Research & Hennepin Health

Transcription

1 Research & Hennepin Health 1

2 Research & Publication Team Committee within the ACO Goal: To coordinate and prioritize research and publication about Hennepin Health by internal and external partners; to promote internal partnerships that result in regional and national presentations/publications Representation from all operational stakeholders Accomplishments: Summary document, tracking sheet, structure to coordinate participation, Health Affairs publication 2

3 Understanding the impact of Hennepin Health, an ACO model for vulnerable patients 3

4 The Research Team Doug Wholey, PhD, UMN Rob Kreiger, PhD, UMN Kate Vickery, MD, MSc, HCMC, UMN Mark Linzer, MD, HCMC, UMN John Connett, PhD, UMN Ross Owen, MPA, Hennepin Health Laura Guzman, MPH, HCMC Brittin Wagner, PhD, UMN * Patient Advisory Council is in formation. * Jeremiah Menk, MS, UMN 4

5 Project Objective Determine the impact of Accountable Care Organizations (ACOs) on highly vulnerable Medicaid patients: Who responds best to ACO-led interventions? What care model elements curb utilization? Generate better health outcomes? Timeline: January, 2015 through June,

6 Hennepin Health Care Model Quality of care Enrollment Primary Care Medical Home* Clinic-based Care Team Outcomes Patient, provider experience and engagement Utilization, Total cost of care Outreach to Connect Patients with Partner Clinics * Extended Care Team providing services in the community* Quality of life * Represent point of linkage to integrated behavioral health care 6

7 Aim 1: Quantitative Compare health care utilization and costs in HH and non-hh Medicaid patients in 3 highrisk populations: - Patients with multiple chronic conditions - Patients who are high-utilizers of inpatient/emergency department care - Racial/ethnic minorities) 7

8 Quantitative Methods (Aim 1) Design: Interrupted time series design to measure differential effects of HH on utilization and cost Data source: 40 mos. of Medicaid claims (inpatient, outpatient, and dental) from MN DHS March, 2011 MA Expansion began Jan., 2012 HH began Roll-Out June, 2012 June, 2013 End of Current Dataset Extended New Data Data June, 2014 Pre-HH Year 1 Post-HH Year 2 Post-HH Measures: Inpatient admissions (preventable admissions, ICU days, 7 day and 30 day readmissions), ED visits, costs, outpatient visits (primary care and specialty care) 8

9 Socio-demographic Measures Enrollment data provides: Age, sex, race/ethnicity, education, marital status Home address Homeless Indicator collected by DHS We ve built: SES indicator for home zip code from census Homeless diagnosis flag Homeless address flag from use of known shelter and/or general delivery address Mental health/chemical dependency diagnosis flags 9

10 Aim 2 (Qualitative) Identify key elements of the care model, as perceived by enrollees and their providers, and describe quality of care and quality of life during program participation 10

11 Qualitative Methods (Aim 2) Design: In-depth, theoretically guided, key informant interviews with HH patients and their providers. Qualita ve Study Design Housing Navigator Primary Care Provider County Mental Health Caseworker Enrollee Goals: Reduced health care Stable/increased health 1. To understand Choose elements enrollees who of have: HH perceived costs as important care costs to different types of enrollees High u lizaand on under which circumstances To describe Mul perception ple Chronic Condi of patients ons about 5-7 their quality of 3-5 care and quality of life Racial/ethnic during minori the time es surrounding 5-7 their enrollment

12 Synergy: Research + Operations + Population Health Improvement Strengthen delivery of the care model by developing and validating measures Increase administrator/leadership awareness of the program Improve patient and provider engagement Identify and expand areas of strength and identify and improve areas of concern Draw evidence-based lessons for replication locally and beyond 12

13 COMMENTS, QUESTIONS? 13

14 Please stay in touch! , 14