UW Foster School of Business / Premera Economic Disruption in Healthcare II
Jul 03, 2015
UW Foster School of Business / Premera
Economic Disruption in Healthcare II
Anatomy of a Crisis…
35
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
9
Strategic Objectives
10
What This Initiative Aims to DeliverH
YS
Activity/H
ea
lth
Me
tric
s
Grade 5 Grade 6
Current path
Desired results
Partnering Organizations
11
What the kids see…
12
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