Title: Health Care Provider, Health Plan
1Health Care Provider, Health Plan Aging Network
Partnerships
- Nora Barkey, Area Agency on Aging of Western
Michigan - Christopher Minnick, Albert Einstein Healthcare
Network - Todd Osbeck, Priority Health
- Tianna Pettinger, Senior Services of Albany
National Council on the Aging - American Society
on Aging 2006 Joint Conference March 18, 2006
2From Research to Practice
- Administration on Aging
- Evidence Based Prevention Programs
- Funding for 12/14 Partnerships
- National Council on the Aging
- Goals of Selected Projects
- Improving chronic disease self management
- Increasing physical activity
- Preventing falls
- Improving nutrition
-
3Three Projects
- You will hear
- AOA- Evidence Based
- Overview of 3 projects
- Original research,
- Partners
- Clients served and outcomes
- What we learned
- Health Partners-benefits and challenges
- Aging Network benefits and challenges
4Issues for all
- Reachtarget audience
- Effectiveness research based
- AdoptionGetting things up and running
- Implementation Fidelity
- Maintenance
5Partners on the P.A.T.H. Chronic Disease Self
Management Grand Rapids, MI
- Partners
- Area Agency on Aging of Western Michigan
- Grand Rapids Community Foundation
- Priority Health (Health Plan)
- Community Aging Service Providers
- Senior Neighbors, Gerontology Network, United
Methodist Community House, ACSET- Latin American
Services - Grand Valley State University
6Evidence Based Stanford Chronic Disease Self
Management Program
- Stanford Research Recommendations are
- Creation of an informed patient
- Peer led learning experience
- Social support for change
- Skill building for decision making and follow
through - Intervention- Core elements
- Six 2½ hour sessions,
- Leaders trained by Stanford Master Trainers,
- Stanford questionnaire
- Scripted curriculum including use of Living a
Health Life with Chronic Conditions workbook and
relaxation tape - http//patienteducation.stanford.edu/programs/cdsm
p.html
7Partners on the P.A.T.H. Participant Profile
- Referrals
- 50 Priority Health
- 289 Community
- 339 participants
- 78 female
- 15 African American
- 10 Latino
- Average Age 73
- Perceive financial need 14
8Partners on the P.A.T.H. Outcomes
- Our follow-up at 6 months (vs. 4 mos. in
original) - Our participants (145-150 per analysis) reported
- Reduced pain
- Less health distress
- More ability to manage symptoms
- Less intrusion of illness in life
- More minutes of aerobic activity
9Harvest HealthChronic Disease Self
ManagementPhiladelphia, PA
- Partners
- Philadelphia Corporation for Aging (AAA)
- Center in the Park (Community Aging Service
Provider) - Albert Einstein Healthcare Network (Health Care
Provider) - Center for Applied Research on Aging and Health,
Thomas Jefferson University (Academic Research
Organization)
10Harvest Health Goals, Objectives and Outcomes
- Goal
- Improve the ability of older African Americans to
manage their chronic health conditions. - Objectives
- Demonstrate effectiveness of CDSMP intervention
for this population - Expected outcomes
- Improved health status
- Behavioral change
- Improved self efficacy
- Reduced healthcare utilization
11Harvest Health Participant Profile
- Target enrollment over three years - 500
- 394 recruited
- 266 enrolled
- 88 completed the program
- 85 Female 15 Male
- 100 African American
- Age range 56 93 mean 72.5
12Harvest Health Participant Recruitment
- Participant Recruitment
- Center in the Park
- Local churches
- Senior social clubs
- Senior apartment complexes
- Primary Care Physician Offices
13Harvest Health Outcomes
- Increased physical activity
- Increased self-efficacy for symptom management
- Reduced health distress
- Reduced illness intrusion
- 95 report continued use of strategies
- Increase in overall health care utilization
(increase in physician visits)
14Women take PRIDEChronic Disease Self
ManagementAlbany, NY
- Partners
- Senior Services of Albany (private non-profit)
- Northeast Health (health provider network)
- Blue Shield of Northeastern NY (insurer)
- Albany County Department for Aging (AAA)
- State University at New York at Albany, School of
Public Health
15Evidence Based University of Michigan Heart
Disease Self Management Program
- Developed by Noreen Clark and colleagues at
University of Michigan - Four-week education and behavior modification
program for women aged 60 with heart disease - Based on Social Cognitive Theory
- Taught by health educator and peer leader
- Clark NM. et al. (2000) Journal of
Gerontology, 55B S117-126.
16Women take PRIDEParticipant Profile
- Albany WTP (N61)
- Age 62-91, mean age 75
- All female
- 0 Less than h.s. education
- 31 High school graduate
- 69 Some college/degree
- 97 White
- 3 African American
- 0 Other
17Women take PRIDEOutcomes
- Pre-post outcome evaluation design with baseline,
4-month and 12-month measurements - Preliminary results resemble those of original
research - Walk further in 6-minute walk
- Number of cardiac symptoms, frequency of symptoms
and bothersomeness of symptoms are reduced.
18Health Plan Partnership Why Would a Health Plan
Want to be a Partner?
- Health Outcomes are Important
- NCQA accreditation depends on it (HEDIS)
- Employer purchasers are demanding quality
- NBCH eValue8 RFI
- Good health results in lower cost
19Health Plan PartnershipChronic Care Model
Wagner EH. Chronic disease management What will
it take to improve care for Chronic illness?
Effective Clinical Practice. 199812-4.
20Health Plan Partnership How does Priority
Health Focus on Quality?
- Members
- Nurse Case Management
- Member Education Mailings
- Web Site Health Management Tools
- Personal Health Records
21Health Plan Partnership How does Priority
Health Focus on Quality?
- Doctors
- Monthly Quality Outcome Reports
- On-Line Patient Lists (Diabetes, Asthma, etc.)
- Incentive Programs based on Quality Outcomes
- Public Reporting of Doctor Performance
- Consulting on Delivery System Design
22Health Plan Partnership Why is PATH Important?
- Patient Self Management Good Outcomes
- Many Patients do not have skills
- Many Doctors do not teach skills
- Not enough time
- Focus on task list
- Self Management Educational Resources are limited
or have limited focus
23Healthcare PartnershipUnderstanding the Health
Care Partner
- What are the benefits for the health care
partner, why should they be interested in
promoting, what measurable outcomes can be
marketed to them? - What is the appropriate entry point for the
program in the health care organization? - What factors need to be understood about the
health care system? - HMO
- Hospital owned practices
- Chain of command
- Champions
24Healthcare PartnershipUnderstanding the Health
Care Partner
- What factors need to be understood about the
practice? - Challenges in patient referral
- Short visits
- Problem-focused v. preventative interaction
- Who makes referral physician, office staff?
25 Healthcare PartnershipBenefits of Partnership
- Primary Care Physician (PCP)
- Facilitates treating patient holistically
- Improves quality of service delivery
- Patient more compliant
- Improved healthcare outcomes
- Patient retention
- Increased referrals to practice by WOM
26Healthcare PartnershipBenefits of Partnership
- Albert Einstein Healthcare Network
- JCAHO Accreditation through the Ambulatory Care
Review Process - Establishment of Standardized Clinical Measures
- Physician Incentive Program based on Quality
Performance - Improved operations
- Better patient care
- Increased competency of staff
27Aging Network PartnersUnderstanding Aging
Partners
- What are the benefits for the agency?
- Does the program fulfill agencys mission?
- What funding is available to support the program?
- Factors to understand
- Diversity of staff (i.e. education level,
experience) - research or intervention may be intimidating
- Interested in individuals, promoting
independence, supporting other programs
(cross-referral, they stay for the congregate
meal etc.) - Good at being flexible, adaptable, resourceful,
working in community settings - Understand seniors
28Aging Network PartnersBenefits of Partnership
- Complimentary expertise
- Access multiple networks, funding streams
- Two heads are better than one multiple
perspectives - Lend credibility to each other, have pull with
different audiences/individuals - Referrals from medical system
- Brings strong evidence-based programming to
senior offerings, develops staff skills
29Lessons Learned
- Challenges engaging PCPs
- Theyre busy!!!!
- Limited time per patient
- Many demands during the visit
- Mindset towards non-compliant patients
- Understanding motivations of PCP
- Patient progress and satisfaction
- Third Party focus on prevention, wellness and
education - Quality Incentives
30Lessons Learned
- Challenges for the Network
- Physician Champion
- Senior Management Support
- Consistent marketing and presence with PCP
offices - Finding the right contact in the PCP office
- Make it easy and simple
31Lessons Learned
- Referrals from health partners
- Talks by nurse educator in the community on
related health topics (sign-up sheet in addition
to printed materials) - Front desk staff asked to distribute brochure to
target population upon signing-in for appointment - Health insurer, able to do mailing to targeted
members (have health info)
32Dissemination You can do this.
- Replication Manuals
- Tool Kits
- How Tos
- Welcome to our network
- www.healthyagingprograms.org
33How to reach us
- Nora_at_aaawm.org
- todd.osbeck_at_priority-health.com
- minnickc_at_einstein.edu
- tpettinger_at_seniorservicesofalbany.com