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This guide explores actionable steps to engage the public effectively in healthcare decision-making, focusing on patient choice, community culture, and transparency. Learn how to drive recognition, educate, and involve diverse stakeholders in buying health services for employees and implementing payment and delivery reforms. Discover innovative approaches, including aligning financial incentives, standardizing standards, and transforming care delivery for equitable and sustainable outcomes.
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Workgroup Ideas Areas of Focus
Engaging the Public • Recognition • Education & recognizing community culture • Menu of services & transparency of who is PCMH • Patient choice
Engaging the Public • Action steps • Development of message content: must include the voice of the public • Available data from NCQA, RCCOs, others • Focus groups, public polls/survey • How do we deliver the message? • Utilization of available data/ask the people
Engaging the Public • Action steps continued • Addition of others to the planning process (including previously mentioned) • Chronic care community • OB/GYN • Faith-based organizations • PATIENTS! (with supports) • Pharmacists • Etc.
Buying Health Services for Employees • Decrease employee absenteeism & increase employee production by offering PCMH programs on top of current/existing health insurance programs to decrease lost time from work • Educate employers on value of primary care & medical homes
Buying Health Services for Employees • Drivers of health care decisions • Cost of health care • Employee productivity • Health (what is health in eyes of the employer?) • Direct & immediate access to all needed healthcare
Buying Health Services for Employees • Parallel a company work-comp/safety program with a work-health health program • Pathways/contracts for both acute & chronic health care • Safety: loss ratio linked to premium reduction • Employer demand for medical homes ( contract with medical homes, similar to work-comp)
Buying Health Services for Employees • Build a business case for, and explain a clear ROI for the PCMH • Engage in a local conversation with businesses & organizations • Infiltrate, integrate, & educate employers at business events • Chamber of Commerce • Colorado HR Association • CO Restaurant Association • Etc. • Involve & engage health insurers & brokers
Payment Reform • Convening all stakeholders • Transparency/alignment of metrics (risk adjustment, benchmarks) • Understanding real cost of PCMH transformation & sustainability • Financial incentives for all stakeholders – aligned across payers
Payment Reform • Transparency – know the cost! Across the public & private plans • Incentivize with goal in mind allocate more funds to primary care • Cover all services needed: • Primary care • Behavioral health • Dental
Payment Reform • Standardize the standards • Insurance reform • Must offer same plans & benefits • Base member on service rather than cost • Publicly funded – privately serviced
Delivery Reform • Set medical home as standard of care • Share the vision • Build the infrastructure tools/resources extension service model
Delivery Reform • Action steps • Support facilitation • Standard quality measures • Cost • Experience • Partnership (culture) • Community • Equitable
Delivery Reform • Transform with hospitals • Build facilitator systems • Equitable • Culture • Language • Patient • Measures