academyhealth engagement, empowerment, enhancement: the role of consumers in health care and...
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Engagement, Empowerment, Enhancement:
Graphic: Flip the Clinic
The Role of Consumers in Health Care and Advocacy
Your team for today’s discussion:
S. Whitney Bowman-Zatzkin, MPA, MSRDirector, Flip the [email protected] | @MsWZ
Thomas Workman, Ph.D.Principal Researcher, American Institutes for [email protected]
Claire Brindis, Dr.P.H.Director, Philip R. Lee Institute for Health Policy StudiesProfessor, Pediatrics and health PolicyDirector, Bixby Center for Global Reproductive healthExecutive Director, Adolescent and Young Adult Health, National Resource [email protected]
Amanda OteroHealth Care Organizer, TakeAction [email protected]
Paving the Road for Patient and Family Engagement
Thomas Workman, Ph.D.Kristin L. Carman, Ph.D.American Institutes for Research
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Kristin L. Carman, Pam Dardess, Maureen Maurer, Shoshanna Sofaer,Karen Adams, Christine Bechtel and Jennifer Sweeney (2013). Patient And Family Engagement: A Framework For Understanding The Elements And Developing Interventions And Policies. Health Affairs 32(2), 223-231
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8 change strategies
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Using the roadmap
• Catalyze efforts – 5 Simple Actions
• Organize current work, identify opportunities for pushing further
• Unify efforts and identify opportunities for partnerships
The power of [the roadmap] will only be fully realized when everyone takes action. Only then will we realize the power of shared goals and partnerships. Only then will we discover the power of the patient at the center of healthcare.”
- SUE COLLIER Clinical Content Development Lead
American Hospital Association/Health Research Educational Trust
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Community and partnership
• Download and share the roadmapwww.patientfamilyengagement.org
#PFEroadmap
• Make a commitmentwww.patientfamilyengagement.org/commitments
• Share a resourcewww.patientfamilyengagement.org/resources
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Let us know how we can help
Kristin L. Carman, PhDVice President, Health and Social Development Program
American Institutes for Research
202-403-5090, [email protected]
Thomas Workman, Ph.D.Principal Researcher, American Institutes for Research
301-592-2215, [email protected]
Pam Dardess, MPHPrincipal Researcher, American Institutes for Research
919-918-2311, [email protected]
AIR’s Center for Patient & Consumer Engagementwww.aircpce.org
Strategies and Tactics for Achieving Meaningful Consumer Engagement in Health CareClaire D. Brindis, Dr. PH., Dana Hughes, Dr.PH, Laura Schmidt, Ph.D., Laurie Jacobs, Ph.D., Caitlin Kennedy, Ph.D.
Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
June 13, 2015
ACA & Consumer Engagement
• ACA & patient-centered care– Hospital Consumer Assessment of Healthcare
Providers and Systems (HCAHPS)
• ACA & consumer engagement in system redesign– CMS’ state demonstrations to integrate care for dual
eligible patients
– CMMI’s testing of new service & delivery models
• Role of advocates in consumer engagement
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CAMPAIGN FOR BETTER CARE
Community Catalyst
PICONational Partnership for Women & Families
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Atlantic Philanthropies’ Campaign for Better Care
Ultimate goal:
Better quality care, better patient experiences with care and more affordable care for low-income older adults and other vulnerable populations
Strategy 1:
• Design and test models of consumer engagement in institutional decision-making which assure the inclusion of the perspectives of vulnerable populations and their families (and result in the ultimate goal)
Strategy 2:
• Identify methods to sustain this work over time
A Multidimensional Framework for Patient and Family Engagement in Health and Health Care
Levels of Engagement
Consultation
Involvement
Partnerships & Shared Leadership
Direct Care
Patients receive information
Patients asked about treatment
preferences
Decisions based on patients’ preferences, medical evidence, &
clinical judgment
Organizations design &
governance
Organization surveys patients about care
experiences
Hospital involves patients as advisors or advisory council
members
Patients co-lead hospital safety & quality improvement committees
Policy Making
Policy agency’s focus groups ask patients about health care
issues
Patients’ research priorities used by public agency in funding decisions
Patients equally represented on agency committee deciding how
to allocate health program resources
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Continuum of Engagement
Carman KL, et al. S. Patient and Family Engagement: A Framework For Understanding The Elements And Developing Interventions and Policies. Health Affairs 32 (2013)
A Multidimensional Framework for Patient and Family Engagement in Health & Health Care
Levels of Engagement
Consultation
Involvement
Partnerships& Shared Leadership
Direct Care
Patients receive information
Patients asked about treatment
preferences
Decisions based on patients’ preferences, medical evidence, &
clinical judgment
Organizations design &
governance
Organization surveys patients about care
experiences
Hospital involves patients as advisors or advisory council
members
Patients co-lead hospital safety & quality improvement committees
Policy Making
Policy agency’s focus groups ask patients about health care
issues
Patients’ research priorities used by public agency in funding decisions
Patients equally represented on agency committee deciding how
to allocate health program resources
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Continuum of Engagement
Carman KL, et al. S. Patient and Family Engagement: A Framework For Understanding The Elements And Developing Interventions and Policies. Health Affairs 32 (2013)
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Centers for Medicare and Medicaid Services
State Demonstrations to Integrate Care for
Dual Eligible Individuals
Primary Care Transformation
Initiatives to Speed Adoption of Best
PracticesAccountable Care Health Care
Innovation Awards
Comprehensive Primary Care
Initiative
Partnerships for Patients Pioneer ACOs
Community Catalyst National Partnership for Women & Families Rutgers /PICO
Community Catalyst
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• Work to build a nationwide network of local & state health advocacy organizations & coalitions
• Share expertise via technical assistance
Organizational Focus
• Shape state policy development & implementation to incorporate consumers
• Institutionalize consumer involvement in state policy & provider/health plan activities
Primary Campaign for Better Care
Goals
• Support state advocates
• Setting: Urban & rural communities & state capitols
Campaign for Better Care Approaches
National Partnership for Women and Families
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• Advocate at the federal level for policies & laws that help women & families
• Support effective implementation at local & state levels
Organizational Focus
• Support implementation of consumer engagement provisions for hospitals, primary care practices, & ACOs
Primary Campaign for
Better Care Goals
• Provide technical assistance/consultation to CMMI & providers
• Setting: Localities where CMS demonstrations are taking place
Campaign for Better Care Approaches
PICO
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• Utilize faith-based community organizing to address problems & concerns within congregations & communities based on shared values
Organizational Focus
• Empower consumers at the local level to improve individual & community health/well- being
• Achieve Medicaid savings for high utilizers & return savings to local communities
Primary Campaign for Better Care
Goals
• Engage in community organizing among Hot Spotter patients & community members
• Direct patient support as part of care management
• Setting: Communities served by local participating PICO federations
Campaign for Better Care Approaches
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Slide Title. Arial Bold, 32ptApproaches to
Consumer Engagement
Community Catalyst
National Partnership PICO
Consumers serve on decision-making bodies
Creation of formal mechanisms for obtaining consumer feedback on health services & health service needs
Technical assistance on decision-making bodies, other engagement techniques
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Slide Title. Arial Bold, 32ptApproaches to
Consumer EngagementCommunity
CatalystNational
Partnership PICO
State-level oversight bodies that include consumers & their advocates
Standards, regulations, & monitoring approaches that best serve the interests of consumers.
Consumer use of programs that help individuals & family caregivers be more engaged in their health
Facilitate consumers and their advocates in conversations with policymakers (state & federal)
Tactics and Strategies Implemented to Increase Consumer Engagement
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Slide Title. Arial Bold, 32ptTactics Community
CatalystNational
Partnership PICO
Federal advocacy
State advocacy
Technical Assistance
Information sharing/learning networks
Community Organizing
Coalition building
Training
Strategy/Tactic #1:
Educate, Engage & Influence Federal & State Policy Makers to Incorporate Consumers’ Needs & Interests into Policy
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Strategy/Tactic #2:
Actively Engage Consumers in Decision Making & Ensure Their Perspective is Heard
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Strategy/Tactic #3:
Engage Health Plans & Providers to Genuinely Involve Consumers in Decision Making
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Strategy/Tactic #4:
Engage With Other Organizations to Act Collectively in Support of Consumer Engagement
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Lessons Learned
What matters:
• Flexibility
• Relationships
• Opportunities for collective learning
• Focus on both the system & local level
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Lessons Learned (continued)
Other Essential Ingredients:
• Provider/clinician investment and commitment
• Consumer engagement recognized as a vital component of system reforms
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Lessons Learned (continued)
Common challenges:
•Consumer health literacy
•Health care system’s complexity
•Fear of feasibility of changes
•Lack of buy-in
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Implications & Future Questions
• For advocates:– Does consumer engagement make a difference?
• For evaluators & researchers:– The need for:
• Metrics
• Sustainable & scalable models
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Leveraging Engagement:Policy Change
Amanda OteroHealth Care Organizer, TakeAction Minnesota
• Among the most comprehensive public coverage
• Among the highest insured rate (95%)
• Lowest premiums
• Highest deductibles
Minnesota
What Advocacy Made Possible: The 9 Lives of Minnesota Care
October 19, 2012, St. Paul Pioneer Press, Front Page
• You want to plan around people’s priorities, needs, preferences.
• You want to understand if/how your plan will impact people.
• You need to simplify complex information for patients or the public.
• You need policy or funding to achieve your HST goals.
You might need consumers/advocates if…
Where can I find them?
• Patients• Community organizations• Advocacy organizations• Everywhere!
Deep Dive
Graphic: Flip the Clinic
Key Points
IMAGE
• Be mindful of your gift to/for others in healthcare
• Consumers and clinicians should be flexible, creative,
and maintain a spirit of adventure
• Huge gains are possible
• Be bold
• Patients and clinicians have permission to experiment, inform, and explore healthcare together.
Graphic: Flip the Clinic
Thank you!
Graphic: Flip the Clinic
S. Whitney Bowman-Zatzkin, MPA, MSRDirector, Flip the [email protected] | @MsWZ
Thomas Workman, Ph.D.Principal Researcher, American Institutes for [email protected]
Claire Brindis, Dr.P.H.Director, Philip R. Lee Institute for Health Policy StudiesProfessor, Pediatrics and health PolicyDirector, Bixby Center for Global Reproductive healthExecutive Director, Adolescent and Young Adult Health, National Resource [email protected]
Amanda OteroHealth Care Organizer, TakeAction [email protected]