Welcome & Call to Order

1. Strategic Investment in Shared Outcomes: Transformative Partnerships between Health Systems and Communities  A Convening of a National Health Systems Learning Group and Senior Health System Leadership US Dept of Health and Human ServicesWashington, DCApril 4, 2013

2. Welcome & Call to Order Heidi Christensen Center for Faith-based and Neighborhood Partnerships Department of Health and Human Services

3. White House Greeting and Welcome Carole Johnson White House Domestic Policy Counsel

4. HHS Welcome and Introduction Acacia Salatti Acting Director, Center for Faith-based and Neighborhood Partnerships, Department of Health and Human Services

5. Howard K. Koh, M.D., M.P.H. . Assistant Secretary of Health US Department of Health and Human Services

6. Nancy SchlichtingChief Executive Officer, Henry Ford Health System, Detroit MI Setting The Stage:Making The Business Case For Partnering With Communities To Transform Population Health Sew Up Safety Net, Henry Ford Health System

7. Gary Gunderson, MDiv, DMin,DDivVice President Faith and Health, Professor of Public Health Science and Divinity Wake Forest Baptist Medical Center An Ensemble Of Practices: Briefing On The Health Systems Learning Group’s Discovery

8. Kimberlydawn Wisdom, MD, MS Senior Vice President Community Health & Equity and Chief Wellness Officer Henry Ford Health System An Ensemble Of Practices: Briefing On The Health Systems Learning Group’s Discovery U.S. Surgeon General, HSLG meeting in Detroit, Oct. 2012

9. Transformative Strategies from the Top of the Mission to the Bottom Line Shifting unmanaged charity care into strategies for community health improvement Integrating care to address socially complex residents at the neighborhood level Engaging communities in transformative partnerships with shared accountability

10. Shifting Unmanaged Charity Care into Strategic Community Health Improvement Rick Rawson, Chief Executive Officer Loma Linda University Medical Center Murrieta Dora Barilla, Dr.PH,MPH,CHES Director, Community Health Development Garden on the Go@, IUHealth

11. Unmanaged Charity Care “We have evaluated the primary focus of our ‘acute care’ role and committed to reclaim our original purpose, that of being trusted community partners in improving health.” “We have a history of doing what is needed before it is required, incented, or penalized.” Health Systems Learning Group (HSLG) Monograph, April 4, 2013

12. Quadruple Aim? Medicare, Medicaid and Mercy (Uninsurable) • Improve the experience of care • Improve the health of populations • Reduce per capita costs of health care • Reduce health disparities

13. Build a Population and Community Health Infrastructure

14. Upstream Design of the Primary Care Network

15. Partner with Individuals, Families, and Community Agencies

16. Financial Management: Design Economic Models that Fit our Purpose

17. Digital and Data Infrastructure Census Demographics Health Status Indicators Service Utilization Primary Care Network Design Community Assets Market Potential

18. Bridge Clinical Care Management to Community-Based Prevention

19. Discussion • What do you view as critical institutional readiness? • What kind of help can we provide to one another to help accelerate that readiness?

20. Kristen Peachey, MSW, MDiv, DMinDirector, Congregational Health PartnershipsCo-Director, The Center for Faith and Community Health TransformationAdvocate Health Care Integrating Care To Address Socially Complex Residents At The Neighborhood Level CLOCC, Advocate Health Care partner

21. Social Determinants of Health

23. Social Complexity Is Powerful

24. Culture Shift • From “Individual” to “Complex People in Socially Complex Communities” • From bearing the load alone to collaborative, cross-sector solutions • From certitude to curiosity

25. CLOCC—Consortium to Lower Obesity in Chicago Children Convened By Lurie Children’s Hospital Of Chicago Broad Collaborative Network Across Sectors—3000 Participants Representing 1200 Organizations Data-driven, Evidence-based, Capacity Building Collaborative Work Groups--environmental Change, Public Education, Advocacy, Research, Outcome Measurement, Program Evaluation 2% Decrease In Obesity In Chicago’s Children In 5 Years.

26. Margaret SabinPresident and CEO,Penrose St. Francis Health System Integrating Care To Address Socially Complex Residents At The Neighborhood Level Sew Up Safety Net for Women and Children, Henry Ford Health System

27. Partnering to Serve the Community • Partners: Penrose - St. Francis Health Service and Faith Communities • Mission: “Preach, teach and heal” • Church touches people at their most critical junctures • Church holds a deep understanding of the link between one’s spirituality and well being • Church members are challenging their leaders to redefine their ministry of health

28. Partnering to Serve the Community • Healthy Church Initiative started • Fresh look at their health ministry by building around wellness rather then disease and death • Preach on the relationship between one’s spirituality and health • Administer “health tool” to congregation and show results • Proven toolkit of resources to continue engagement • Provide ongoing support

29. Partnering to Serve the Community • Partners: Local hospitals and fire department. • Goal: Decrease unnecessary 911 calls and hospital ED visits. • Paramedics visit patient’s home completing home safety visits, medication review, education and coordinating services with their PCMH. • Ongoing evaluation to fill in gaps of care.

30. Partnering to Serve the Community • Partners: Penrose - St. Francis Health Services, Old North End Neighborhood • Included pre and post health screenings, health risk assessment survey, 1:1 coaching and access to our classes. • Total of 289 participated, 203 completed (70%) • Improvements validated: Risk Categories improved in BMI by 15%, Blood pressure by 35% and Total Cholesterol by 15%.

31. Partnering to Serve the Community • Partners: Penrose - St. Francis Health Services, its employees and partner physicians • Tiered network benefit design & paid PMPM to focus on specific chronic conditions • Rewarded employees to participate • Plan Results: Medical cost trend decreased by 1.1% for those in the pilot plan compared to 15% increase in non pilot program • Wellness Results: Risk Categories improved; BMI 9%, Cholesterol 6%, and BP 3%

32. Discussion What do you view as critical institutional readiness? What kind of help can we provide to one another to help accelerate that readiness?

33. Strategic Investments in Shared Outcomes: Transformative Partnerships between Health Systems and Communities Break Promotores de Salud, Inova Summer Feeding Program, Promedica Gardens on the Go@, IUHealth

34. Arts of Alignment: Engaging Communities in Transformative Partnerships with Shared Accountability John McConnell, M.D.Chief Executive Officer Wake Forest University Baptist Medical Center Teresa Cutts, Ph.D.Director Of Research For InnovationMethodist Le Bonheur Healthcare Faith Health Event, Methodist Le Bonheur

35. Why Transformative Partnerships? Ask the Institute of Medicine. From “Primary Care & Public Health” (2012): Dramatic rise in health care costs leads everyone to innovate. Health research reinforces priority of social determinants, primary care for prevention and condition management. Rich data helps all understandand address population health. ACA provides overarching opportunity to change the way we approach health in the U.S. http://www.iom.edu/Reports/2012/Primary-Care-and-Public-Health.aspx

36. Transformative Partnerships Help Solve Big Health Systems Problems Uncompensated care Inappropriate ED use Readmissions Spiraling chronic disease Declining reimbursements “We need to move from ‘what’s the matter?’ medicine to ‘what matters to you?’” - Maureen Bisognano, IHI, Out of the Blocks Conference, 2012

37. How Do We Engage Great Community Partners? Short Answer: Be a Great Partner. Santa Rosa Community Clean-Up, St. Joseph Health System Sonoma County

38. How Do We Engage Great Community Partners? Assess community health needsandassets; identify partner roles and contributions Community Health Assets Mapping or CHAMP, Methodist Le Bonheur

39. How Do We Engage Great Community Partners? • Focus on shared gains opened up by new policies “with some assembly required” • Community Benefit • ACA, Medicaid expansion, • Healthy People 2020, etc. San Bernardino County’s Healthy Communities Program, Loma Linda, CA,

40. How Do We Engage Great Community Partners? Assume scale, spread and sustainability: Memphis Tri-State Congregational Health Network and Wake Forest University Baptist Medical Center’s Partnership with NC Hospital Association MEMPHIS I

41. How Do We Engage Great Community Partners? Choose measures of success together for mutual accountability • CeaseFire Violence Prevention Program, Advocate Health Care Partner

42. How Do We Engage Great Community Partners? Develop measurable, strategic communications Sew Up Safety Net for Women and Children, Henry Ford Health System

43. How Do We Engage the View Out my Window? Community and values become part of normal strategic vision: Strategically analyzing partnerships such as the children’s home. Employees and Faculty Community Roles are aligned, strengthened and leveraged: Environmental Service Workers

44. How Do We Engage the View Out My Window? How do we structure expanded accountability to our partners? Where and how do we converge with our competitors? How can an AMC pursue discoveryto enhance change and advance health? Winston-Salem, NC Wake Forest University Baptist Medical Center

45. Discussion What do you view as critical institutional readiness? What kind of help can we provide to one another to help accelerate that readiness?

46. John O’ BrienImmediate Past President and CEO of UMass Memorial Health Care CEO Response To Recommendations HOPE Coalition, UMass Memorial

47. Working Lunch: “Operationalizing” the Vision Thomas Strauss Chief Executive Officer, Summa Health Douglas Hawthorne Chief Executive Officer, Texas Health Resources James Skogsbergh Chief Executive Officer, Advocate Healthcare

48. Sally Howard . Chief of Staff Department of Health and Human Services

49. Blue Button+Presentation to Senior Leadership Summit, Health System Learning Group Pierce Graham-Jones Innovator-in-Residence Dept. of Health & Human Services April 4, 2013

50. Untapped Demand for eHealth • 90% agree you should be able to get your own medical info electronically • 2 out of 3 would consider switching to a provider who offers online access • 52% would use a smart phone to monitor health • 69% track a health indicator • 20% have accessed their health info online • 10% have a personal health record (PHR) • 9% have mobile app to manage health • 21% of individuals who track use a form of technology