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Hennepin Health

Hennepin Health. People.Care.Respect Jennifer DeCubellis. A social disparities approach to healthcare reform. The Crisis. Depressed economy + Increased demand for safety net services +Decreased revenues =System Crisis. Focused Problem. Problem: High need population Crisis driven care

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Hennepin Health

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  1. HennepinHealth People.Care.Respect Jennifer DeCubellis

  2. A social disparities approach to healthcare reform

  3. The Crisis Depressed economy + Increased demand for safety net services +Decreased revenues =System Crisis

  4. Focused Problem Problem: • High need population • Crisis driven care • System fragmentation Need: • Address social disparities • Improve patient outcomes • Increase system efficiencies

  5. What is Hennepin Health? Minnesota Department of Human Services (DHS) & Hennepin County Collaborative for Healthcare Innovation Hennepin County Partners- Hennepin County Medical Center (HCMC) NorthPoint Health & Wellness Human Services and Public Health Dept (HSPHD) Metropolitan Health Plan (MHP)

  6. Premise • Need to meet individuals basic needs before you can impact health • Social disparities often result in poor health management and costly revolving door care • By coordinating systems and services, we can improve health outcomes and reduce costs

  7. Population Served • MA expansion in Hennepin County (previous GAMC population) • 21-64 year old Adults, without dependent children in the home • At or below 75% federal poverty level ($677/mo for one person) • Targeting ~10,000 members/mo

  8. Population Characteristics • ~68% Minority status • ~45% Chemical Use • ~42% Mental health needs • ~30% Chronic Pain Mgmt • ~32% Unstable housing • ~30% 1+ Chronic diseases

  9. Objectives • Improve quality of life and patient experience • Improve quality of care • Improve provider/staff experience • Reduce costs (County, State, and Federal) • Reduces health/social disparities • Is sustainable/replicable

  10. Core Elements • Patient-centered care • Health care home model • Integration of providers across systems • One core patient record • Primary care partnered with behavioral health and social services • Value vs. volume driven system

  11. Implementation • Live-January 1, 2012 • 4800 Enrollees • 13 clinics • ~20% of build completed

  12. Goals- Yr 1 & 2 • Decrease admissions by >10% • Reduce ED visits by >10% • Increase primary care “touches” by ~5%

  13. Finance model • 100% at risk contract • Partners share risk/gains • Tiering approach • fee for service pmpm • with outcome contracts

  14. Phase 2Initiate once primary build complete and outcomes realized

  15. Run Charts

  16. Early lessons learned Care Enhancements • Engagement/Contacts • Dental in ED • Pharmacy Consults

  17. Early lessons learned System Enhancements • Health plan outreach, in care system • In reach –corrections, shelters • Nurse line at the hospital • Continuum of care links

  18. Sample-Initiatives Going Forward • Health Care for the Homeless • Prescription delivery • Housing • Set aside units • MH/CD • Community partners on site

  19. Future Initiatives to consider • Virtual visits • Home or site specific monitoring • Peer driven education and activation • Alternative contacts (email/text command centers)

  20. Hennepin Health Bringing systems & people together Video and more information: www.hennepin.us/healthcare

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