Transformadores de Corriente 1 Características Técnicas

The third element of the Innovation Model is the Community Health Innovation Region. While

Accountable Systems of Care will provide a structure for clinical integration and provider accountability, Michigan stakeholders strongly support the development of a community-based organizing mechanism composed of partners from many different fields in the community who will work together for better population health and health care at lower costs. Given the complex nature of the health system and the substantial impact of social, economic, behavioral, and environmental factors on health and health care, no one sector alone can achieve significant improvements in population health. Broad partnerships are needed across the health system and beyond. To be effective and sustained over time, these partnerships will take a collective impact approach,7 with a long-term commitment to a common agenda, shared measures, and effective strategies for engaging the community in improving health and the health care delivery system while containing costs.

The Innovation Model advisory committee members included representatives of innovative health coalitions and public health practitioners who are working to build capacity to improve health in the community through population-level strategies, and by making seamless connections across the health care delivery system, community services, and public health. These stakeholder groups agreed with physicians within the advisory committee that public health and other social services were critically necessary to achieve quality and cost targets. This led to the recommendation that community partnerships be a central element of the system as a whole.

The Community Health Innovation Region can be described as a consortium, composed of a broad partnership of community organizations, government agencies, business entities, health care providers from Accountable Systems of Care, payers, and individuals (including those from vulnerable populations) that come together with the common aim of raising the community’s capacity for improving population health. The Community Health Innovation Region

will build on existing community partnerships in Michigan that are working collaboratively for a collective impact on health outcomes. It can leverage Prosperity Region initiatives (described in chapter B) that provide greater efficiency and consolidation of resources. Community Health Innovation Regions must demonstrate that they have a broad base of financial support from their local partners (such as health plans, businesses, Community Benefit funding, and philanthropy).

To sustain these partnerships, a Community Health Innovation Region will have a formal backbone organization that functions as the governing body, and serves as the fiduciary. Core infrastructure and staff will be needed for logistical support,

management, and quality improvement processes.8 The role of this backbone organization will be to convene stakeholders to improve health outcomes, and create greater integration across the health system, thereby reducing sources of health risk, and strengthening assets that protect and promote health in the community. The Community Health Innovation

Region will work with health systems, public health departments, and community stakeholders to conduct community health needs assessments and to identify and implement strategies that address community priorities. Additionally, the backbone organization and its stakeholders will work to establish greater integration across the health system and organized entry points for access to care with links to coordinated community services.

Community Health Innovation Regions will perform the following functions:

I. Act as a convener of cross-sector stakeholders, including facilitating partnerships among stakeholders that are competing in a market-based health system

a. Governed by a Board of Directors and by-laws b. Convene diverse stakeholders

c. Engage and sustain the commitment of leadership from local government, purchasers, payers, providers, community, and public health

d. Facilitate a process to develop and define a common agenda and community health improvement goals

e. Facilitate a process to develop and define how to measure improvements

Cross-sector Partners in the Community Health Innovation Region

Consumers/ Community representatives Local public health agencies Community mental health service providers Department of Human Services Local health plans Representatives from Accountable Systems of Care Health system leadership Veterans groups Faith-based organizations Nonprofit organizations Philanthropic organizations Community support infrastructure and services Government entities Elementary, secondary, and higher education institutions Business leaders Chambers of Commerce Economic development entities Community and economic development and investment

f. Assure accountability to improvement goals

II. Provide backbone organizational body for governance and a staff that carries out the day-to-day organizational and administrative functions

III. Coordinate activities with state and local public health

IV. Develop a systematic approach to community-wide public engagement, education, and mobilization for ongoing input into improvements in the health care delivery system and

community-centered population level strategies, with special emphasis on vulnerable populations V. Develop a core set of community performance measures with input from community members,

collaborating with the state-level Performance and Recognition Committee

VI. Maintain a public community dashboard that provides community specific measures, target performance, and compares level of improvement against target performance goals

VII. Ensure a community needs assessment is completed including development of strategic priorities for health improvement in the community

VIII. Develop and effectively champion strategic interventions to drive improvements in health and health care; examples of strategic interventions include:

a. Coordination of health care services with human services (e.g., implement Pathways Hub model or leverage Pathways to Potential Family Resource Centers, as described in chapter B) b. Integration of medicine, public health, and community resources in addressing health

priorities (e.g., a community-wide approach to childhood obesity)

c. Public reporting of performance measures in health care delivery and at the community level d. Local approaches or policies that create healthy environments

e. Develop community-level, culturally appropriate health literacy and consumer engagement strategies

IX. Champion the need to achieve greater balance in investments in health care and other social determinants of health and marshal available resources within the community (financial, knowledge/skills, leadership, manpower, etc.) to achieve collective impact in community-based strategies that improve health and health care, including:

a. Community benefit dollars (as required by IRS)

b. Community investment/development funds (as required by the Community Reinvestment Act)

c. Philanthropic funding

d. Federal, state and local funding (e.g., Metropolitan Planning Organizations investing transportation dollars in a healthy built environment)

e. Community trust funds

f. Funding streams that represent a shared savings from a high-performance health system g. Expanding billing for services by local public health departments

h. Comprehensive payment reform that pays for value

Over time, the Community Health Innovation Region will demonstrate value by improving health outcomes and reducing health risks. As these community partnerships demonstrate the ability to collaborate across partners, engage leadership in the community, and demonstrate improved health outcomes, they will garner broad-based support and funding from stakeholders. A demonstrated return on investment will enable the Community Health Innovation Region to secure sustainable funding sources.