The Power of Collaboration-When Competitors Become Collaborators

Community Indicators Consortium Conference

"A group becomes a team when each member is sure enough of himself and his contribution to praise the skills of others."

Norman Shidle

It’s in our DNA…BayCare’s 2018 Community Benefit contribution was $462 million totaling 11%

of annual operating revenue!

All 3 of these are measured in un-reimbursed costs.

Medicaid/Income-based Programs - $311

million Underinsured – Patients with some

insurance but not enough to cover medical

bills.

Charity Care - $117 million

Patients will have their medical bills waived if

they fall under the criteria set in BayCare’s

Financial Assistance Policy

Unbilled Community Services - $34 million

Health professional education, community

health services, cash and contributions to

community groups, and other services.

What is a Community Health Needs Assessment?

CHNA completed

every 3 years

✓ Comprehensive analysis of

health priorities

▪ Rigorous review of available data

▪ Focus on the voices of our community

✓ Develop Implementation Plan

▪ Evidence based data driven

interventions

▪ Impactful and measurable outcomes to

improve health

Our New Vision

New survey design

• Literacy Review

• Validated Questions

• Focus on emerging trends

• Adverse Childhood Events

• Food Insecurity

• Housing instability

• Opiate use

• Social Isolation

Boots on the ground

Shared Implementation Strategy

• County focus

• Increased impact

• Strong support from hospital leadership and Boards

Leaning Into Collaboration Across the System

Creating a

shared vision

Identify and

address

organizational

needs

Establish

regular and

consistent

communication

Shared

resources,

common

deliverables

Does Strong Vision Ensure Success?

We challenged the local industry norms

• Never worked together

• Competing brands

• Established a new standard for collaboration and accountability

Integrity

Commitment

Values

Truth

Listen

Consistency

Trust

Challenges Turn to Wins: Survey Methodology

Representative sample-raising the bar

• Weekly data review

Shared contact lists to expand survey reach

Internal alignment and support

Deeper insight into community

Demographic Breakdown

Outreach

•Faith Community Nurses

•Community Health Team

•Free Clinics

•FQHC’s

•Libraries

•Local community events

•Housing Authority

•Barbershops

•City/County connections

•Tax Collectors Office

Improvement: Survey Numbers

Survey responses across our footprint19,534

3,9206,494

5,304

3,038

Balm!!!

Joint Prioritization Meetings

EXERCISE, NUTRITION & WEIGHT

453

981 1,004 968 902

230 59

18-24 25-34 35-44 45-54 55-64 65-74 75 or older

FOOD INSECURE INDIVIDUALS BY AGE (N = 4,597)

29.4% of survey respondents who self-reported food insecurity

39.4% (N = 714) 38.5% (N = 353)33.5% (N = 488) 33.0% (N = 464)

Hillsborough County Pasco County Pinellas County Polk County

SURVEY RESPONDENTS WITH CHILDREN IN THE HOME WHO SELF-REPORTED FOOD INSECURITY (N = 2,019)

Childhood Risk Factors for Obesity

Parent survey respondents who answered “NO” to the following:

Do children living in your home…

Question Hillsborough Pasco Pinellas Polk

Eat at least 3 servings of fruits and

vegetables every day? 25.1% 34.6% 27.9% 25.6%

Exercise at least 60 minutes every day? 32.1% 38.0% 31.2% 32.7%

27.6% 31.0%

64.7%

30.3% 30.5%

63.2%

Middle School Students High School Students Adults

OVERWEIGHT OR OBESE RATES 2016

Footprint Florida

In the last 12 months, did you or anyone living in your home ever get emergency food from a

church, a food pantry, or a food bank, or eat in a soup kitchen?

13.0% responded ‘yes’

Hillsborough32.7%

Pasco32.0%

Pinellas26.7%

Polk27.4%

11,161 ED Visits including a diagnosis of Congestive Heart Failure

8,413 ED Visits for Uncontrolled Diabetes

Zip codes with the highest number of ED visits across the system

Top Zip Codes

Winter Haven 33881

Winter Haven 33880

Bartow 33830

Plant City 33563

Clearwater 33756

Dunedin 34698

2019 Top Health Priorities

Behavioral Health

1

Access to Healthcare

2

Exercise, Nutrition &

Weight

3

Social Determinants to Health: Food Insecurity

29.4% of respondents

self-reported food insecure

In the last 12 months, did you or anyone

living in your home ever get emergency

food from a church, a food pantry, or a

food bank, or eat in a soup kitchen?

13.0% responded ‘yes’

0

200

400

600

800

1,000

1,200

18-24 25-34 35-44 45-54 55-64 65-74 75 or older

Food Insecure Individuals by Age

Are you worried or concerned that in

the next 2 months you may not have

stable housing that you own, rent, or

stay in as part of a household?

10.2% responded ‘yes’

Hillsborough: 12.1%

Social Determinants to Health: Unstable Housing

Has there been any time in the past 2 years when you were living on the street, in a car, or in a temporary shelter?

5.1% responded ‘yes’

Hillsborough and Pinellas: 6.0%

Social Determinants to Health:Social Isolation

Social Isolation Questions % Disagreed

"I am happy with my friendships and

relationships” 8.2%

“I have enough people I can ask for help

at any time” 15.8%

"My relationships are as satisfying as I

would want them to be" 16.3%

Adverse Childhood Experiences

Percentage of survey respondents reporting four or more Adverse Childhood Experiences:

OR

28.2%

4,208 Respondents

Self Harm

Over the past 12 months, how often have you had thoughts that you would be better off dead or of hurting yourself in some way?

OR 1,814 Respondents11.6%

Indicated they had these thoughts several days, more than half of

the days or nearly every day over the last 12 months.

BayCare Health System ED UtilizationMental Health and Substance Abuse

8417

4318

2250

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

2 Visits 3-4 Visits 5 or More Visits

Nu

mb

er

of

Ind

ivid

uals

2018 Mental Health and Substance Abuse ED Utilization: Repeat Visits

2018: 78,715 ED Encounters

Repeat Visits:

2,250 individuals with 5+ visits

Heat Maps:ED Utilization for Uncontrolled Diabetes

Every Voice

Matters

“If you are working on something exciting

that you really care about, you don’t have

to be pushed. The vision pulls you.”