DRAFT: This module has unpublished changes.

Unit 6: Losing Hope

 

Hannah Hohendorf

 

Assignment Date: February 16, 2018

 

Models

Two case studies were brought forward as possible models for application in Losing Hope. Model 1 was a project implemented in Akron, OH which created an Accountable Care Community organization, brought 70 community partners together to address the preventable issue of type 2 diabetes in the community. The focus was on improved management of those with type 2 diabetes and the prevention of others from developing it through community education and programs to improve diet and exercise (Janosky, n.d).

 

Model 2 was a project implemented in Hennepin, MN which brought four healthcare partners together to create a care continuum that sought to address a large population of uninsured with varying costly health problems including mental health, chemical dependency and multiple co-morbidities. This project involved the implementation of a data warehouse where providers could see data from multiple providers of the patient’s care. Also, integration of mental health professionals and care coordinators helped patients get the help that they needed to stay healthy. Lastly, a big part of this project was the expansion of Medicaid to cover these individuals and ensure that the healthcare partners were paid for their services (Garrett, n.d.).

 

These two models will be discussed in the memo below using three criteria for comparison, then a recommendation of how the county should move forward will be discussed.

 

Criteria 1: Population

The Akron, OH population consisted of 38% with private health insurance, 31% with Medicare or Medicaid, and 31% with no health insurance (Janosky, n.d). Furthermore, their chief health concern was type 2 diabetes.

 

The Hennepin, MN population was not broken down by insurance coverage, however a chief part of the plan was to extend Medicaid to the poor, childless adult population (Garrett, n.d.). Furthermore, their chief health concerns included chemical dependency, mental health, and multiple chronic diseases (Garrett, n.d.).

 

Losing Hope is a community with a high population of working poor. The rate of uninsured is high due to many of the call center jobs not offering benefits. Some residents are eligible for Medicaid, but the rest utilize the hospital Emergency Department (ED) and county free clinic which has caused the county’s budget to strain from Medicaid (Case, 2015). Furthermore, the primary health concern is a decrease in physical activity.

 

Using just population as a comparison, the Akron, OH case study would appear to be a closer fit since their population is suffering from type 2 diabetes, which is a risk for the Losing Hope population’s sedentary lifestyle.

 

Criteria 2: Partners

The Akron, OH project involved 70 diverse community groups including local employers, public health department, local healthcare providers, public parks and more. Their approach was to harness the power of the entire community to tackle type 2 diabetes and its prevention (Janosky, n.d.).

 

The Hennepin project involved four community health partners including two health centers, a health plan and the county’s Human Services and Public Health Department (Garrett, n.d.). Their approach was to create a continuum of care among providers that supported the patient throughout their care.

 

Unfortunately, Losing Hope does not have a lot of healthcare providers in the area with which to partner. However, there is a county health department, along with other community groups that could be helpful in improving the health of Losing Hope.

 

Using partners as the only criteria for choosing a model would make Akron, OH project stand out because it did not depend on multiple healthcare partners in the area, but rather the entire community to put forth initiatives that help to prevent the very disease that Losing Hope residents are at risk of developing through sedentary living.

 

Criteria 3: Focus

The Akron, OH project team focused their efforts on a single issue that was the highest preventable drain on the healthcare dollar, type 2 diabetes. This disease focus allowed them to work on not only helping the population suffering from type 2 diabetes, but also to keep more people from developing the disease. They could address the problem from multiple angles to improve the health of their population as a whole.

 

The Hennepin, MN project team focused their efforts on the social determinants of health and their care continuum to improve the health of the overall population. This required expansion of the Medicaid program in their county so that the population had health coverage and greater integration of health information technology so that the care providers did not experience gaps in health information making the care continuum more robust.

 

The Losing Hope community does not have the ability to expand Medicaid as it is already stretching the county’s budget. Furthermore, there are fewer healthcare providers in the area with which to partner making improvement to the care continuum less of a priority. By using the criteria of focus alone, the Akron, OH project is more feasible because it brings community groups into the project to expand resources with the mission to prevent disease which is where the Losing Hope community could use help.

 

Recommendation

Having taken the following three criteria into account: population, partners, and project focus; it was found that the Akron, OH project would be the most feasible to implement in Losing Hope. With few healthcare partners and funds to put toward the project, it would be best to bring in community partners to expand available resources. Also, since there is not a specific disease state on which to focus, a community initiative based on prevention may help curb the health risks that Losing Hope residents are currently experiencing before they become costly chronic illnesses. Particularly, the health education and screening could help reduce the overutilization of the ED and free clinic. Also, the complete streets could increase utilization of alternative modes of transportation such as bicycling and walking. Overall, with some changes to suit the Losing Hope population and resources, the Accountable Care Community project could improve the Losing Hope community health status and help to avoid the escalating cost of a population with chronic illnesses in the future.

 

References

Case Study. (2015). 6.10 Individual Assignment Week 6. Retrieved from Class Online Web site: https://2gw.mha.gwu.edu/mod/page/view.php?id=16006.

 

Garrett, Nancy. (n.d.). How a Social Accountable Care Organization Improves Health and Saves Money and Lives. Retrieved from Class Online Web site: https://2gw.mha.gwu.edu/mod/page/view.php?id=15998.

 

Janosky, Janine. (n.d.). Akron, Ohio — The First Accountable Care Community in Action. Retrieved from Class Online Web site: https://2gw.mha.gwu.edu/mod/page/view.php?id=15998.

 

Hannah_Hohendorf_Assignment Week 6.pdf

DRAFT: This module has unpublished changes.