Rural Strategic Planning. A New Rural Health Care Model It is time to develop a new blue-print for rural health care delivery. –The current disjointed.

Rural Rural Strategic Strategic

PlanningPlanning

A New Rural Health A New Rural Health Care Care ModelModel

It is time to develop a new blue-print It is time to develop a new blue-print for rural health care delivery.for rural health care delivery.– The current disjointed “system” is The current disjointed “system” is

unsustainable.unsustainable.– A redesigned and more integrated A redesigned and more integrated

health care system can deliver health care system can deliver superior care at lower cost.superior care at lower cost.

A New Rural Health A New Rural Health Care ModelCare Model

Rural communities may be Rural communities may be uniquely prepared to step into a uniquely prepared to step into a new model.new model.– Most health services are already Most health services are already

integrated under one organizational integrated under one organizational model.model.

– Policy and political leaders are Policy and political leaders are asking regions to plan together.asking regions to plan together.

MembershipMembershipVic Dirksen, CHAIR Jefferson Healthcare

John Anderson, MD Cle Elum Medical Center

Joan Baird Glover Kittitas Valley Community Hospital

Gladys Campbell NWONE

Bill Dowling, Ph.D. U of W (Prof. & Chair)

Leo Greenawalt WSHA

Claudia Haglund Providence Health & Services

Peter House University of Washington

Karen Jensen DOH

Tom Locke, MD Clallam County Health & Human Services

Mary Looker WA Assoc’n. of Community and Migrant Health Centers

Tom Martin Lincoln Hospital

Jeff Mero AWPHD

Kris Sparks DOH

Mike Lee DOH

Robb Menaul WSHA

Brenda Suiter WSHA

Cheri Berthon OFM

ProcessProcess

Vision & Principles Vision & Principles (Completed)(Completed)– Environmental Assessment: DOH & Environmental Assessment: DOH &

WSHAWSHA– Mega-Issues:Mega-Issues:

1.1. Work ForceWork Force2.2. Quality/Care Delivery ProcessesQuality/Care Delivery Processes3.3. IT/TechnologyIT/Technology4.4. Community and Population HealthCommunity and Population Health5.5. FinanceFinance

ProcessProcess

Study Sessions On Mega-Issues Study Sessions On Mega-Issues (90% complete)(90% complete)

Intensive Multi-Day Session to Intensive Multi-Day Session to Develop Plan with Develop Plan with Recommendations in OctoberRecommendations in October

PROJECT TIMELINEPROJECT TIMELINE

Develop implementation plan

Oct 08

TODAY

Nov 08

Develop demonstration project proposals

Initiate demonstration projects

Jun 09

Develop principles, mission, goals

May 08

Study Mega-Issues Communicate Plan

VISION VISION

& &

GUIDING PRINCIPLESGUIDING PRINCIPLES

Vision For Our Rural Vision For Our Rural Health Care SystemHealth Care System

We envision a health care We envision a health care

system that is: system that is:

– strongstrong

– reliablereliable

– publicly accountablepublicly accountable

Vision For Our Rural Vision For Our Rural Health Care SystemHealth Care System

The system will:The system will:

ensure those who need care receive the right ensure those who need care receive the right

care at the right time in the right place care at the right time in the right place

provide personal and population health services provide personal and population health services

responsive to the unique needs of each responsive to the unique needs of each

community (including dental and mental health community (including dental and mental health

care)care)

provide a medical home for all people in the provide a medical home for all people in the

local communitylocal community

deliver planned access to the full continuum of deliver planned access to the full continuum of

care through regional systems that formally link care through regional systems that formally link

primary and specialty services. primary and specialty services.

Vision For Our Rural Vision For Our Rural Health Care SystemHealth Care System

The system will produce: The system will produce: high quality outcomeshigh quality outcomes promote healthy communitiespromote healthy communities merit the confidence of the communitymerit the confidence of the community

The leadership to create and support a better The leadership to create and support a better

ruralrural

health care system will come from communities health care system will come from communities

andand

providers working together.providers working together.

To achieve this vision, the rural health To achieve this vision, the rural health care system will embody the following care system will embody the following principles:principles:

1. The rural health care system will be community-1. The rural health care system will be community-centric while recognizing the essential role of centric while recognizing the essential role of providers in achieving community health. Rural providers in achieving community health. Rural health care will take advantage of the inherent health care will take advantage of the inherent strengths of rural communities including close strengths of rural communities including close integration of physicians and the other health integration of physicians and the other health and human service providers in the community and human service providers in the community with the local hospital, community resources, with the local hospital, community resources, community leadership, and community self-community leadership, and community self-reliance.reliance.

2. The rural health care system will actively 2. The rural health care system will actively promote personal and family health in homes, promote personal and family health in homes, schools, workplaces, and in the community at schools, workplaces, and in the community at large.large.

To achieve this vision, the rural health To achieve this vision, the rural health care system will embody the following care system will embody the following principles:principles:

3. The rural health care system will provide 3. The rural health care system will provide services as close to the community as possible services as close to the community as possible whenever they can be delivered safely, whenever they can be delivered safely, effectively, and in a timely manner at a high effectively, and in a timely manner at a high level of quality.level of quality.

4. As the centerpiece of the rural health care 4. As the centerpiece of the rural health care system, the role of primary care will be system, the role of primary care will be broadened to become “medical homes” broadened to become “medical homes” providing access to comprehensive, patient-providing access to comprehensive, patient-centered primary care, health information, centered primary care, health information, health promotion, chronic care management, health promotion, chronic care management, and coordination of primary and specialty and coordination of primary and specialty services to ensure seamless integration of care.services to ensure seamless integration of care.

To achieve this vision, the rural health To achieve this vision, the rural health care system will embody the following care system will embody the following principles:principles:

5. Formally-structured relationships and 5. Formally-structured relationships and integrated information systems will link integrated information systems will link primary and specialty care providers in each primary and specialty care providers in each region to assure rural residents seamless region to assure rural residents seamless access to care across the full range of access to care across the full range of services.services.

6. The rural health care system will be sufficiently 6. The rural health care system will be sufficiently financed to assure access to appropriate care, financed to assure access to appropriate care, promote continuous improvement, and promote continuous improvement, and support the principles outlined here.support the principles outlined here.

To achieve this vision, the rural health To achieve this vision, the rural health care system will embody the following care system will embody the following principles:principles:

7. 7. Payment methods and formal linkages Payment methods and formal linkages between primary and specialty care between primary and specialty care providers will align incentives while providers will align incentives while supporting the medical home model and supporting the medical home model and care coordination within the regional care coordination within the regional systems.systems.

8.8. Investments in prevention and health Investments in prevention and health promotion will address physical, oral, and promotion will address physical, oral, and mental health and reflect both the short mental health and reflect both the short term and long term payoffs of health term and long term payoffs of health promotion.promotion.

To achieve this vision, the rural health To achieve this vision, the rural health care system will embody the following care system will embody the following principles:principles:

9. The rural health care system will develop, 9. The rural health care system will develop, attract, and retain an adequate supply of attract, and retain an adequate supply of well-trained providers; advance new provider well-trained providers; advance new provider roles; provide professional development roles; provide professional development opportunities locally; and employ opportunities locally; and employ organizational structures that attract organizational structures that attract providers and promote good care.providers and promote good care.

10. Community health assessment and 10. Community health assessment and evidence-based care protocols will drive the evidence-based care protocols will drive the planning of care, decisions about services, planning of care, decisions about services, performance measurement, and performance measurement, and accountability for care provided both in the accountability for care provided both in the local community and through formal linkages local community and through formal linkages with other providers in each regional system.with other providers in each regional system.

To achieve this vision, the rural health To achieve this vision, the rural health care system will embody the following care system will embody the following principles:principles:

11.11. Responsibility and accountability for Responsibility and accountability for community health will be shared by community health will be shared by community leaders, health care providers, community leaders, health care providers, public health, and the community at large.public health, and the community at large.

12. Community leaders, employers, providers, 12. Community leaders, employers, providers, and payers will work together to ensure and payers will work together to ensure private and public health care coverage private and public health care coverage and access to care for all members of the and access to care for all members of the community.community.

To achieve this vision, the rural health To achieve this vision, the rural health care system will embody the following care system will embody the following principles:principles:

13.13. Rural health care leaders will assume an Rural health care leaders will assume an active voice in seeking public policies that active voice in seeking public policies that support a strong, reliable, publicly support a strong, reliable, publicly accountable rural health care system accountable rural health care system consistent with these principles.consistent with these principles.

14. Quality health care available locally will 14. Quality health care available locally will continue to be essential to the social and continue to be essential to the social and economic integrity and vitality of rural economic integrity and vitality of rural communities. communities.

FEEDBACKFEEDBACK

FEEDBACKFEEDBACK

What questions or concerns do you What questions or concerns do you havehave

about the principles?about the principles?

Is their meaning clear?Is their meaning clear?

Is the rural health care system Is the rural health care system described worth reaching for?described worth reaching for?

FEEDBACKFEEDBACK

How should community-level leadership be How should community-level leadership be activatedactivated

and organized?and organized?

What are the characteristics of What are the characteristics of leadership leadership needed to drive this vision needed to drive this vision forward? forward?

How do we ensure that this leadership How do we ensure that this leadership involves involves meaningful participation by all meaningful participation by all elements of the elements of the community? community?

What examples are there of how this What examples are there of how this leadership leadership might be structured? might be structured?

FEEDBACKFEEDBACK

How might local leadership need to beHow might local leadership need to be

augmented, assisted, or supported if the augmented, assisted, or supported if the visionvision

is to be implemented?is to be implemented?

What help would you need to move What help would you need to move this vision forward?this vision forward?

What role might AWPHD and WSHA What role might AWPHD and WSHA play?play?

FEEDBACKFEEDBACK

What questions or concerns do you What questions or concerns do you havehave

about the medical home model?about the medical home model?