Criteria for Best Practices
Creating the health infrastructure we need in order to achieve ‘quadruple aim’ goals will require both institutional alignment within health systems, and external alignment across the WHOLE system, including health systems and all community assets. Health system elements to be addressed include:
- Operational links between finance and community benefit
- Integration of community benefit and organizational strategic planning
- Inter-department accountability to address disparities
- Population health competencies among members of senior leadership
- Metrics and rewards tied to performance
Some key considerations for health systems are that the need to:
- Be able to calculate bundled costs and construct equitable ways of sharing ever-shrinking reimbursement, in the light of global financing.
- With the extension of coverage through health reform, to adjust models for calculating readmission rates and other key indicators to account for the differing disease trajectories faced by populations grappling with disparities.
- Identify and be transparent about true ED costs, and costs associated with other potential stakeholders in the community (ambulatory, post-acute, primary care, mental health, support programs)-this could evoke innovative models for providing the ‘right care at the right time.’
- Identify and understand direct and indirect costs of poor health outcomes (e.g. readmissions, cognitive, functional, activities of daily living skills, IADLS, quality of life, medical-particular disease, employer, Medicaid, Medicare, private insurance) outside of the hospital, to understand and develop ‘community metrics’ that could lead to more sustainable partnerships and expectations of those partnerships.
A Health Provider Finds Success in Keeping Hospital Beds Empty, The experience of a health system in Chicago shows just how hard it will be to expand its approach, known as “accountable care,” and keep costs from resuming their relentless rise.
ProMedica, Partnering with Community Organization to End Hunger. To help address hunger in metro Toledo, ProMedica, YMCA, and JCC of Greater Toledo, University of Toledo and other community organizations are driving a community wide dialogue in order to create and promote policy changes that will enhance local food production (addressing policy and other barriers to community gardens at faith-based organizations in neighborhoods and schools) and support community collaborations that will create a stronger safety net. ProMedica has also been also selected to join the No Kid Hungry Allies program and partner with Share Our Strength®, a national nonprofit working to end childhood hunger in America. As a No Kid Hungry Ally, ProMedica will be working to increase participation in Summer Meals and to increase support for the school breakfast and afterschool meals. ProMedica recruited sites served 45,000 meals in the summer of 2011.