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CIVHC Convenes Innovation Challenge Applicants with Foundation, Payers to Leverage Triple Aim Projects

The spirit of innovation is alive and well in Colorado health care. And, even as providers, patient advocates and health plans respond to local needs, they’re identifying many of the same problems. Even more striking: they agree that the changes they need to make to improve health, improve care and control costs can’t be done without radically transforming the way we pay for health care.

These are some of the key points that emerged from two recent meetings CIVHC convened with organizations from around the state that applied for the Health Care Innovation Challenge. This program, funded through the Affordable Care Act by the Center for Medicare and Medicaid Innovation, provides three-year awards of up to $30 million to health care delivery redesign initiatives that deploy the health care workforce in new ways and foster broad-based partnerships. Click here for an overview of projects awarded in Colorado.

On June 18 and 25, CIVHC brought together Innovation Challenge applicants with Colorado foundation and health plan representatives. The meetings were designed to “connect the dots” among these proposals and other reform initiatives currently underway in our state. What are the common themes? What is the white space that needs to be filled? How can we leverage and scale up these ideas into a comprehensive, statewide Triple Aim strategy?

A few things stand out starkly:

·       Integration and coordination are the name of the game. Every single applicant we heard from described some way of knitting together the disparate pieces of the health care system – primary care and specialty care, physical and behavioral health, clinical care with public health and community resources. The notion that our current siloed delivery system just doesn’t meet patients’ needs pervaded every idea that was presented. Here are the primary approaches to coordination we heard about:

  • Colorado has embraced the idea of coaches and navigators to improve patients’ care experience and coordinate their care. Almost all the proposals include this element in some way. Some would train lay people to take on these roles; others rely on non-physician providers.
  • Integrating physical and behavioral health care is a top priority for communities large and small. Fully one-half of the proposals on our list either focus on this exclusively or include it as a major component. These proposals all note that you can’t separate mind and body health – you have to address both, together, to improve outcomes and control costs for many high-risk and chronically ill populations.
  • Many proposals used care coordinators, telehealth or other interventions to improve transitions between hospitals and other care settings.

Underlying these different recommendations for coordinating care was an explicit call for new types of payment that reward coordination and outcomes, not pay for piecework. Presenter after presenter noted that coordinated interventions they propose to improve quality simply aren’t possible in a fee-for-service world.

·       The notion of targeting the highest-risk, highest-cost, highest-use “hot spotter” patients resonates across the board.

CIVHC is continuing to analyze the proposals and place them into a statewide context. We’ll meet again with the foundations and health plans to go over our findings and talk about the opportunities for creating “critical mass” by linking these proposals with existing work.

This is an exciting – and creative – time in Colorado health care. Stay tuned and we’ll share our findings and recommendations in upcoming posts.

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nice post, it's very useful for me, thanks for sharing!
8/8/2012 12:19:02 AM

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