2 health systems advancing population health via collaboration

Improving community health as a fundamental mission for nonprofit hospitals and health systems, and measuring the impact was described by two local leaders and the leader of a study of collaborations.

Male doctor pointing to documentWays to achieve success were shared by Phyllis Wingate, president of Carolinas HealthCare System NorthEast, and Amy Vance, senior vice president of Population Health with Novant Health. An overview of 12 highly successful multisector partnerships was provided by Dr. Lawrence Prybil, Norton Professor in Healthcare Leadership in the College of Public Health at the University of Kentucky.

The forum was the Healthcare Provider Conference, which brought health care and business professionals to Charlotte, N.C., for a fall 2015 gathering co-sponsored by Grant Thornton LLP, AON and McGuireWoods LLP. One of the topics — population health — was addressed by Wingate, Vance and Prybil, and moderated by Anne McGeorge, national managing partner of Grant Thornton’s Health Care practice.

The panel discussion was moderated by Anne McGeorge, former national managing partner of Grant Thornton’s Health Care practice.Successful collaborations offer lessons and recommendations Prybil began the session by discussing the multisector partnerships across the country his team studied and reported on in Improving Community Health through Hospital-Public Health Collaborations.1

The reason providers need to work with public health and other sectors, he said, is to lift health to a higher level: “America’s health care expenditures per capita are higher than in all other developed nations, but we lag behind them on multiple measures of population health. We can continue to increase our investment in health and medical services, but we’re never going to really improve the health of our American population in any significant way unless we address the other determinants. That’s why we need to forge partnerships.”

5 recommendations for effectivenessHe went on to describe key characteristics of successful partnerships and provide five recommendations for creating an effective collaboration:
  1. Focus on clearly defined community health needs that will inspire broad-based interest and support.
  2. Build partnerships with parties that have mutual respect, trust and commitment to the partnership’s mission and goals.
  3. For long-term success, partnerships need to generate sustainable funding, including one or more “anchor institutions,” such as health systems, that have deep dedication to the partnership’s mission and commitment to provide ongoing financial support for it.
  4. All partnerships focused on improving community health should develop clear metrics and targets, continually assess progress toward those targets, and prepare evidence-based impact statements for all stakeholders and the community at large.
  5. Hospitals and health systems should establish standing board committees with oversight responsibility for their organization’s involvement in addressing community health needs and community benefit strategies, programs and impact.

Healthy Cabarrus assesses community needs, takes action
The longest-lived collaboration studied by Prybil’s team is Healthy Cabarrus, anchored by the Carolinas HealthCare System NorthEast, a regional 457-bed not-for-profit medical center that is the largest employer in the Concord, N.C., area.

The mission of Healthy Cabarrus, Wingate said, is “to unite through partnerships and commit the time, talents and financial resources of partners to create a healthy community and hope for all.”

She described the collaboration’s structure and the factors in its success, starting with the fact that it’s a voluntary partnership, not a separate 501(c)(3). It operates through an advisory board that comprises representatives from the religious community, the government, the hospital itself and other not-for-profits from across the community.

One of Healthy Cabarrus’ functions is conducting the community needs assessment (CNA). Two results of tackling items in the CNA are the reduction of the county’s infant mortality rate and half the statewide rate) and the creation of a public transportation system.

4 main contributors to successAccording to Wingate, there are four main contributors to the collaboration’s success:
  1. Strong leadership and the right partners, including the advisory board
  2. A culture of collaboration
  3. Innovativeness of the health department
  4. Creative funding

Novant Health leverages data to identify needs, measure results
Collaborative work in keeping with its mission statement ― “to improve the health of our communities, one person at a time” ― is led by Novant Health, a four-state integrated network of physician clinics, outpatient centers and hospitals headquartered in Winston-Salem, N.C.

Technology is of prime importanceA component that Novant Health recognizes as being of prime importance is technology. Unlike business, health care is new at collecting data to predict where it’s going and creating operating models. “Fortunately, we’re now playing in that space and using electronic health records to collect clinical biometric data that is directing us and assisting us in achieving outcomes differently,” Vance said.

Vance described Healthy Charlotte, a subcouncil of the Charlotte Chamber of Commerce co-led by Novant Health and Carolinas HealthCare System: “We have over 150 business leaders engaged in and partnering with us on affecting the health and outcomes of those in the Charlotte community. We’re focused on physical activity ― specifically we’re focused on smoking, the race to quit and those initiatives ― and we’re focused on nutrition. We are also engaged with the Robert Wood Johnson Foundation on defining metrics and a county-to-county comparison. Our goal is to become one of the top 10 healthiest cities in the country.”

In summing up the work of Novant Health and others such as Healthy Cabarrus, Vance pointed to what it takes to reach the goal of benefiting the community: “It’s collaborative efforts, it’s creating partnership with payors, recognizing that there are no winner or losers, and that if we partner differently and collaborate differently, we can achieve different results.”

Learn more in the full report of the discussion.

1 Prybil, Lawrence, et al. Improving Community Health through Hospital-Public Health Collaborations, Commonwealth Center for Governance Studies Inc., November 2014. See for the report.