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Vermont Blueprint for Health

Vermont Blueprint for Health. Sharon Moffatt Commissioner of Health August 2007. Sickest 10 % Account for 64 % of Health Care Expenses. Expenditure threshold (2003 dollars). 1%. 5%. 24%. 10%. $36,280. 49%. $12,046. 64%. 50%. $6,992. 97%. $715.

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Vermont Blueprint for Health

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  1. Vermont Blueprint for Health Sharon Moffatt Commissioner of Health August 2007

  2. Sickest 10 % Account for 64 % of Health Care Expenses Expenditure threshold (2003 dollars) 1% 5% 24% 10% $36,280 49% $12,046 64% 50% $6,992 97% $715 Source: The Commonwealth Fund. Data from S. H. Zuvekas and J. W. Cohen, “Prescription Drugs and the Changing Concentration of Health Care Expenditures,” Health Affairs, Jan./Feb. 2007 26(1):249–57.

  3. Cost of Chronic Conditions is Both Personal and Financial Care for people with chronic conditions accounts for 83% of health care spending 81% of hospital admissions 76% of all physician visits 91% of all prescriptions filled

  4. Vermonters with Chronic Disease

  5. The Cost of Obesity One-third of total direct health care costs in the U.S. are related to 15 Diseases Associated with Obesity Medical expenses attributable to Adult Obesity inVermont 141 Million Annually

  6. Chronic Disease and Obesity

  7. Reducingdiabetes deaths: options Deaths Per Thousand Adults 2.50 No Change Better Care 2.25 Obesity Prevention 2.00 1.75 1.50 1.25 1980 1990 2000 2010 2020 2030 2040 2050 Time (Year)

  8. 2.50 2.25 2.00 1.75 1.50 1.25 Reducing diabetes deaths: comprehensive approach No Change No major changes – status quo Obesity Prevention and Better Care Care and reduction in caloric intake 1980 1990 2000 2010 2020 2030 2040 2050 Time (Year) Deaths from complications–per thousand Adults

  9. The Model for Chronic Disease Care

  10. Vermont Blueprint Model for Health Blueprint Partnership Community Public Policy Public Health • Built Environment • Health Services • Health Awareness • Healthy Options • Information • Systems Patients and Families Healthy Vermonters • Policies • Infrastructure • Financing • Resources • Advocacy • Regulation • Information • Systems • Health • knowledge • Self-manage- • ment skills • Supportive • home • environment • Information • Systems Health Systems • System policy • Quality care • Reimbursement • Financing • Continuity • Coordination • Information • Systems Health Provider Team • Practice standards • Office Systems • Support • Information • Systems

  11. Public Policy Governor Douglashas focused on investing in full System Approach • Blueprint for Health • Fit and Healthy Kids • Drug Enforcement, Treatment, Education and Treatment (DETER ) • Catamount Health

  12. Public Policy Legislation 2006 and 2007 • Full support of Governor Douglas’s Blueprint Budget • Requires all private insurers, Medicaid and state employee health insurance to following Blueprint model • Requires all clinical guidelines to be the same for all insurers

  13. Provider Practice and Health Systems • Best practice clinical standards forpatient care • Microsystems change at practice level • Support the patient with connections to other parts of the health care system and the community • Use e-health tools to link information and resources to the provider and patient

  14. Information Technology Chronic Care Information System Supports medical decision making: • Clinical standards built in to guide the clinical care for individuals and targeted populations • Provides reminders for recall visits • Provides timely info from labs, specialties • Emergency rooms will have immediate access to patients’ medications list

  15. Healthy Living ParticipantsMedical Care Visits to a health care provider’s office and the Emergency Dept decreased significantly at 6 & 12 months MD Visits ED Visits

  16. Daily Activities Participants report, after 12 months, their health condition does not interfere with their daily activities such as social activities with friends, hobbies, recreational activities and household chores.

  17. Community 53% of Vermont Adults are obese or overweight • Communities have walking programs year round for all ages • Farmers’ Markets have doubled in the last 5 years

  18. Blueprint Budget 2006 By Focus Area

  19. Best Practice Guidelines • Agency for Healthcare Research and Quality www.guidelines.gov • Institute for Clinical Systems Integration www.icsi.org • American Diabetes Association www.diabetes.org • American Heart Association www.americanheart.org

  20. Resources/References • The Chronic Care Model: Improving chronic illness care a national program of The Robert Wood Johnson Foundation, www.improvingchroniccare.org • Wagner, E.H. Chronic Disease Management: What will it take to improve care for chronic illness? Effective Clinical Practice 1998; 12-4.

  21. Resources/References • Crossing the Quality Chasm: A New Health System for the 21st Centry, Institute of Medicine, National Academy of Sciences, 2001. • To Err is Human: Building a Safer Health System,Institute of Medicine, National Academy of Sciences, 2000.

  22. Resources/References • The Model for Improvement by the Institute for Health Improvement www.ihi.org • The Quality of Health Care Delivered to Adults in the United States. New England Journal of Medicine 2003, 348:26. • Vermont Department of Health website: www.healthvermont.gov

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