Prevention Agenda Year One
Implementation Progress Report
Office of Public Health Practice
July 11, 2017
New York State Health Initiatives
STATE HEALTH INNOVATION PLAN (SHIP)
PREVENTION AGENDA
Pillars and Enablers:
- Improve access to care for all New Yorkers
- Integrate care to address patient needs seamlessly
- Make the cost and quality of care transparent
- Pay for healthcare value, not volume
- Promote population health
- Develop workforce strategy
- Maximize health information technology
- Performance measurement & evaluation
Priority Areas:
- Prevent chronic diseases
- Promote a healthy and safe environment
- Promote healthy women, infants, and children
- Promote mental health and prevent substance abuse
- Prevent HIV, sexually transmitted diseases, vaccinepreventable diseases, health care associated infections
ALIGNMENT:
Improve Population Health
Transform Health Care Delivery
Eliminate Health Disparities
MEDICAID DELIVERY SYSTEM REFORM
INCENTIVE PAYMENT (DSRIP) PROGRAM
Key Themes:
- Integrate Delivery – create Performing Provider Systems
- Performance-based payments
- Statewide performance matters
- Regulatory relief and capital funding
- Long-term transformation & health system sustainability
POPULATION HEALTH IMPROVEMENT
PROGRAM (PHIP)
PHIP Regional Contractors:
- Identify, share, disseminate, and help implement best
practices and strategies to promote population health
- Support and advance the Prevention Agenda
- Support and advance the SHIP
- Serve as resources to DSRIP Performing Provider Systems
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July 11, 2017
Prevention Agenda Year One Progress
• 170 responses (as of 12/31/2014)
– 53 out of 58 Local Health Departments
– 117 Hospital/hospital groups out of 148 CSPs submitted in 2013
– 340 interventions reported on (2 per survey response)
• Information on:
–
–
–
–
–
–
Interventions
Status of efforts
Disparities being addressed
Partners participating
Partnerships organizations require help developing
Successes and challenges
• Help Ad Hoc Committee Members take appropriate action
4
Percentage Of Local Health Departments, Hospitals Reporting On At least One Intervention* By Priority Area,
December 2014
100
96.2
95.7
80
Percent
60
43.4
40
28.2
25.6
20.8
20
11.3
10.3
7.7
1.9
0
Prevent Chronic Diseases
Promote a Healthy and Safe Environment
Promote Healthy Women, Infants and
Children
Promote Mental Health and Prevent
Substance Abuse
Prevent HIV/STDs,
VaccinePreventableDisease, and
HealthcareAssociatedInfections
Priority Area
LHDs
Hospitals
LHDs N=53
Hospitals N=117
5
Chronic Disease Focus Areas Among Local Health Departments, Hospitals, December 2014
60
52.3
52.0
50
40
39.3
Percent
35.4
30
20
12.3
8.7
10
0
Reduce Obesity in Children and Adults
Reduce Illness, Disability and Death Related to Tobacco Use and
Secondhand Smoke Exposure
LHDs
Hospitals
Increase Access to HighQuality Chronic Disease Preventive Care and
Management in Clinical and Community Setting
LHDs N=65 Hospitals N=150
6
Healthy And Safe Environment Focus Areas Among Local Health Departments, Hospitals,
December 2014
100
91.7
90
80
70
66.7
Percent
60
50
40
33.3
30
20
8.3
10
0
Built Environment
Injuries, Violence and Occupational Health
LHDs
Hospitals
LHDs N=6 Hospitals N=12
7
Healthy Women, Infants And Children Focus Areas Among Local Health Departments, Hospitals,
December 2014
90
83.3
80
70
63.6
Percent
60
50
40
30
27.3
20
10.0
9.1
10
6.7
0
Maternal and Infant Health
Child Health
LHDs
Hospitals
Reproductive, Preconception and InterConception Health
LHDs N=11 Hospitals N=30
8
Mental Health And Substance Abuse Focus Areas Among Local Health Departments, Hospitals,
December 2014
60
48.5
50
39.1
Percent
40
30
39.1
27.3
24.2
21.7
20
10
0
Promote Mental, Emotional and Behavioral WellBeing in Communities
LHDs
Prevent Substance Abuse and other Mental Emotional Behavioral
Disorders
Hospitals
Strengthen Infrastructure across Systems
LHDs N=23 Hospitals N=33
9
Infectious Disease Focus Areas Among Local Health Departments, Hospitals, December 2014
100
100
90
80
70
Percent
60
50
44.4
44.4
40
30
20
11.1
10
0
0
0
Prevent HIV and STDs
Prevent VaccinePreventable Diseases
LHDs
Hospitals
Prevent Health CareAssociated Infections
LHDs N=1 Hospitals N=9
10
Chronic Disease Interventions Among Local Health Departments, Hospitals, December 2014
50
46.7
45
44.6
40
35
Percent
30
25
22.7
20
20
15.4
15
10.0
10
9.2
6.0
5
0
0
0
Other
Increase participation of adult with chronic
Create linkages with local health care
Increase the number employers and service Support use of alternative locations to
illness in a class to learn how to manage systems to connect patients to community providers in your county to adopt standards deliver preventive services, including cancer
their condition.
preventative resources.
for healthy food and beverage
screening.
procurement.
LHDs
Hospitals
LHDs N=65 Hospitals N=150
11
Healthy Women, Infants And Children Interventions Among Local Health Departments, Hospitals
December 2014
60
54.6
50
43.2
40.0
Percent
40
30
27.3
20
13.3
9.1
10
9.1
3.3
0
Promote Breastfeeding
Other
LHDs
Provide timely, continuous and
Provide education to health care providers
Integrate preconception and
comprehensive prenatal care services to
to reduce preterm birth.
interconception care into routine primary
pregnant women
care for women
Hospitals
LHDs N=11 Hospitals N=30
12
Mental Health And Substance Abuse Interventions Among Local Health Departments, Hospitals,
December 2014
60
50
48.8
40
Percent
33.3
30
20
13.0
12.1
12.1
8.7
10
4.4
3.0
0
Other
Build community coalitions that advance the State's
'Suicide as a Never Event' through promotion and
prevention activities
LHDs
Hospitals
Administer screening programs such as SBIRT,
Symptom Checklist 90 etc.
Implement mental health promotion and antistigma
campaigns
LHDs N=23 Hospitals N=33
13
Percent Of Interventions Addressing A Disparity Among Local Health Departments, Hospitals, December 2014
100
90
80
77.4
73.9
70
Percent
60
50
40
30
20
10
0
Addressing A Disparity
LHDs
Hospitals
LHDs N=106
Hospitals N=234
14
Number Of Interventions Addressing Each Type Of Disparity, By Local Health Departments, Hospitals,
December 2014
160
140
135
120
Number
100
76
80
72
70
63
60
45
36
40
23
27
24
26
21
20
14
14
0
Income/SES
Race/ethnicity
Geography
Age
Other
Disability
Gender
Disparity Type Intervention Addresses
LHD
Hospital
15
Current Status Of Implementation Efforts Of Interventions Reported Local Health Departments, Hospitals,
December 2014
80
73.1
70
64.2
60
Percent
50
40
30
20
17.9
16.0
12.4
10
9.4
5.1
1.9
0
Ahead of Schedule
On track with schedule
Behind projected schedule
Have not started
Current Status
LHDs
Hospitals
LHDs N=106
Hospitals N=234
16
Top Partner Types Among Local Health Departments & Hospitals, December 2014
200
184
180
160
158
140
121
Number
120
95
100
89
88
87
81
80
79
73
60
40
20
0
Pre-existing local
Other community
coalition (e.g.
based organization
tobacco prevention)
Community health
Government or
Government or
center/Federally
community-based community-based
Qualified Health organization - Social organization - Mental
Center
Services
and Behavioral
Health (including
Substance Abuse)
Media
Faith-based
organization
Schools (K-12)
Business
College/University
Partner Types
17
Top Partner Types Among Those Reporting Chronic Disease Interventions, December 2014
120
113
111
100
87
Number
80
63
57
60
57
53
51
50
45
40
20
0
Other community
based organization
Pre-existing local
coalition (e.g.
tobacco prevention)
Community health
center/Federally
Qualified Health
Center
Media
Business
Schools (K-12)
Faith-based
organization
Clinical or Community Government or
Based Lifestyle
community-based
Change Program
organization - Social
Services
College/University
Partner Types
18
Top Partner Types Among Those Reporting Mental Health And Substance Abuse Interventions, December 2014
50
45
44
40
37
35
Number
30
26
25
21
21
20
18
17
16
16
14
15
10
5
0
Government or
Pre-existing local
Government or
community-based coalition (e.g. tobacco community-based
organization - Mental
prevention)
organization - Social
and Behavioral Health
Services
(including Substance
Abuse)
Faith-based
organization
Government or
community-based
organization-Youth
Focused
Other community
based organization
Schools (K-12)
Community health
center/Federally
Qualified Health
Center
College/University
Media
Partners Types
19
Percent Of Local Health Departments, Hospitals Requiring Help Getting Partners For This Intervention,
December 2014
40
35
30
Percent
25
23.6
20
16.7
15
10
5
0
Need Help Getting Partners
LHDs
Hospitals
LHDs N=106
Hospitals N=234
20
Top Partnerships Local Health Departments And Hospitals Require Help To Develop, December 2014
25
21
20
20
18
14
14
Business
Media
Number
15
10
5
0
Health Insurance Plan
Faith-based organization
Schools (K-12)
Partnerships
21
Top Implementation Successes Reported For Interventions Reported By Local Health Departments & Hospitals,
December 2014
300
263
255
250
228
Number
200
177
177
Identifying process and outcome measures
to monitor progress toward reaching goals
Developing data collection methods
150
100
50
0
Reviewing and monitoring progress with
partners
Making adjustments to implementation
plan/timeline based on progress
Establishing clear implementation
timelines/milestones
22
Top Implementation Challenges Reported By Local Health Departments & Hospitals, December 2014
160
146
140
120
Number
100
85
80
75
73
71
60
40
20
0
Other
Developing data collection methods
Engaging community leaders to address
problem
Educating the community about the
problem
Disseminating results broadly through a
variety of methods
Implementation Challenges
23
Hospitals Reporting Interventions Part Of DSRIP Application, December 2014 (N=117 Hospitals/Groups)
60
50
47.9
Percent
40
29.1
30
20
14.5
10
8.6
0
Yes
No
Unsure
Interventions Part of DSRIP Application
No DSRIP application
24
Schedule H Community Benefit Reporting By New York State Hospitals, 2010
Source: New York Academy of Medicine, Achieving the Triple Aim in New York State: the Potential Role of Hospital Community Benefit (Issue Brief June 2014)
25
Interventions On Hospital’s Schedule H Tax Form, December 2014 (N=117 Hospitals/Groups)
45
39.3
40
35
30
25
Percent
23.9
21.4
20
15.4
15
10
5
0
Just one on Schedule H
Yes both on schedule H
Interventions On Schedule H
No
Unsure
26
July 11, 2017
27
What’s Next?
Data for two interventions will be provided by region for
individual Local Health Departments and Hospital/Hospital
Systems
• Intervention progress
• Measures used to track progress
• Target populations
• Disparities being addressed
• Partners engaged
• Successes and challenges
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July 11, 2017
28
Acknowledgements
NYAM for helping develop survey tool
NYSDOH Division of Chronic Disease for support
Office of Public Health Practice staff for data analysis
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July 11, 2017
29
QUESTIONS
29