SIMPMO: Work Group Solicitation - Pop Health

Population Health Council Member Solicitation

The SIM Program Management Office and the Department of Public Health seek to fill three vacancies on the SIM Population Health Council. We place a high priority on promoting participation by members with diverse racial, ethnic, and experiential backgrounds. Representation is being sought from municipal leadership, health economy, and urban or rural school districts. We also are soliciting responses from subject matter experts in community health improvement strategies (this opportunity is subject to approval by the Healthcare Innovation Steering Committee). If you are interested in serving on this Council, please read the information provided, complete the application and submit it no later than January 24th at 5 p.m.

Click here to apply!

Please note: due to routine site maintenance, this application will not be assessable for approximately 12 hours beginning on January 5 at 5 p.m.

What is the purpose of the SIM Population Health Council?
The Population Health Council is an advisory council to the State Innovation Model (SIM) initiative. SIM is a Center for Medicare & Medicaid Innovation (CMMI) effort to develop and implement state-led, multi-payer healthcare payment and service delivery model reforms that will promote healthier people, better care, health equity, and smarter spending in participating states. The Population Health Council is charged by the SIM Healthcare Innovation Steering Committee with developing a strategy for improving population health in the context of payment, insurance and care delivery reforms, and community integration and innovation. The council will focus on advising on two major SIM initiatives:

  • Health Enhancement Community Initiative: An ambitious health improvement and financing strategy that will combine innovations in clinical healthcare delivery, payment reform, and population health to improve health as a regional, multi-sector approach. (More information below)
  • Prevention Service Initiative: The council will continue to monitor and advise on the implementation of the PSI, which was designed in 2017 and is launching on 4/1/2018.

A council charter and the member listing can be found here.

Please note that all selected members will be asked to sign and abide by the SIM conflict of interest policy.

What is the Health Enhancement Community initiative?
Connecticut’s SIM is implementing a range of care delivery and payment reforms to improve health care and slow the growth of healthcare spending. However, taken alone, these are not enough to make Connecticut a place where preventable deaths, diseases, and health disparities are eliminated and every person enjoys the best health possible. To achieve these goals, Connecticut’s SIM will partner with communities to design a Health Enhancement Community initiative that moves beyond treating illness, to address root causes, behavior, and social determinants of health. Connecticut is proposing to create the conditions that promote and sustain cross-sector community-led strategies focused on prevention.

Connecticut is in the very early phases of designing the HEC strategy. A provisional definition to begin the planning process was developed:

A Health Enhancement Community is accountable for health, health equity, and related costs for all residents in a geographic area; uses data, community engagement and cross sector activities to identify and address root causes; and operates in an economic environment that sustainably funds and rewards such activities by capturing the economic value of improved health.

Many components of the HEC definition are intentionally undefined in order to accommodate a thoughtful, community-driven planning period that will lead to an actionable strategy by the summer of 2018.

More Needs to be Done to Shift the Focus to Prevention
More than half of all Americans suffer from one or more chronic diseases. Health disparities around chronic conditions also persist—people of color face higher rates of diabetes, obesity, stroke, heart disease, and cancer. A study by the Milken Institute found that chronic conditions drive 96% of Medicare costs and 83% of Medicaid costs and are responsible for two thirds of the rise in overall healthcare costs since 1980. Despite the fact that 40% of cancer, 80% of heart disease, and 80% of type 2 diabetes are preventable, the rates and costs of chronic conditions are predicted to rise significantly over the coming years.

Bringing Everyone to the Table
Preventing chronic disease is beyond the reach of any one sector of the community. Inadequate healthcare, for example, contributes about 10% to a person’s chances of dying prematurely. Moreover, prevention in healthcare is difficult in the current “sick care” system. Even in the most advanced alternative payment models, preventing chronic disease is not rewarded.

Health behaviors, such as smoking and diet, are the most important determinants, contributing 40% to the risk of premature death. Improving health also depends heavily on addressing the non-behavioral determinants of health– the conditions in which people are born, grow, work, live and age.

Working together, the business, municipal, educational, social service, public health, and healthcare sectors can influence both behavior and the social determinants of health. Local organizations and community members are the best experts on local community challenges and how to approach them.

Research validates that preventable deaths have been reduced when multi-sector networks undertake health initiatives. National efforts have also emphasized cross-sector initiatives. For example, Accountable Communities for Health (ACH) (e.g., CHCS report, NASHP report) are coming to the forefront in many states. National efforts such as REACH have been shown to make an impact on health equity. In Connecticut, local collective efforts are also forming, including multi-sector collaboratives that identify and prioritize the most pressing health needs in a community (e.g., North Hartford Triple Aim Collaborative, The Vita Health and Wellness District in Stamford, Healthier Greater New Haven Partnership, Primary Care Action Group in Bridgeport, coalitions to complete Community Health Needs Assessments, and others).

Why Setting the Table is Not Enough
Despite increased awareness of health disparities and a range of collaborative efforts to improve the health of populations, health risks for many chronic diseases continue to rise. Significant challenges exist for multi-sector, regional efforts such as ACHs, including long term financial sustainability, and data and measurement. This prevents significant investments in upstream prevention strategies. Bringing stakeholders together without addressing the barriers that prevent communities from fully enacting and sustaining a prevention strategy is not likely to curb the rising rates of chronic disease.

The State can play a critical role in supporting communities and facilitating solutions to these challenges. For example, the State can 1) assist communities to establish a framework for measurement and accountability, 2) support the development of local multi-stakeholder alignment and locally tailored governance structures and 3) solve for financial sustainability by defining, demonstrating and capturing the value of improved health due to prevention and create conditions that attract investments and innovations in prevention.  Financial sustainability solutions may include but are not limited to waivers, market-oriented-solutions, public-private partnerships in financing or development of wellness trusts.

What is the Context in Which the Population Health Council Exists?
The Lieutenant Governor provides overall leadership and oversight for SIM and the SIM PMO is leading the implementation of SIM. The planning and execution of the HEC initiative will be done with extensive engagement of a broad array of people and sectors, inside and outside of government, and in communities. The HEC initiative and planning efforts are being jointly administered by the PMO and the Department of Public Health.

The PMO engages more than 150 stakeholders through a number of advisory councils that focus on particular components of SIM. These councils are comprised of consumers, employers, healthcare providers, community organizations, and subject matter experts. The Population Health Council will play a key advisory role for the HEC initiative, and will be engaged throughout the planning and implementation process. Councils make their recommendations to the Healthcare Innovation Steering Committee, which will also be actively engaged throughout the planning of the HEC initiative.

Content Last Modified on 1/5/2018 1:23:15 PM