|
|
|
June 18, 2018
Greetings All,
I have had the extreme pleasure over the past few months to visit several clinics in the state and learn firsthand about the benefits, challenges, and opportunities of providing primary care as a certified clinic or organization. Regional nurse planners and I scheduled conversations with many HCH teams and gained valuable insights and information on how clinics are working to improve what they do through participation in the HCH program, as well as obstacles they encounter.
A few of the many nuggets from our meetings with you include comments on how HCH certification has contributed to an organized team practice and increased clinician and staff satisfaction. We have also heard much support for the HCH model, and learned about some of the many challenges facing primary care like ongoing workforce shortages. The opportunities voiced reinforced our thinking in areas we are pursuing for improvement such as the need for sustainable financial reimbursement and standardized measures.
Thanks to everyone who has taken time from his or her busy day to meet with us. I plan to continue meeting with clinic stakeholders and welcome an invitation to visit with you and your team!
Best Wishes,
Bonnie
|
|
|
Funding Opportunity - Time Sensitive
|
The Minnesota Department of Health (MDH) is seeking proposals to advance the work of Health Care Homes through partnering with local public health or a Tribal health division, and a behavioral health organization in a Learning Community to address shared goals to improve health and health outcomes of a community. The grants are intended to increase and strengthen partnerships between primary care, local public health or a Tribal health division, behavioral health, and other community based organizations through use of data and information to support shared population goals.
Applications must be submitted by a MDH certified health care home on behalf of a partnership, that must include a local public health or Tribal health division, and a behavioral health organization. The Learning Community, established by the Minnesota Department of Health, will be led and guided by MDH Health Care Homes staff.
Approximately $120,000 is available for up to four grants for a period of nine months from September 2018 through June of 2019.
This grant funding will support participation of a MDH certified Health Care Home, local public health or a Tribal health division, and a behavioral health organization in a Learning Community to develop a shared narrative; advance knowledge of primary care, public health, and behavioral health; and engage in a process to share de-identified data to better understand the health status of a shared population and support combined population health goals. The strategy of the Learning Community will be to convene partners to identify shared priorities, use both population health and clinical data; and increase the capacity to share electronic health data (EHR) to improve community health.
Proposals must be received by 4:30 pm CDT on Wednesday, July 18.
For more information, please visit the HCH Learning Collaborative Request for Proposals webpage.
For questions about this funding opportunity, contact Janet.Howard@state.mn.us
|
|
After four and a half years, Minnesota formally concluded the federally funded State Innovative Model (SIM) project in May. SIM used approximately 93% or $41.9 million of available grant funds to implement innovative health care payment and delivery reforms throughout Minnesota.
Examples of SIM accomplishments include:
- Over 460,000 Minnesotans now receive care through a Medicaid accountable care organization called an Integrated Health Partnership (IHP).
- IHPs surpassed the cost savings goal of $100 million to achieve savings of $213 million in 2016.
- 67% of care providers in Minnesota are now participating in Accountable Care Organizations (ACO) or similar model that holds them accountable for costs and quality of care.
- Value Based Purchasing (VBP) through an ACO covers 39% of commercially insured lives.
- 88% of organizations engage in health information exchange.
- 60% of patients in Minnesota receive care that is patient-centered and coordinated across settings.
- 57% of providers are health care home or behavioral health home certified.
- 15 Accountable Communities for Health were established and several projects have succeeded in sustaining efforts.
Information on Minnesota’s SIM project includes final evaluation findings and a project directory, Minnesota Forward: Carrying on Minnesota’s Accountable Health Model.
|
HCH Rule Advisory Committee
|
HCH has embarked on updating its administrative rule. Revisions may ultimately include additional levels of certification for clinics as they mature and progress in providing patient-centered care. The program is excited to have the expertise of a 30-member Rule Advisory Committee that will be meeting throughout 2018 and providing input on revisions and improvements to the rule. Rulemaking website pages provide a listing of Rule Advisory Committee members and meeting schedule, background on possible changes to the rule, and the process for rule revision in Minnesota.
|
HCH Program has New Staff!
|
HCH is pleased to add new staff to the program team.
 Dorothy Hull joined the HCH team as an information and Communications Coordinator. She will be handling web site management, document accessibility, communications for Learning Activities, record management and business operations. Dorothy has a Bachelor of Science degree in Public Affairs and Legal Studies from the University of Minnesota-Minneapolis. She has five years of experience at the Department of Revenue and 28 years of communications experience at an advertising agency.
 Shirley Scheuler initially joined HCH in 2014 as a health educator with the State Innovation Model (SIM) grant. She transitioned to MDH Office of Health Information Technology as a SIM grants manager, before returning to HCH as the Evaluation Coordinator working on program evaluation and measurement efforts. Shirley has had a variety of experiences and opportunities in the education, government and military systems working in Florida, Georgia, Kansas, Minnesota, and Nebraska. She enjoys learning and has a Master of Arts in Health, Physical Education and Recreation, and a Master of Library and Information Science.
|
Certified Health Care Homes - Happenings Around the State
|
Source: Submitted Innovations featured on Wall of Fame at Learning Days 2018.
Alexandria Clinic created a RN Clinician role to work independently at the top of their license. They demonstrated patient care efficiencies and improved outcomes with greater longevity in the role and less burnout.
Fairview Medical Group – North Region engaged patients in the “Well Together Program” with improved patient activation scores, fruit and vegetable intake, daily activity, and significant decreases in weight, BMI, and blood pressure.
Lake Region Healthcare – Fergus Falls is improving patient engagement in their healthcare through participation in community wide health initiatives. Efforts concentrated on actively engaging patients in community based events including the Living Well Education Series, I Can Prevent Diabetes program, and a Community Health Expo.
Lake Superior Community Health Center – Duluth expanded care coordinator training to include a tobacco cessation specialist and health coach certification. The care coordinator links patients with community resources and closely tracks home monitored hypertensive patients and those referred out for prenatal care.
Lakewood Health System – Staples quality improvement efforts generated >93% vaccination rates, a comprehensive plan for Ebola, a pharmacy led “Antimicrobial Stewardship” committee, and patient transfer and referral process improvements. The high functioning quality team worked with providers on the American Heart Association Aspirin Initiative to educate and improve screenings. The team also developed new processes and workflows to counsel and monitor opioid patients resulting in successful tapering or cessation of opioid therapy.
Mayo Clinic – Rochester Employee and Community Health integrated nine Community Health Workers (CHW) into their patient-centered, team-based care model. CHWs serve all ages, diagnoses, and communities, holistically aligning home visits, resources, and community agencies.
North Memorial Health – Fridley implemented an advanced care planning initiative using lay volunteers from Patient Advisory teams. In a short period, over 75 patients completed an advanced health directive.
St. Luke’s Clinics – Duluth offered “Wellbeing Series” sessions to patients and community members, promoted by social media. Patient Advisory Committees helped determine topics of interest to patients.
St. Paul Family Medical Center customized their plan-do-study-act (PDSA) template and developed an organized system to allow the clinic’s quality team to quickly access and review any of the PDSA cycles they had completed.
Sanford Health – North Region (Wahpeton Clinic ND) wanted to know how addressing social determinants affects patient health outcomes. They hired a social worker and used a social determinants of health screening tool to identify barriers and provide a warm handoff to the social worker who followed up to secure needed resources. Diabetes, hypertension and depression remission quality scores improved.
University of Minnesota Physicians - Bethesda, Broadway, Smiley’s, and Phalen Clinics collaborated to develop and implement a standard opioid treatment protocol across all clinics. Providers and staff expressed increased satisfaction with new processes, drug screens, and naloxone prescriptions for at-risk patients.
|
|
|
Noteworthy Info & Resources
We Can Navigate is a new resource for people experiencing the symptoms of psychosis and their families who need greater outreach efforts and access to information that helps them find the help they need. The WeCanNavigate website serves three main purposes:
-
Informs the public on the signs and symptoms of psychosis
-
Provides friends, family members, and healthcare professionals with tools for helping someone experiencing psychosis
-
Describes the NAVIGATE program, an evidence-based treatment program for persons with first episode psychosis.
The website came out of a collaboration between the Minnesota Center for Chemical and Mental Health (MNCAMH), the Minnesota Department of Human Services, and the University of Minnesota Psychiatry Department. For more information, email: MNCAMH, UMN School of Social Work or Phone: 612-626-9042.
As of April 1, 2018, Minnesota’s suicide prevention and mental health crisis texting services - DHS Crisis Lines - are now available 24 hours a day, seven days a week.
Connecting Communities with Data (PDF) offers practical guidance for using EHR data to support community health. For more information please see the MDH e-Health webpage.
The 2017 Health Resources Directory for Diverse Cultural Communities webpage provides a resource directory of low-cost services and covers dental services, disability services, domestic violence services and sexual assault services, health services, home health services, hotlines, mental health services, and vision services.
The 2017 Diverse Community Media Directory (PDF) provides a quick reference for individuals working to identify appropriate media channels that reach a broad cross section of diverse groups including populations of color, American Indians, GLBT, people with disabilities, immigrants and refugees in the Twin Cities metro area and, to a limited extent, in greater Minnesota.
Another diversity reference, the 2017 MAA-DBO Directory (PDF), is for individuals working to identify appropriate mutual assistance associations (MAAs) and community-based organizations (CBOs) that serve Minnesota’s many diverse communities. Listings are by ethnic group.
|
|
|
|
