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www.wisehealthsystem.com/chi
www.WiseHealthSystem.com/CHI
Our Secret
Projects
TEAMStarted in 2012
Project Description
Baseline
Reported
DY5 Reported 3 Year
Telemedicine Renal Disease 30-day Readmission Rate 17.91% 11.76%
Telemedicine COPD 30-day Readmission Rate 7.89% 4.35%
Pediatrics Pediatric ED Visits per 100,000 19,891 21,775
BH IOP
Behavioral Health/ Substance Abuse Admission Rate per
100,000
10,523 9,158
BH IOP RAND Short Form 36[1] (SF-36) Health Survey 47.99 63.25
Diabetes Hypertension (HTN) Admission Rate per 100k 442 250
Diabetes COPD Admission Rate per 100k 2105 1941
Child Obesity
Weight Assessment and Counseling for Nutrition and
Physical Activity for Children/Adolescents
3.25% 36.63%
Child Obesity
Reduce Pediatric ED visits for Ambulatory Care Sensitive
Conditions
11.35% 8.44%
Care Transitions Risk Adjusted All-Cause Readmissions 0.922 0.6920775
Care Transitions Congestive Heart Failure (CHF) Admission Rate per 100k 3,345 2,273
CHC Flu and Pneumonia Admission Rate per 100k 4,018 2,954
CHC Reduce ED visits for Ambulatory Care Sensitive Conditions 22.90% 22.00%
PCMH Diabetes Care: HbA1c poor control (>9.0%) 49.70% 38.46%
PCMH Patient Satisfaction Survey CG-CAHPS 92%-DY4 93.82%
What we accomplished:
Extraordinary Results
Lowered Preventable
Admissions
Lowered Preventable
Readmissions
Lower Diabetic HbA1c
Improved Reported
Behavioral Health
Increased Patient
Satisfaction
Blue Zones
Characteristics
Move Naturally
Know Your Purpose
Down Shift
Right Tribe
Belong
Family First
80% Rule
Plant Slant
Wine At 5
The
Community
Health
Needs
Assessment
24.74%
This page needs some sort of statistic
or graphic.
• Survey was made available between June 13th and August 15th, 2017
• 291 responses collected from 76 Question survey
• Gathered social and demographic data from multiple sources
• Included face-to-face Stakeholder Interviews with 21 individuals
219
44
18 10
Doctor's Office
Hours
Transportation
Knowing Where
To Go In A
Healthcare
Facility
Cost or Expense
Health
Knowledge
Insurance Issues Stigma
Culture and
Language
Medicaid Rules
2013 17.56% 2.29% 5.34% 38.93% 11.83% 12.98% 10.31% 0.00% 0.76%
2017 22.41% 2.76% 5.86% 34.14% 13.79% 13.45% 5.52% 0.34% 1.72%
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
40.00%
45.00%
2013 2017
Survey Responses
What is the biggest barrier to receiving health care in in our community (check one):
Improved Unemployment Rates
2013 2014 2015 2016 2017
Wise County 5.1% 3.0% 4.5% 4.3% 4.1%
Texas 6.3% 5.0% 4.4% 4.6% 4.8%
United States 6.7% 5.6% 5.0% 4.7% 4.3%
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
Wise County Texas United States
Source: U.S. Bureau of Labor Statistics
Improved Health Insurance Status
Source: DHG Healthcare, ©2017 The Claritas
Company, ©2017 Truven Health Analytics LLC
Health Insurance Status by Age - 2015
County Under 65
Uninsured
Percent
Uninsured
Under 65
Insured
Percent
Insured
Wise
County
9,763 18.5% 43,062 81.5%
Texas
(1000s)
4,536 19.2% 19,140 80.8%
Wise County
2011
23.7% 39,074 76.3%
Slight Increase in Poverty
Source: U.S. Census Bureau, Small Areas Estimates Branch
2014 2015 2016
Wise 10.0% 12.1% 12.0%
Texas 17.2% 15.9% 15.6%
United States 15.5% 14.7% 14.0%
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
18.0%
20.0%
All Persons
2014 2015 2016
Wise 15.3% 17.4% 18.1%
Texas 24.5% 22.9% 22.4%
United States 21.7% 20.7% 19.5%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
Under Age 18
2014 2015 2016
Wise $59,904 $58,367 $57,609
Texas $53,067 $55,668 $56,583
United States $53,657 $55,775 $57,617
$48,000
$50,000
$52,000
$54,000
$56,000
$58,000
$60,000
$62,000
Median Household Income
2014 Ranking 2017 Ranking Ranking Change
Healthy Behaviors 188 87 +101
Clinical Care 120 72 +48
Quality of Life 35 17 +18
Socioeconomic 37 52 -15
Physical Environment 56 132 -76
Length of Life 82 100 -18
County Health Ranking Changes
Out of 243 ranked counties in Texas, Wise County ranked 42nd overall in 2017.
County Health Ranking Changes
2014 2017 Texas Average (2017) % Change
Premature Death 7,486 7,800 6,700 4%
Adult Smoking 18% 15% 15% -3%
Adult Obesity 32% 31% 28% -1%
Physical Inactivity 30% 21% 23% -9%
Motor Vehicle Crash Rate 34 25 13 -26%
Sexually Transmitted Infections 183 162 496 -11%
Teen Birth Rate 49 44 49 -10%
Uninsured Adult Rate 26% 20% 21% -6%
Primary Care Physicians 2,463:1 1,990:1 1,670:1 -19%
Preventable Hospital Stays 84 56 54 -33%
Mammography Screening 50% 50% 58% -
Some College 50% 47% 60% 3%
Violent Crime Rate 268 152 408 -43%
Source: countyhealthrankings.org
www.wisehealthsystem.com/chi
Let’s Invest in Our Community
www.WiseHealthSystem.com/CHI
Community
Health
Improvement
Model
Step 1:
Reflect and
Strategize
Step 2:
Identify and Engage
Stakeholders
Step 3:
Define the
Community
Step 4:
Collect and
Analyze Data
Step 5:
Prioritize Community
Health Issues
Step 6:
Document and
Communicate Results
Step 7:
Plan
Implementation
Strategies
Step 8:
Implement
Strategies
Step 9:
Evaluate
Process
Why is this good for WHS?
Source: Wise Health System
Community
Benefit
2015 2016
Uncompensated
Care
$29,587,000
$21,456,322
Charity/ Indigent
Care
$21,546,000 $35,492,095
Total Benefit: $51,133,000 $56,948,417
Our Mission
Provide compassionate and innovative care
to our community and patients with
transparency and excellence.
Our Vision
Transformed and improved lives through
better health and extraordinary outcomes.
GOOD FOR YOU?
W H Y I S C O M M U N I T Y H E A L T H
• Economic Impact
• Social Impact
• Educational Impact
Williamson County
Community Health
Improvement Plan
Williamson County established their
CHIP in response to their 2016
CHNA. The WWA is the county’s
health and wellness coalition and
oversees health improvement
activities, recommends direction and
priorities, and promotes ways for
groups to rally around health issues.
HealthyWilliamsonCounty.org
www.yourwebsite.com
2017 CHNA
Summary of Needs
1) Obesity (#2)
2) Primary Care Physicians (#4)
3) Lack of Mental Health Services (#6)
4) Uninsured / Lack of Access to Services (Cost)(#1)
5) Diseases of the Heart (#5)
6) Physical Inactivity (#8)
7) Diabetes (#3)
8) Poor Nutrition (#7)
9) Utilization of Emergency Room for Episodic Care (new)
10) Lack of Health Education (#9)
Health Priority
Committees
TEAMThe needs assigned to each
committee will not be the only
subjects that can be improved
upon. Each committee with
established a goal, metric,
timeline and strategy for each
need listed.
Mental Health and Substance Abuse Committee
Needs Addressed:
(3) Lack of Mental Health Services
(11) Alcohol/ Drug Abuse
(17) Adult Smoking
Healthy Behaviors Committee
Needs Addressed:
(1) Obesity (7) Diabetes
(5) Diseases of the Heart (8) Poor Nutrition
(6) Physical Inactivity
Healthcare Resource Awareness Committee
Needs Addressed:
(4) Uninsured/ Lack of Access
(9) Utilization of ED for Episodic Care
(10) Lack of Health Education
(12) Transportation
www.WiseHealthSystem.com/CHI
Health
Priority
Action
PlansA
M
www.WiseHealthSystem.com/CHI
W
www.WiseHealthSystem.com/CHI
How to Participate
In Community Health Improvement
How Can We All Participate in Community Health Improvement?
• Implement the CHI by joining the Wise CHI and participating in one or multiple committees
How Can Local Government Participate?
• Incorporate CHI into strategic and future planning
• Advocate for policies and resources that improve the
health priorities
How Can Businesses and Employers Participate?
• Promote worksite wellness policies and resources that
focus on the health priorities
• Encourage employees to participate in a committee
How Can Health Care Systems, Insurers, and
Clinicians Participate?
• Work to increase insurance coverage and access to
healthcare to Medicaid, low income, and uninsured
individuals, especially for mental health
How Can Early Learning Centers, Schools, Colleges
Participate?
• Share CHI plan with fellow educators
• Equip educators with skills to promote and improve
health
How Can Community, Non-Profit, and Faith-Based
Organizations Participate?
• Align health improvement efforts with the CHIP
• Leverage additional resources by referencing the CHIP
How Can Individuals and Families Participate?
• Practice and Promote health behaviors in the
community
• Advocate for community health improvement in the
places where you live, work, worship, play, and learn
Our Ask
• Join committee(s) in areas you would like to influence
• Help in development of a working written plan by March 31,
2018
• Sign a commitment letter to partner with the Wise CHI and
adopt its principles
• Participate in and promote activities identified to influence a
healthier Wise community
• Participate in the next CHNA in 2020 and celebrate your success
Resources
www.healthyntexas.org
www.countyhealthrankings.org
www.healthycommunities.org
www.cdc.gov/chinav
www.countyhealthrankings.org/roadmaps/what-
works-for-health
www.cdc.gov/sixeighteen
www.cdc.gov/policy/hst/hi5
www.thecommunityguide.org
www.rhp10waiver.com
www.bluezonesproject.com
www.wisehealthsystem.com/chi
Questions?
www.WiseHealthSystem.com/CHI
Jordan Holzbog
940-393-0512
jholzbog@wisehealthsystem.com
Paul Aslin
940-626-3863
paslin@wisehealthsytem.com

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CHI Presentation 2018

  • 3. Project Description Baseline Reported DY5 Reported 3 Year Telemedicine Renal Disease 30-day Readmission Rate 17.91% 11.76% Telemedicine COPD 30-day Readmission Rate 7.89% 4.35% Pediatrics Pediatric ED Visits per 100,000 19,891 21,775 BH IOP Behavioral Health/ Substance Abuse Admission Rate per 100,000 10,523 9,158 BH IOP RAND Short Form 36[1] (SF-36) Health Survey 47.99 63.25 Diabetes Hypertension (HTN) Admission Rate per 100k 442 250 Diabetes COPD Admission Rate per 100k 2105 1941 Child Obesity Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents 3.25% 36.63% Child Obesity Reduce Pediatric ED visits for Ambulatory Care Sensitive Conditions 11.35% 8.44% Care Transitions Risk Adjusted All-Cause Readmissions 0.922 0.6920775 Care Transitions Congestive Heart Failure (CHF) Admission Rate per 100k 3,345 2,273 CHC Flu and Pneumonia Admission Rate per 100k 4,018 2,954 CHC Reduce ED visits for Ambulatory Care Sensitive Conditions 22.90% 22.00% PCMH Diabetes Care: HbA1c poor control (>9.0%) 49.70% 38.46% PCMH Patient Satisfaction Survey CG-CAHPS 92%-DY4 93.82% What we accomplished: Extraordinary Results Lowered Preventable Admissions Lowered Preventable Readmissions Lower Diabetic HbA1c Improved Reported Behavioral Health Increased Patient Satisfaction
  • 4. Blue Zones Characteristics Move Naturally Know Your Purpose Down Shift Right Tribe Belong Family First 80% Rule Plant Slant Wine At 5
  • 5.
  • 6. The Community Health Needs Assessment 24.74% This page needs some sort of statistic or graphic. • Survey was made available between June 13th and August 15th, 2017 • 291 responses collected from 76 Question survey • Gathered social and demographic data from multiple sources • Included face-to-face Stakeholder Interviews with 21 individuals 219 44 18 10
  • 7. Doctor's Office Hours Transportation Knowing Where To Go In A Healthcare Facility Cost or Expense Health Knowledge Insurance Issues Stigma Culture and Language Medicaid Rules 2013 17.56% 2.29% 5.34% 38.93% 11.83% 12.98% 10.31% 0.00% 0.76% 2017 22.41% 2.76% 5.86% 34.14% 13.79% 13.45% 5.52% 0.34% 1.72% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00% 2013 2017 Survey Responses What is the biggest barrier to receiving health care in in our community (check one):
  • 8. Improved Unemployment Rates 2013 2014 2015 2016 2017 Wise County 5.1% 3.0% 4.5% 4.3% 4.1% Texas 6.3% 5.0% 4.4% 4.6% 4.8% United States 6.7% 5.6% 5.0% 4.7% 4.3% 0.0% 1.0% 2.0% 3.0% 4.0% 5.0% 6.0% 7.0% 8.0% Wise County Texas United States Source: U.S. Bureau of Labor Statistics
  • 9. Improved Health Insurance Status Source: DHG Healthcare, ©2017 The Claritas Company, ©2017 Truven Health Analytics LLC Health Insurance Status by Age - 2015 County Under 65 Uninsured Percent Uninsured Under 65 Insured Percent Insured Wise County 9,763 18.5% 43,062 81.5% Texas (1000s) 4,536 19.2% 19,140 80.8% Wise County 2011 23.7% 39,074 76.3%
  • 10. Slight Increase in Poverty Source: U.S. Census Bureau, Small Areas Estimates Branch 2014 2015 2016 Wise 10.0% 12.1% 12.0% Texas 17.2% 15.9% 15.6% United States 15.5% 14.7% 14.0% 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0% 20.0% All Persons 2014 2015 2016 Wise 15.3% 17.4% 18.1% Texas 24.5% 22.9% 22.4% United States 21.7% 20.7% 19.5% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% Under Age 18 2014 2015 2016 Wise $59,904 $58,367 $57,609 Texas $53,067 $55,668 $56,583 United States $53,657 $55,775 $57,617 $48,000 $50,000 $52,000 $54,000 $56,000 $58,000 $60,000 $62,000 Median Household Income
  • 11. 2014 Ranking 2017 Ranking Ranking Change Healthy Behaviors 188 87 +101 Clinical Care 120 72 +48 Quality of Life 35 17 +18 Socioeconomic 37 52 -15 Physical Environment 56 132 -76 Length of Life 82 100 -18 County Health Ranking Changes Out of 243 ranked counties in Texas, Wise County ranked 42nd overall in 2017.
  • 12. County Health Ranking Changes 2014 2017 Texas Average (2017) % Change Premature Death 7,486 7,800 6,700 4% Adult Smoking 18% 15% 15% -3% Adult Obesity 32% 31% 28% -1% Physical Inactivity 30% 21% 23% -9% Motor Vehicle Crash Rate 34 25 13 -26% Sexually Transmitted Infections 183 162 496 -11% Teen Birth Rate 49 44 49 -10% Uninsured Adult Rate 26% 20% 21% -6% Primary Care Physicians 2,463:1 1,990:1 1,670:1 -19% Preventable Hospital Stays 84 56 54 -33% Mammography Screening 50% 50% 58% - Some College 50% 47% 60% 3% Violent Crime Rate 268 152 408 -43% Source: countyhealthrankings.org
  • 14. www.WiseHealthSystem.com/CHI Community Health Improvement Model Step 1: Reflect and Strategize Step 2: Identify and Engage Stakeholders Step 3: Define the Community Step 4: Collect and Analyze Data Step 5: Prioritize Community Health Issues Step 6: Document and Communicate Results Step 7: Plan Implementation Strategies Step 8: Implement Strategies Step 9: Evaluate Process
  • 15. Why is this good for WHS? Source: Wise Health System Community Benefit 2015 2016 Uncompensated Care $29,587,000 $21,456,322 Charity/ Indigent Care $21,546,000 $35,492,095 Total Benefit: $51,133,000 $56,948,417 Our Mission Provide compassionate and innovative care to our community and patients with transparency and excellence. Our Vision Transformed and improved lives through better health and extraordinary outcomes.
  • 16. GOOD FOR YOU? W H Y I S C O M M U N I T Y H E A L T H • Economic Impact • Social Impact • Educational Impact
  • 17. Williamson County Community Health Improvement Plan Williamson County established their CHIP in response to their 2016 CHNA. The WWA is the county’s health and wellness coalition and oversees health improvement activities, recommends direction and priorities, and promotes ways for groups to rally around health issues. HealthyWilliamsonCounty.org
  • 18. www.yourwebsite.com 2017 CHNA Summary of Needs 1) Obesity (#2) 2) Primary Care Physicians (#4) 3) Lack of Mental Health Services (#6) 4) Uninsured / Lack of Access to Services (Cost)(#1) 5) Diseases of the Heart (#5) 6) Physical Inactivity (#8) 7) Diabetes (#3) 8) Poor Nutrition (#7) 9) Utilization of Emergency Room for Episodic Care (new) 10) Lack of Health Education (#9)
  • 19. Health Priority Committees TEAMThe needs assigned to each committee will not be the only subjects that can be improved upon. Each committee with established a goal, metric, timeline and strategy for each need listed. Mental Health and Substance Abuse Committee Needs Addressed: (3) Lack of Mental Health Services (11) Alcohol/ Drug Abuse (17) Adult Smoking Healthy Behaviors Committee Needs Addressed: (1) Obesity (7) Diabetes (5) Diseases of the Heart (8) Poor Nutrition (6) Physical Inactivity Healthcare Resource Awareness Committee Needs Addressed: (4) Uninsured/ Lack of Access (9) Utilization of ED for Episodic Care (10) Lack of Health Education (12) Transportation www.WiseHealthSystem.com/CHI
  • 22. How to Participate In Community Health Improvement How Can We All Participate in Community Health Improvement? • Implement the CHI by joining the Wise CHI and participating in one or multiple committees How Can Local Government Participate? • Incorporate CHI into strategic and future planning • Advocate for policies and resources that improve the health priorities How Can Businesses and Employers Participate? • Promote worksite wellness policies and resources that focus on the health priorities • Encourage employees to participate in a committee How Can Health Care Systems, Insurers, and Clinicians Participate? • Work to increase insurance coverage and access to healthcare to Medicaid, low income, and uninsured individuals, especially for mental health How Can Early Learning Centers, Schools, Colleges Participate? • Share CHI plan with fellow educators • Equip educators with skills to promote and improve health How Can Community, Non-Profit, and Faith-Based Organizations Participate? • Align health improvement efforts with the CHIP • Leverage additional resources by referencing the CHIP How Can Individuals and Families Participate? • Practice and Promote health behaviors in the community • Advocate for community health improvement in the places where you live, work, worship, play, and learn
  • 23. Our Ask • Join committee(s) in areas you would like to influence • Help in development of a working written plan by March 31, 2018 • Sign a commitment letter to partner with the Wise CHI and adopt its principles • Participate in and promote activities identified to influence a healthier Wise community • Participate in the next CHNA in 2020 and celebrate your success