COLLABORATIVE INITIATIVES OF THE FRANKLIN COUNTY HOSPITAL SYSTEMS AN OVERVIEW OF OUR WORK NOVEMBER...
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Transcript of COLLABORATIVE INITIATIVES OF THE FRANKLIN COUNTY HOSPITAL SYSTEMS AN OVERVIEW OF OUR WORK NOVEMBER...
COLLABORAT
IVE IN
ITIA
TIVES O
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THE F
RANKLIN C
OUNTY H
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COHC BOARD OF DIRECTORS
Dave Blom, OhioHealth
Claus Von Zychlin, Mount Carmel
Steve Allen, Nationwide Children’s
Sheldon Retchin, Wexner Medical Center
COHC MISSION
The Central Ohio Hospital Council serves as the forum for community hospitals to come
together to address issues that impact the delivery of health care to central Ohioans.
Through the COHC, member hospitals collaborate with each other and with other
community stakeholders to improve the quality, value and accessibility of health care
in the central Ohio region.
COMMUNITY
HEALTH
NEEDS ASSESSMENT
IRS REQUIREMENTS
501C3 hospitals must conduct a community health needs assessment and implement a strategic plan, based on assessment, every 3 years;
Must partner with Public Health and a university, where available;
$50,000 penalty (or loss of tax exemption) for those not in compliance.
WHY THE REQUIREMENT?
IRS attempting to tie assessment to hospitals’ community benefit
10 YEAR LOOK AT UNCOMPENSATED CARE
Franklin County hospitals have provided $2.2 billion in uncompensated care over the past decade.
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 $-
$50,000,000
$100,000,000
$150,000,000
$200,000,000
$250,000,000
$300,000,000
$350,000,000
Franklin County Hospital Uncompensated Care -- Charity Care and Medicaid Losses
Franklin County Hospital Un-compensated Care -- Charity Care and Medicaid Losses
5 YEAR LOOK AT TOTAL COMMUNITY BENEFIT
Franklin County hospitals have provided $2.4 billion in community benefit over the past five years.
FRANKLIN COUNTY HOSPITAL COMMUNITY BENEFIT
FY 2013 Community Benefit for Franklin County hospitals
FRANKLIN COUNTY CHNA: A COMMUNITY COLLABORATIVE
Mount Carmel Health System
Nationwide Children’s Hospital
Ohio State University Wexner Medical Center
OhioHealth
Central Ohio Trauma System
Columbus Public Health
Columbus Neighborhood Health Centers
Franklin County Public Health
Heart of Ohio Family Health Centers
Lower Lights Christian Health Center
Ohio State University College of Public Health
United Way of Central Ohio
Ohio Department of Health (Disabled)
Ohio Department of Aging
Healthcare for the Homeless
OUR PROCESS
½ Day Planning Retreat
PLANNING RETREAT OUTCOMES
Social determinants
Health Resource Availability
Behavioral Risk Factors
Wellness care
Maternal and Child Health
Oral Health
Mental and Social Health
Death, Illness and Injury Measures
Infectious Diseases
Youth Issues
Steering Committee identified 170 indicators under 10 categories to be included in report:
2ND HALF DAY RETREATSTEERING COMMITTEE WORK
All indicators were reviewed.
Those where Franklin County fared worse than Ohio or U.S. or where indicator got worse since HM 2013 were pulled
All were rated using 9 criteria (National Association of City and County Health Officials)
1. Cost Effectiveness2. Issue worse here than elsewhere?3. Federal/state mandates prohibit or require addressing issue?4. Is there a valid intervention to positively impact the issue?5. Is a sizeable percent of population affected by the issue?6. Does intervention keep people well?7. Degree to which issue impedes ability to work, attend school, function, etc.?8. Does issue cause severe illness and/or premature death?9. Has the problem worsened or improved in the last 5 years
HEALTH NEEDS IDENTIFIED
Through Grouping
6 Health Needs
HEALTH NEEDS PRIORITIZED
Steering Committee Prioritized Health Needs Based on:
Number of indicators in each group;Rating for the indicators in the group;Internal feedback received from clinicians.
6 PRIORITIZED HEALTH NEEDS
1.Obesity
2.Infant Mortality
3.Access to Care
4.Mental Health and Addiction
5.?
6.?
HEALTHMAP 2016
For each health need, HM 2016
will provide disparity data:
1. Top zip codes
2. Gender
3. Race
4. Age
• April 2016
RELEASE TO PUBLIC
CHNA NEXT STEPS
Each hospital must:• Post CHNA on hospital’s Website;• Develop a written plan that addresses
each health need identified thru the CHNA
Strategies must be adopted by hospital governing boards or executive committees;
Strategies must be attached to IRS Form 990 (Community Benefit Reporting).
CURRENT
COLL
ABORATIVE
INIT
IATI
VES
CURRENT COLLABORATIVE WORK
Infant Mortality/Preterm Birth
• Every week in Franklin County, two to three babies die before the age of 1.
• Every week in Ohio, 3 babies die in unsafe sleep environments. In fact, sleep-related infant deaths are the leading cause of death for babies who are 1 month to 1 year of age.
COHC INFANT MORTALITY INITIATIVES
Early Elective Deliveries
• All 8 birthing hospitals prohibits the practice of scheduling deliveries before 39 weeks without a medical reason
Breastfeeding Promotion
• All 8 birthing hospitals following agreed-to standards to promote the initiation of breastfeeding before discharge
Safe Sleep
• All 9 hospitals implementing practices that encourage safe sleep environments
Very Low Birth Weight Babies
• Ensuring VLBW infants are delivered in hospitals with a higher volume of delivering these babies
EARLY ELECTIVE DELIVERIES
All 8 birthing hospitals developed policies that reduce the practice of scheduling early deliveries, without medicalindication, before 39 weeks completed gestation
CURRENT COLLABORATIVE WORK
Behavior Health
Mental Health Bedboard
Goal: Place ED patients needing mental care in an inpatient psych bed in a timely manner
BEDBOARD RESULTS
FUNDING PARTNERS AND LEADERSHIP
PROJECT TEAM LEADERS
Phil Cass, Ph.D. Central Ohio Trauma SystemLisa Courtice, Ph.D. The Columbus FoundationJeff Klingler Central Ohio Hospital CouncilDavid Royer ADAMHMark Hurst, MD Ohio Department of Mental Health
FUNDERS
TASK FORCE MEMBERSNationwide Children’s Hospital David A. Axelson, MD - Chief of Psychiatry & Medical Director of Behavioral Health Ohio Department of Mental HealthMark Hurst, MD- Medical Director Twin Valley Behavioral Health Veronica Lofton - Chief Executive Officer Alan Freeland - Chief Clinical Officer Ohio Hospital for Psychiatry Marcia Berch, RN, MSN, NE – Chief Executive Officer Ohio HealthDallas Erdmann, MD - Medical Director of Behavioral Health & Chairman Department of PsychiatryConnie Gallaher - System Vice President OSU Wexner Medical Center/Harding HospitalJohn Campo, MD - Chair, Department of PsychiatryNatalie Lester, MD - Director, Psychiatric Emergency ServicesAmanda Lucas, MEd, MBA - Executive Director & Chief Operating Officer Osteopathic Heritage FoundationTerri Donlin Huesman - Vice President Program Primary One HealthReed Fraley - Senior DirectorBeth Whitted, MBA, Dr.PH – Director of Regional Operations
ADAMH Franklin CountyDavid Royer - Chief Executive OfficerDelany Smith, MD - System Chief Clinical Officer Central Ohio Hospital CouncilJeff Klingler - President and CEO Central Ohio Trauma SystemPhillip H. Cass, PhD - Chief Executive Officer The Columbus FoundationLisa Courtice, PhD - Executive Vice President Dublin SpringsGarry Hoyes - Chief Executive Officer MaryhavenPaul Coleman, JD - President and CEOSara McIntosh, MD - Medical Director Mount Carmel WestSharon Hawk-Carpenter – Unit DirectorSean McKibben - President and Chief Operating Officer National Alliance of Mental Illness, Franklin Co.Rachelle Martin - Executive Director Netcare AccessKing Stumpp - President and CEOPablo Hernandez, MD - Medical Director
WHY CREATE THE PCES TASK FORCE?
PCES
Escalating community need
Increase in med/surge referrals
Overcrowding in ERs
Medicaid expansion
Other payment reform
RECOMMENDATIONSCENTRALIZED, COLLABORATIVE MODEL
H U B & S P O K E M O D E L
Inclusive model with all spokes engaged and accountable
Netcare and OSU hub
Illustrative spokes Law enforcement EMS Hospitals AOD providers Community health centers Payors Community and civic leaders Others
1OSU
Netcare
Work group co-chairsJohn Campo, MD - Chair, Department of Psychiatry, OSU/Wexner Medical CenterKing Stumpp - President and CEO, Netcare
RECOMMENDATIONS
Identify and develop additional options for intermediate and ambulatory care for individuals in need of mental health and/or alcohol and drug addiction treatment.
2• Expand role of select community mental
health centers (pilot program)• Increase the number of sub-acute detox
beds and ambulatory treatments.• Increase the use of crisis action teams,
mobile crisis teams, and telepsychiatry.
RECOMMENDATIONS
Build collaborative, effective working relationships with the payor community to favorably encourage an improved model which ensures that patients receive access to high quality care in a cost-efficient manner.
3• Foster positive, productive relationships
with payors• Work with public officials to eliminate
barriers to necessary treatment because of the IMD exclusion
• Improve collaboration and communication between clinical service providers and payers by developing a standardized care coordination system that transcends specific levels of care
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0%
10%
20%
30%
40%
50%
FCBB Referrals by Payer MixMedicaid MedicarePrivate Insurance Uninsured
4
CHRISTMAS IN JULYJULY 27, 2015 FCBB
94 PATIENTS AWAITING PLACEMENTNEARLY ALL SYSTEMS ON SURGE
OF THE 94 PATIENTS:
50 MEDICAID (61%)16 SELF PAY (21%)21 MEDICARE (13%)7 PRIVATE INSURANCE (5%)
GENERAL HOSPITALS HAD 7 BEDS AVAILABLE
POTENTIAL BED CAPACITY
# of existing beds
# of proposed
beds
# of existing
bedsDublin Springs 72 72 18 Mount Carmel
Ohio Hospital for Psychiatry 90 40 39 OhioHealth
Twin Valley 85 53 OSU Wexner
Sun Behavioral Health 116
TOTALS 247 228 110
475 585
IMDs General Hospitals
FEDERAL ACTION
CMS Proposed Rule (CMS-2390-P) Released May 27, 2015 Published in the Federal Register June 1, 2015 Comments due July 27, 2015 Final rule expected February 2016
Clarifies that Medicaid managed care plans could receive a capitation payment for enrollees aged 21 to 64 who have a short term stay of no more than 15 days in any given month in an IMD.
COMMUNITY SUPPORT
PCES Support
Dispatch Editorial Support
Legislative Support
SUPPLIE
R DIV
ERSITY
I.T. MEET & GREET
JEFF
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