1. Population Healthcare Access and Health Status
A single County example in North Carolina
2. Social Systems Include Human Resources, Governance
Structures, Work Processes, Technology and Capital
Healthcare is a local phenomenon
Health literacy is a local characteristic
Definition of health is largely cultural
Question:
Should our communities act locally in response to Federal and State
standards through self definition?
3. Our Regional PartnershipOften regional partnerships may be
created:If the politics do not interfere.
Possible 8 county collaborative
4. Few US Citizens are familiar with the moral categories
established by Adam Smith. Including those of nature: Propriety,
Prudenceand Benevolence and Motive: Self-love, Reason and
Sentiment. It is in this treatise that Smith first introduces the
metaphor: 'The Invisible Hand' referring to society's
self-regulation through channeling ambition to meet society's
needs.
Weal
th
High Low
Where should the resources go?
5. 2009 Medicaid Eligibility Will now expand greatly under
PSACA
6. There is a great distance between families and they travel
farther for care
7. Travel farther and have fewer choices
Co
Our counties
8. Fewer choices for primary AND specialty care
Note Specialty Care Deficit
9. Who are our RACs Where are our trauma centers
Our RAC
So do patients with severe trauma go
10. Where are they treated?
Cross County Collaborative
Residents Hospital Referrals
11. Unusually high hospital discharge rates for
conditions
that should be treated in ambulatory setting
12. How confusing can this get?Do we have a
solution?
13. County Health Profile
Not so good news
Good News
Ref NC CATCH 2006
14. Adolescent Health
Ref NC CATCH 2006
15. Adolescent Health
16. Adolescent Health
17. Cancer Prevalence
18. Cancer Prevalence
19. Typical Rural Cancer In NC
Low prevalence
VERY Important
Low incidence rate
Cancer caught in late stage
Due to lack of screening
High mortality
20. Cancer in Sampson County
21. Cardiovascular Disease
22. Diabetes Outcomes
Excessive mortality
Excessive hospital days
End Stage Renal Disease
Excessive kidney failure
23. Chronic Respiratory Disease
Smoking and Smoking
24. STDs
Risky behavior
25. Murder, Rape and Property Crime Sampson County
Crime Risk
26. Access to Dental Care
Bad teeth = Bad Hearts
27. Disability
Children at risk
28. Substance Abuse
Accidents
29. 29
A Solution is needed to Manage the Supply ChainAccessing Care
Services based on Patient NeedsPlease do not forget rural
America
Targeted Patients with highly complex conditions (Top 1%)
Case Management
Targeted Patients with unstable chronic conditions, barriers to
behavioral change and or multiple co-morbidities
Extended Care Team Focus
Care Coordination: Patient/Family Coaching
& Care Coordination
Scope, Intensity & Cost of Services
Targeted Patients with uncomplicated chronic conditions and
preventative care needs
Medical Home contract established with population of focus
Supported Self Management:
Proactive Outreach & Monitoring Services
Practice Focus
Acute Care Only
Informed Self Service : Education and Self Service
Instructions
Usual Care: Diagnosis & Treatment Services
Distribution of Services across the Population
0%
100%
Proprietary & Confidential
30. Untangled Health Thanks You
Do not hesitate to contact us for references.