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PopulationHealthundertheACA1 MarlboroCollegeGraduateCenter Brattleboro,VT April15,2014 Moderator:CraigMiskovichattorneyDownsRachlinMartinPLLClongtimehealthcare administrationfacultyinstructoronlegalissuesinhealthcare,andalegaladvisortohealthcare organizationsinVermontandNewHampshire RobinLunge,directorofhealthcarereformforthestateofVermont Overnextthreeyearsexploringthreedifferentpaymentmethods Bundledpayments AccountablecareorgsthreeinVTe.g.OneCarehttps://www.onecarevt.

org Globalbudgetsoncommunitybasis

BeaGrause,RN,JD,presidentandCEOoftheVermontAssociationofHospitalsandHealth Systems Workhappensatdifferentlevels/howtomakeeffective? Journeynotatacticusedatatoguide Recruitmentofphysiciansstillhugechallenge&verycompetitive YvonneGoldsberry,Ph.D.,vicepresidentofpopulationhealthandclinicalintegration,Cheshire MedicalCenter/DartmouthHitchcockKeene populationhealthdifferentfrompublichealthbecauselatterhasgovernmentalaspectbutthere isoverlap/partnershipwithpublichealth Goals: Expandaccess Quality Enhancedpreventionwellness Connectwithcommunity

Dichotomy:beingpaidforeachwidget(feeforservice)vs.paymentbasedonqualityoutcomes Populationisgeographicareaserved HealthyMonadnockisanexampleofcommunityoutreach


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Populationhealthisdefinedasthehealthoutcomesofagroupofindividuals,includingthedistributionof suchoutcomeswithinthegroup.

http://www.cheshiremed.com/vision_2020.html TomDee,presidentandCEOofSouthwesternVermontHealthCarehttp://svhealthcare.org/ reductionof21%to7%onthestatistic%readmitsin30daysofmedicaidpatients=>isgood newsfromaqualityperspectivebutpresentsafinancialchallengeduetothefeeforservice model 40%ofSWVTpatientshavebehavioralhealthissuesandSWVTwithnomentalhealthunit. Trustandcommunicationneedstobedeveloped "attributed"tooneprimarycarephysicianimportanttohavesufficientnumber DeehailsfromNewYorkStatewherehefoundhighercompletionamonghospitalsandmore emphasisonfeeforservicethanVT Somediscussionaboutallhospitalscombiningintooneadministrativeentityinordertobetter dealwiththeseissueswithparticipant,Dr.RobertE.Simpson,Jr.,MPH,DSWPresident& ChiefExecutive,BrattleboroRetreat,joking,maybetwohospitals. Reference:
BlueribbonpaneltoaddresspopulationhealthunderObamacare

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