NH Health Care Town Hall Blog
Wednesday, June 23, 2010
Boulder-Watching in the Granite State
By Laura Davie
NH Institute for Health Policy and Practice/NH Citizens Health Initiative
As the current Citizens Health Initiative pillar projects—Medical Home, Payment Reform, and Health Promotion Disease Prevention—move forward, Initiative leadership has started to look forward to determine what’s next.
In today’s post-health-reform-law world, this is not an easy question to answer. In its first five years, the Citizens Health Initiative took on many of the important issues related to reforming New Hampshire’s health system. When I speak of the accomplishments of the Initiative, I am speaking of the accomplishments of hundreds of people who have contributed time and expertise across all of projects. This work has ranged from developing strategic plans for health information technology/exchange and primary care, to implementing a multi-payer primary care medical home pilot project, to aligning our work on the leading actual causes of illness and death. The Citizens Health Initiative’s most recent effort under the Payment Reform pillar project is developing an Accountable Care Organization pilot. This pilot relies heavily on the partnerships, trust, and leadership developed during the course of the Initiative’s first five years. This work has laid a foundation in New Hampshire for implementing the health reform law. But what’s next?
This is not an easy question to answer (and it needs to be answered by many more organizations then just the Citizens Health Initiative). During a recent meeting of Initiative leadership, an analogy was made relating health reform to a boulder. Before the recent legislation passed, we were trying to push a boulder up a hill. Now that the legislation has passed, the boulder is now rolling down the other side. By the end of the meeting, there was agreement that health reform is more than just one boulder. It is several boulders of varying sizes, moving at different speeds.
New Hampshire needs a way to identify the boulders, track their paths, and make adjustments as needed. The Citizens Health Initiative leadership will continue to identify and discuss areas which would benefit from the partnerships, trust, and leadership built over the past five years.
Wednesday, June 16, 2010
The Power of Leadership – The Power of Community
By Ned Helms
Three separate but related events this week have reminded me in a vivid way about the power and importance of engaged and enlightened community leadership.
On Monday the Citizens Health Initiative and the Endowment for Health hosted a meeting with senior representatives of two national foundations that are leaders in innovation in the Health and Health Care field. The purpose of the meeting was to share with them the work we are undertaking in New Hampshire to launch an Accountable Care Organization Pilot. During the morning session, leaders representing hospitals, clinicians, employers, consumers, health insurers and our University system reviewed our progress to date and the importance they saw in a project that would create systems of care that were accountable not simply for treating individual illness but truly maintaining a population’s health. At noon, we took our guests to the State House for lunch. In the Governor and Council Chamber they listened to and asked questions of our Governor, the Speaker of the House, the President of the Senate, the Chairs of our House and Senate Health and Commerce Committees, the Commissioners of HHS and Insurance as they explained their commitment to our ACO Pilot. As I sat there I wondered: “ In what other state have they experienced a meeting with that kind of senior state policy leadership in one spot?” Remember too that our Pilot is not a result of a law or a regulation, yet here were elected and appointed leaders giving strong support to a voluntary effort. The next day we received a note from one of the guests who answered my question. In a word they were amazed at the level of commitment of the people, the health leaders the business leaders and the policy leaders to such an ambitious effort that relied on a willingness to commit to a path of change and improvement.
Yesterday, I began the task of reviewing the applications that we have received from health care systems in the state to be a part of the ACO Pilot. Let me repeat, this is a voluntary effort. No one has commanded these systems to participate in the pilot. The path to becoming an ACO is not clearly marked out and will require innovation and openness to change. The systems that have come forward understand that the failed system of fee for service will need to give way over time to one that creates target budgets, shared savings and ultimately accountability for cost, quality and results. Not every system has stepped forward and we are still treating the applications confidentially but let me simply say that the systems that have shown the leadership to undertake such a journey represent areas from across our state, north to south, east to west that cover about 40% of our population, and include over 600 clinicians. That is an impressive first step.
The final of the three events occurred last night as over 1,000 people gathered in Manchester to say thank you to Lew Feldstein as he prepares to end a quarter century as head of the New Hampshire Charitable Foundation. It was a wonderful evening full of memories, laughs, music and reflection. In his brief comments at the end of the evening Lew spoke to the true power of New Hampshire; and what he said helped me to pull the events of the last couple days together. Lew observed that New Hampshire is not a state with a powerful central government. Rather we rely for our progress as a state and as a people on the power of leadership and volunteers from all parts of our society. We are not a state that relies on progress by using top down mandates. We are a state that constantly refreshes itself and shapes itself by bottom up community activity. Our true advantage is our commitment to voluntarily, and collaboratively call on each of us to be leaders.
Health care reform, as I have said before here on this blog, ultimately will come down to action taken at the local and regional level. It will require leaders from all sectors of our state to come forward and say we know we can do better than we have done. We know we can create a system that provides higher value and better outcomes. We know we can do this in a way that does not sacrifice our economic future with constantly rising costs.
The critical ingredient is willing leadership. I have seen that leadership in the meetings on Monday and in the thoughtful applications from creative and courageous health care systems that are willing to shape a new system of accountable health and health care. I was reminded by Lew of what we can accomplish when we voluntarily choose to shape a brighter future. I was reminded in each instance of why I love this state so much and have such hope for the tomorrows we help shape each day.
Let me close by saying to Lew…once again Lew you were there when I needed you to put it all together for me. Now let’s go out and put it all together for ourselves and our state.
Wednesday, June 9, 2010
We Are All in This Together: Health Reform and Public Health
By Elaine Frank, President New Hampshire Public Health Association, www.nhpha.org
I agree wholeheartedly with Ned Helms. Things have changed dramatically and for the better with the signing of the Patient Protection and Affordable Care Act. It is now up to us individually and collectively to see that the promised increase in access to health care and its emphasis on evidence based practice results in improving the health status of ALL our residents. Not just the young and the old but also young adults and those in middle age; not just the rich and the poor but also the working poor and the middle class; not just those suffering from physical illnesses but also those dealing with illnesses of the mind and co-occurring disorders; and not just those with acute distress but those with chronic conditions that impact them every day. We are all in this together and our communities are only as healthy as the least well among us.
Read more »
Wednesday, May 26, 2010
Screening, Brief Intervention, Referral and Treatment: An Important Component in Health Reform
by John F. Bunker, ScD, MHS
President, New Futures
There are many different pieces to the new federal health care law, and many different organizations trying to make sense of how the law will impact New Hampshire. Our organization, New Futures, is one of those organizations. New Futures is a nonprofit, nonpartisan advocacy organization working to reduce underage alcohol problems and increase access to treatment in New Hampshire.
Read more »
Leave a Comment