The Health Care and Housing Model: Supporting the Whole Person - - PDF document

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The Health Care and Housing Model: Supporting the Whole Person - - PDF document

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6/27/2019 The Health Care and Housing Model: Supporting the Whole Person Whole Person Care and IOPCM Programs June 3, 2019 HOUSEKEEPING Multi-site CE/CME must sign in Evaluation Electronic Devices 1 6/27/2019 CONFLICTS

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The Health Care and Housing Model: Supporting the Whole Person

Whole Person Care and IOPCM Programs

June 3, 2019

 Multi-site  CE/CME – must sign in  Evaluation  Electronic Devices

HOUSEKEEPING

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All presenters have signed a conflict of interest form and have declared that there is no conflict

  • f interest and nothing to disclose

for this presentation.

CONFLICTS OF INTEREST

The Health Care and Housing Model: Supporting the Whole Person

Whole Person Care and IOPCM Programs

June 3, 2019

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Welcome and Introductory Comments

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Liz Gibboney, MA

Chief Executive Officer

Partnership HealthPlan of California

Mission:

To help our members, and the communities we serve, be healthy.

Vision:

To be the most highly regarded managed care plan in California.

About Us

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  • Dr. Robert Moore, MD, MPH, MBA

Chief Medical Officer

Partnership HealthPlan of California

Welcome and Introductory Comments

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  • Complex Case Management
  • Social Influencers of Health

Introductory Reflections

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What happens to health care costs? Depending on the intervention and target population: Increased costs

  • Outpatient visits to PCP and specialists
  • Prescription drugs

Potential Decreased costs:

  • Fewer ED visits
  • Fewer Inpatient hospital days
  • Cost of one inpatient day = 12 ED visits

Intensive Care Management

Regression to the Mean: Is this savings real?

1 2 3 4 5 Qtr 1 Qtr 2 Qtr 3 Qtr 4

Inpatient Costs

Intervention A 0.5 1 1.5 2 2.5 3 3.5 4 4.5 Qtr 1 Qtr 2 Qtr 3 Qtr 4 Intervention A Control 1 0.5 1 1.5 2 2.5 3 3.5 4 4.5 Qtr 1 Qtr 2 Qtr 3 Qtr 4 Intervention A Control 2

Control 1 Control 2 Good If you start with statistical outliers, performance will move toward the average, without intervention

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  • Traditional Term: Social Determinants of Health
  • Definition of Determinant: “A factor which

decisively affects the nature or outcome of something.”

  • Issue: Implication of inevitability, when goal is

intervention to prevent this outcome.

  • Newer Term: Social Influencers of Health

Terminology

  • Social Influencers of Health are “the circumstances

in which people are born, grow up, live, work and age, and the systems put in place to deal with

  • illness. These circumstances are in turn shaped by

a wider set of forces: economics, social policies, and politics”

  • World Health Organization

Defining Social Influencers of Health

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1.) Economic Stability- Poverty, Employment, Food

Security, Housing Stability

2.) Education- High School Graduation, Enrollment in

Higher Education, Language and Literacy, Early Childhood Education and Development

3.) Social and Community Context- Social Cohesion,

Civic Participation, Discrimination and Inequity, ACEs, Incarceration/ Institutionalization

4.) Health and Healthcare- Access to Health Care,

Access to Primary Care, Health Literacy

5.) Neighborhood and Build Environment- Access to

Healthy Foods, Quality of Housing, Crime and Violence, Environmental Conditions

5 Key Areas of SIOH

Chain of Causation

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Interventions for Social Determinants of Health

  • Assess individual issues
  • Address: Navigate, Collaborate, Provide
  • Track

Individual Interventions

  • Community activation, engagement
  • Collective impact

Community Interventions

  • Health in All Policies
  • Local, State, Federal

Wider, societal Interventions