17.0%
24.3%
2.3% 5.7% 8.0%
SMH Readmission Rate for 2009
“Transitions Care Coach first, nurse second.” “Personalized
Technology”
“Healthy Bottom Line”
Treating the Cause, Not the Illness!
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Horizontal Integration & Silo Busting
In-Home Services
Day Health Care
Acute Hospital
Transit Skilled
Nursing Facility
Medical Specialty
Meals Service
Primary Care
PATIENT
Patients/caregivers provided social support services, by referral or direct provision, to reduce the risk of avoidable readmission.
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CARE TRANSITIONS INTERVENTION Evidence-based program to reduce hospital readmissions
Patient- and caregiver-centered
Supported by a Transition Coach
Patients with complex care needs receive specific tools - electronic or paper Patients learn self-management skills
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IT Boomers!
Providing alternative
pathways for general
information and access to services
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Live Well Roadmap
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Live Well, San Diego is capitalizing on the inherent linkages between the public, private, and non-profit sectors and using them to promote wellness at the client and neighborhood levels.
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Innovation Works!
Using innovative approaches such as mobile libraries that take services
to residents in their own
neighborhoods
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Live Well Perspective Matures
Past
Transactional
Volume-Based
Competitive Advantage
Silos & Categorical
Connecting the Unconnected
Sick Care/Social Welfare
Present Future
Transformative
Value-Based
Co-opetition
Integrated System
InterOptimability
Wellness
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QUIET OPTIMISM Policy makers, providers, customers and advocates are
committed
Relationships are expanding and being built on trust
Shifting from collaboration/integration to generation
Realistic approach with implementation – marathon, not a sprint
Data sharing & Technology have become effective enablers
Winnable battles on chronic health and safety conditions are showing improvements with meaningful results
Public is beginning to believe and engage
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Live Well San Diego!