Population/Community Health

Population/Community Health / en Mon, 28 Apr 2025 22:12:28 -0500 Wed, 23 Apr 25 15:18:57 -0500 Community Health Improvement Week | Center /center/community-health-improvement-week Sat, 25 May 2024 08:00:00 -0500 Population/Community Health Application window closes May 6 for 2026 AHA Foster G. McGaw Prize /news/headline/2025-04-23-application-window-closes-may-6-2026-aha-foster-g-mcgaw-prize The deadline for health delivery organizations to apply for the AHA’s 2026 Foster G. McGaw Prize is 1 p.m. ET May 6. The award honors organizations that demonstrate alignment between community health needs and co-designed programs. The honorees forge effective collaborations with a broad range of community organizations to improve access to care and address societal factors influencing health. The winning prize is $100,000 while finalists will be awarded $10,000. <a href="/fostermcgaw">LEARN MOR</a> Wed, 23 Apr 2025 15:18:57 -0500 Population/Community Health From virtual singing to walking groups, Dartmouth Health’s programs for older adults enhance health /role-hospitals-virtual-singing-walking-groups-dartmouth-healths-programs-older-adults-enhance-health <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-5"><img src="/sites/default/files/2025-04/stc-dartmouth-aging-resource-center-700x532.png" alt="Dartmouth Health. A female art teacher stands talking to an older woman seated at a craft table" width="700" height="532"></div>Food for Your Soul: Reading Poetry Together. Get Hooked on Walking. Virtual Morning Sing. How to Eat to Improve Our Resilience to Stress. These classes are among hundreds offered by the Dartmouth Health Aging Resource Center in Lebanon, N.H., each year.The Aging Resource Center, part of the health system’s Geriatric Center of Excellence, offers free educational classes, support and services to improve the minds, bodies and spirits of older adults and their families. Programs and support groups are held in person and virtually.Older adults can take a class or series of classes to improve their balance, get help using their iPhone, participate in a morning virtual sing or in-person singing group, write poetry, learn strategies for coping with symptoms of chronic disease and get tips for eating healthy when money is tight — and much more. In addition, they can access the Aging Resource Center to simply relax, read, browse the internet or enjoy exhibits by local artists who also are older adults.The center also hosts a Memory Café for individuals with dementia and their caregivers, which is organized by Dartmouth medical students and an attending physician. The café provides social, cognitive and physical activities for patients, including live music, arts and crafts, and chair exercises, and offers informational sessions for caregivers.One older adult with Parkinson’s disease noted, “We often feel like we’re on our own fighting the progression of this disease. We’re excited to have access to this support group and are looking forward to attending future sessions.”A Food for Your Soul program participant observed, “Reading and discussing poetry biweekly lifts our spirits and engages our minds and emotions in new, challenging and inspiring ways.”<a class="btn btn-primary" href="https://www.dartmouth-hitchcock.org/aging-resource-center" target="_blank">LEARN MORE</a></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/center/population-health">Improving Health and Wellness</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Fri, 11 Apr 2025 13:10:53 -0500 Population/Community Health Hospital’s Community Friendship Volunteer Program helps reduce social isolation among older adults /role-hospitals-elizabethtown-community-hospitals-community-friendship-volunteer-program-helps-reduce-social-isolation-among <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-5"><img src="/sites/default/files/2025-04/ths-elizabethtown-senior-friendship-volunteer-700x532.jpg" alt="Elizabethtown Community Hospital. A young female caregiver helps an elderly woman shop in a grocery store" width="700" height="532"></div>Loneliness and social isolation are a growing public health concern. In 2023, the U.S. Surgeon General’s Office released “<a href="https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf" target="_blank">Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community</a>.” The report highlights data showing that loneliness is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety and premature death. The highest rates of social isolation are found among adults age 65 or older.To reduce social isolation and loneliness among older adults and help improve their health and well-being, Elizabethtown (N.Y.) Community Hospital launched the Community Friendship Volunteer Program in fall 2024. Developed with Mercy Care for the Adirondacks, a nonprofit organization that provides support services for seniors, the program pairs older adults with volunteers who provide companionship and support, but not clinical assistance. All volunteers must complete an application and background check.“Too often seniors in our community experience social isolation and loneliness, and this can have drastic effects on their health,” <a href="https://www.ech.org/News/Detail/94" target="_blank">observes Julie Tromblee</a>, vice president and chief nursing officer at Elizabethtown Community Hospital, part of the University of Vermont Health Network.Program volunteers visit older adults at their home or talk by telephone and may assist with correspondence and with shopping or other errands. Together, a volunteer and older adult may plan outings, enjoy music and literature, and participate in crafts, gardening or other activities. Families, friends and older adults themselves can request a volunteer match, and all services are free.The hospital is part of the Age-Friendly Health Systems initiative and views its volunteer program as complementary support. “The AFHS and Community Friendship Volunteer Program help ensure that we are supporting seniors both here at the hospital and in their own home,” Tromblee said.<a class="btn btn-primary" href="https://www.ech.org/About-Us/Community-Friendship-Volunteer-Program" target="_blank">LEARN MORE</a></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/center/population-health">Improving Health and Wellness</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Mon, 07 Apr 2025 13:04:38 -0500 Population/Community Health AHA Comments on PTAC Total Cost of Care Model Proposal /lettercomment/2025-03-27-aha-comments-ptac-total-cost-care-model-proposal March 27, 2025Terry Mills Jr., M.D., M.M.M, Co-chair Soujanya Pulluru, M.D., Co-chair ATTN: Physician-Focused Payment Model Technical Advisory Committee&nbsp; Assistant Secretary for Planning and Evaluation, Room 415F U.S. Department of Health and Human Services 200 Independence Avenue, SW Washington, D.C. 20201RE: Request for Input Reducing Barriers to Participation in Population-Based Total Cost of Care Models and Supporting Primary and Specialty Care TransformationDear Co-chairs Mills and Pulluru,&nbsp;On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the �� Association (AHA) appreciates the opportunity to share our comments regarding the Physician‐Focused Payment Model Technical Advisory Committee’s (PTAC) request for input on barriers to transitioning to population-based total cost-of-care (PB-TCOC) and primary and specialty care models.In particular, we urge the PTAC to:<ul><li>Adopt common principles that will support the implementation of PB-TCOC, primary and specialty care models.</li><li>Recommend removal of high/low revenue thresholds, which inappropriately prevent certain providers from entering primary and specialty care models.</li><li>Recommend extension of the advanced alternative payment model (APM) incentive payments.</li><li>Recommend more sustainable reimbursement to support the transition to value better.</li></ul>Our detailed comments on these issues follow.<h2>COMMON PRINCIPLES FOR PB-TCOC, PRIMARY CARE AND SPECIALTY MODELS</h2>Our members support the U.S. health care system moving toward the provision of more outcomes-based, coordinated care, and we continue to redesign delivery systems to increase value and better serve patients. Over the last 15 years, our hospital and health system members participated in a variety of APMs, including primary care and specialty care models as well as total cost-of-care models.While the movement to value holds tremendous promise, the transition has been slower than anticipated and more needs to be done to drive long-term system transformation.There are principles that we believe should guide the design of such APMs to make participation more attractive for potential participants, including hospitals, health systems and independent providers. These include:<ul><li>Appropriate On-ramp and Glidepath to Risk. Model participants should have an adequate on-ramp and glidepath to transition to risk. They must have adequate time to implement care delivery changes (e.g., integrating new staff, changing clinical workflows, implementing new analytics tools) and review data prior to initiating the program.</li><li>Adequate Risk Adjustment. Models should include adequate risk adjustment methodologies to account for chronic risk factors and clinical complexity. This will ensure models do not inappropriately penalize participants for treating the sickest, most complicated and underserved patients.</li><li>Voluntary Participation and Flexible Design. Model designs should be flexible, incorporating features such as voluntary participation and options for participants to leave models.</li><li>Balanced Risk Versus Reward. Models should balance risk versus reward in a way that encourages providers to take on additional risk but does not penalize those who need additional time and experience before they are able to do so. A glidepath approach should be implemented, gradually migrating from upside-only to downside risk.</li><li>Guardrails to Ensure Hospitals Do Not Compete Against Their Own Best Performance. Models should provide guardrails to ensure that participants are not penalized over time when they achieve optimal cost savings and outcomes performance. Participants must have incentives to remain in models for the long term.</li><li>Resources to Support Initial Investment. Upfront investment incentives should be provided to support organizations in the transition to value-based payment. To be successful in such models, hospitals, health systems and provider groups must, for example, invest in additional staffing and infrastructure to support care delivery redesign and outcomes tracking.</li><li>Transparency. Models’ methodologies, data and design elements should be transparently shared with all potential participants. Proposed changes should be vetted with stakeholders.</li><li>Adequate Model Duration. Models should be long enough in duration to truly support care delivery transformation and assess the impact on outcomes. Historically, models have been too short and/or have had multiple, significant design changes even within the designated duration, making it difficult for participants to self-evaluate and change course when necessary.</li><li>Timely Availability of Data.&nbsp;Model participants should have readily available, timely access to data about their patient populations. Ideally, the Centers for Medicare &amp; Medicaid Services (CMS) would dedicate staff and technology to helping provide program participants with more complete data as close to real-time as possible.</li><li>Waivers to Address Barriers to Clinical Integration and Care Coordination. Models must include waivers to Medicare program regulations that inhibit care coordination and work against participants’ efforts to ensure that care is provided in the right place at the right time.</li></ul>We urge the PTAC to adopt these core principles for future APM model design.<h2>REMOVING PROBLEMATIC LOW-REVENUE THRESHOLDS AS CRITERIA FOR APM PARTICIPATION AND INVESTMENT PAYMENTS</h2>As mentioned above, hospitals and health systems are critical stakeholders in the journey to value. However, certain policies have hampered their ability to participate in certain models. For example, CMS has leveraged captured revenue to distinguish Accountable Care Organizations (ACOs) as “low-revenue” or “high-revenue,” and by proxy, to identify ACOs as either physician-led (low-revenue) or hospital-led (high-revenue). The agency has then limited participation in certain APMs or qualification for advanced investment payments (AIPs) to only physician-led or low-revenue ACOs. It has based this policy on the faulty assumption that low-revenue ACOs perform better than high-revenue ACOs. However, research shows there is no significant difference in performance between high- and low-revenue ACOs.1Furthermore, high-revenue ACOs often have more clinically complex, higher-cost patients attributed to their model. In addition, limiting eligibility for AIPs to only low-revenue ACOs inappropriately penalizes high-revenue ACOs, many of which are actually small organizations that critically need these resources for infrastructure investment to transition to APMs. For example, analysis suggests that critical access hospitals, federally qualified health centers and rural health centers are predominantly classified as high-revenue and therefore ineligible for AIPs. This partially explains the disparity in APM adoption in rural and underserved areas, which the PTAC has previously highlighted. We, therefore, urge PTAC to recommend the removal of these problematic high- and low-revenue thresholds that inappropriately preclude certain ACOs from obtaining necessary resources for infrastructure investment.<h2>EXTENSION OF ADVANCED APM INCENTIVE PAYMENTS</h2>The bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) provided incentive payments of 5% for providers participating in advanced APMs. These payments were designed to assist with the provision of non-fee-for-service programs like meal delivery programs, transportation services, digital tools and care coordinators that promote population health. However, MACRA statute only provided the advanced APM bonuses through the calendar year (CY) 2024 payment period. Congress has passed single-year extensions (although at lower rates) through the CY 2026 payment period. These incentive payments provide crucial resources for providers considering the transition to PB-TCOC, primary and specialty care APMs. As such, we urge PTAC to work with CMS to urge Congress to extend these incentive payments, which will better support providers transitioning to primary, specialty and total cost of care models.<h2>PHYSICIAN ACQUISITION AND PB-TCOC, PRIMARY AND SPECIALTY CARE MODELS</h2>Some presenters in the March PTAC meeting cited the acquisition of physician practices as a barrier to APM competitiveness. However, this discussion did not fully address the situation. Specifically, much like hospitals and health systems, physicians across the country face increased costs, inadequate reimbursements and administrative burdens from public and private insurer practices. These factors create major barriers to operating an independent practice. Furthermore, the transition to value-based programs often requires infrastructure investment for electronic health records, quality reporting, analytics and support staff, which many practices may not have the economies of scale to support. As a result, physicians are increasingly looking for alternative practice settings that will provide financial security so they can focus more on clinical care and less on managing their own practice.&nbsp;While a disproportionate amount of attention has been placed on hospitals’ acquisition of physician practices, the reality is that large commercial insurers have collectively invested billions in physician practice acquisitions. Based on an AHA analysis of Levin Associates data, private equity, physician groups and health insurers have acquired the vast majority of physician practices during the last five years.2 Comparatively, hospitals rank relatively low in the acquisition of physician practices. In fact, private equity-backed startups have acquired 65% of physician practices from 2019 to 2023, and insurers have acquired 14% of practices in that same timeframe. This is compared to hospitals and health systems that have only acquired 6% of physician practices.&nbsp;Therefore, we urge PTAC to recommend policies, such as more sustainable reimbursement aligned with inflation. Doing so will better support all providers’ abilities to transition to value-based care.&nbsp;We thank you for your consideration of our comments. Please contact me if you have questions, or feel free to have a member of your team contact Jennifer Holloman, AHA’s senior associate director of payment policy, at <a href="mailto:jholloman@aha.org" target="_blank">jholloman@aha.org</a>.&nbsp;Sincerely,&nbsp;/s/&nbsp;Ashley B. Thompson&nbsp; Senior Vice President&nbsp; Public Policy Analysis and Development__________1 <a class="ck-anchor" href="https://premierinc.com/newsroom/blog/pinc-ai-analysis-hospital-led-acos-perform-as-well-as-physician-led-models" target="_blank" id="https://premierinc.com/newsroom/blog/pinc-ai-analysis-hospital-led-acos-perform-as-well-as-physician-led-models">https://premierinc.com/newsroom/blog/pinc-ai-analysis-hospital-led-acos-perform-as-well-as-physician-led-models</a>2 <a href="/system/files/media/file/2023/06/Private-Equity-and-Health-Insurers-Acquire-More-Physicians-than-Hospitals-Infographic.pdf" target="_blank">/system/files/media/file/2023/06/Private-Equity-and-Health-Insurers-Acquire-More-Physicians-than-Hospitals-Infographic.pdf</a> Thu, 27 Mar 2025 13:46:53 -0500 Population/Community Health Idaho’s First Hospital-at-Home Program Showing Promising Results /role-hospitals-st-lukes-regional-medical-center-idahos-first-hospital-home-program-showing-promising-results <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-6"><img src="/sites/default/files/inline-images/TTHS-St-Lukes-Regional-Medical-Center-Hospital-at-Home.jpg" data-entity-uuid="870e9f8a-ba45-4d6b-b28f-0d2f38f63a58" data-entity-type="file" alt="Idaho’s First Hospital-at-Home Program Showing Promising Results. A paramedic listens to a women's heartbeat using a stethoscope as part of hospital-at-home care in Idaho." width="700" height="532"></div>The St. Luke’s Hospital at Home program, launched in late 2024, provides hospital-level care to patients in the comfort of their homes. This initiative is especially timely given Idaho's rapid population growth, which has increased the demand for health care services. The program allows patients with conditions such as heart failure, infections requiring IV antibiotics, pneumonia or asthma to receive necessary treatments at home, reducing the strain on emergency departments.Patients in the program are equipped with medical devices like scales, tablets, blood pressure monitors and IV pumps. Paramedics visit patients twice daily and are connected to doctors and nurses through a tablet, ensuring continuous care. This setup not only provides medical support but also allows health care providers to understand the patient's living environment and involve social work if needed, enhancing overall careThe program is supported by Medically Home and offers a cost-effective alternative to traditional hospital stays. St. Luke’s is the first hospital in Idaho to start the program, which has been around since the 1960s. “We have a type of care that is very comparable to the outcomes of a brick-and-mortar hospital,” said the program’s Medical Director Adam Balinger.It also provides a healing environment where patients can be with their families and pets, which can aid in recovery. With Medicare authorizing billing for hospital care at home since 2021, programs like St. Luke’s Hospital at Home are becoming more viable and beneficial, especially during times when hospitals are overwhelmed, such as during the pandemic.<a class="btn btn-primary" href="https://www.idahopress.com/news/local/hospital-care-at-home-st-lukes-launches-hospital-at-home-program/article_e740f5ca-ea40-11ef-94d8-bbde4c8e5aba.html" target="_blank">LEARN MORE</a></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/topics/promoting-healthy-communities">Supporting Public Health</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Mon, 24 Mar 2025 09:19:29 -0500 Population/Community Health AHA podcast: WellSpan Health — A Commitment to Quality and Community /news/headline/2025-03-05-aha-podcast-wellspan-health-commitment-quality-and-community In this conversation, Mindy Estes, M.D., former CEO of Saint Luke's Health System and former AHA board chair, and Roxanna Gapstur, R.N., CEO of WellSpan Health, discuss the strategies that enabled WellSpan to maintain high-quality care during and after the COVID-19 pandemic, solutions for nursing retention and how WellSpan is addressing critical community health challenges.<div></div> Wed, 05 Mar 2025 15:23:39 -0600 Population/Community Health WellSpan Health: A Commitment to Quality and Community /advancing-health-podcast/2025-03-05-wellspan-health-commitment-quality-and-community WellSpan Health's commitment to health care innovation and quality earned it the �� Association’s Quest for Quality Prize in 2024. In this conversation, Mindy Estes, M.D., former CEO of Saint Luke's Health System and former AHA board chair, and Roxanna Gapstur, Ph.D., R.N., CEO of WellSpan Health, discuss the strategies that enabled WellSpan to maintain high-quality care during and after the pandemic,&nbsp;solutions for nursing retention, and how WellSpan is addressing critical community health challenges.<hr><div class="raw-html-embed"><details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> View Transcript </h2> </summary> 00:00:01:05 - 00:00:29:17 Tom Haederle Welcome to advancing Health. Every hospital, every day and everywhere is striving to improve its quality of patient care. As the winner of the �� Association's prestigious 2024 quest for quality prize, WellSpan health serving 12 counties in Pennsylvania, is among the best at advancing health for those who depend on it. In today's podcast, we learn more about how the efficiencies WellSpan adopted during the pandemic are still in place and still paying dividends today. 00:00:29:20 - 00:00:43:05 Tom Haederle Your host is Doctor Mindy Estes, former president and CEO of Saint Luke's Health System and former chair of the Board of trustees. 00:00:43:07 - 00:01:19:27 Mindy Estes, M.D. I'm Dr. Mindy Estes, and today we have the privilege of speaking with Dr. Roxanna Gapstur, the president chief executive officer of WellSpan health, a position she has held since January 2019. Doctor gaster brings over 25 years of extensive health care leadership experience, having worked across various settings including practices, academic institutions and integrated health systems. Her background in strategic planning, business development and operational leadership, both at ambulatory and hospital settings, has been instrumental in her success at, well, speed. 00:01:20:00 - 00:01:36:03 Mindy Estes, M.D. So let's just dive right in. To begin, can you provide our listeners with an overview of WellSpan health and its mission? Understanding the foundation of the health system gives context to the strategic discussions we'll be talking about today. 00:01:36:06 - 00:02:04:24 Roxanna Gapstur, Ph.D., R.N. Yes, absolutely. WellSpan health is an integrated care delivery system in central Pennsylvania. We serve 12 counties and about a million and a half people have nine hospitals, 23,000 team members and about 2500 providers in our system. We are the largest provider of behavioral health in our region, and we also have a clinically integrated network which provides a basis for our value based care strategy. 00:02:04:26 - 00:02:07:27 Mindy Estes, M.D. So your geographic footprint is quite large. 00:02:07:29 - 00:02:16:00 Roxanna Gapstur, Ph.D., R.N. It's about 12 counties now in the center of the state. Yeah. We've been growing and serving more patients each and every year. 00:02:16:05 - 00:02:44:12 Mindy Estes, M.D. Were you in WellSpan in 2019? And soon after a small event happened, the world was confronted with the Covid 19 pandemic. And despite these challenges, WellSpan was noted for maintaining high quality care and extensive community support. Could you share 3 or 4 critical factors that enabled your leadership team to be successful during this period, and what you've taken from it since? 00:02:44:14 - 00:03:11:23 Roxanna Gapstur, Ph.D., R.N. Yeah, absolutely. One of our values here at WellSpan is working as one. And I think this was a moment for us to really live that value. And throughout the pandemic, we were able to rapidly adapt to changes. We practiced agility, and we practiced one of our other values to find a better way. We have a significant focus in a pretty big community health team that works across central Pennsylvania. 00:03:11:25 - 00:03:40:22 Roxanna Gapstur, Ph.D., R.N. And little did we know that the pandemic was going to highlight some of the challenges. And that team really helped us respond quickly to some of those challenges. We focused significantly on the well-being of our team. Again, I think we all found at the beginning of the pandemic, perhaps this wouldn't last a long time. But as the pandemic went on, we needed to make sure that our team was taking care of and being one of the largest providers of behavioral health services. 00:03:40:22 - 00:04:03:24 Roxanna Gapstur, Ph.D., R.N. We had pretty significant internal resources that we were able to bring to that issue. And then finally, we really empowered our teams to think differently. And at one point during the pandemic, even had developed our own N95 mask. So I think those were were some of the pieces that were most important because we unleashed the innovation within our own teams. 00:04:03:27 - 00:04:21:26 Roxanna Gapstur, Ph.D., R.N. We were able to move pretty quickly on things like the outdoor testing, things like out-of-pocket costs. We were one of the first in the nation to say that we would provide things without charge. Really proud of the team for embracing agility and making sure that the well-being of our teams were front and center. 00:04:21:28 - 00:04:49:18 Mindy Estes, M.D. You know, I want to pick up on something that you said, most of us in health care study things, and we study things for a long time, and then we pilot things, and sometimes we're pilot things. And I think the Covid crisis, if you think about making lemonade out of lemons, really told us that we could be agile, that we could make decisions quickly and in TAC one way or the other if we needed to. 00:04:49:21 - 00:04:55:13 Mindy Estes, M.D. And the question I have for you, have you been able to maintain that agility? 00:04:55:15 - 00:05:23:13 Roxanna Gapstur, Ph.D., R.N. We have actually, so was one of the things that we said to ourselves during our after action reviews that what were some of the silver linings of Covid, and how might we continue to capitalize on those? And one of those was being agile and making decisions quickly. I think because we are locally governed and one of the only health systems in our area that is locally governed, it helps us make decisions quickly because our headquarters are here and our family, friends and neighbors are here. 00:05:23:13 - 00:05:40:27 Roxanna Gapstur, Ph.D., R.N. And so that is something we've been able to maintain. One of the things that I did with my team during Covid was we split into two teams. We had one team really focused on our long term strategy and another team that just focused on operations and taking care of patients each and every day. We've used that as well. 00:05:40:28 - 00:05:49:02 Roxanna Gapstur, Ph.D., R.N. Since the pandemic ended, it was a great way for us to still make progress on some things, even though, you know, we had a lot on our plates. 00:05:49:05 - 00:06:06:24 Mindy Estes, M.D. Well, you make an important point. The work of health care and the future of health care and what what we as organizations were going to do once the immediacy of the pandemic was over, it was tempting to put that on the back shelf and get back to it. But, you know, once you let it go, it's very difficult to restart. 00:06:06:25 - 00:06:28:21 Mindy Estes, M.D. One of the things I was impressed by that I think goes into this long term thought, is that you had low nursing staff turnover during the pandemic. What strategies did you implement to have such a successful retention of nursing staff during, admittedly, an incredibly stressful and unknown time? 00:06:28:24 - 00:06:51:04 Roxanna Gapstur, Ph.D., R.N. Yeah, that's a great question. I think one of the biggest areas was just the focus on the well-being of the team. We had a lot of peer to peer support going on, as well as our psychologists and psychiatrists across the system, working with our frontline care teams every single day. So we had real time coaching and support on all of our units. 00:06:51:07 - 00:07:12:26 Roxanna Gapstur, Ph.D., R.N. We also did a lot of state interviews and a lot of work on understanding what people needed now because as you know, you know, things evolve during Covid and lots of changes happened over those 2 or 3 years. I would say a benefit to us is that generally, our region tends to lag a little bit on things that occur. 00:07:12:26 - 00:07:31:27 Roxanna Gapstur, Ph.D., R.N. So we saw surges in new Jersey and New York prior to central Pennsylvania getting those same surges. And so we were working to try and learn from our colleagues and maybe what was coming. Our way, and how we could do a better job with our teams and with our nurses. So those were some of the things we did. 00:07:31:29 - 00:07:40:13 Roxanna Gapstur, Ph.D., R.N. I think later when you ask about innovation, if you do, I can talk a little bit about some of the innovations we've done in nursing that I think also made a difference. 00:07:40:15 - 00:07:46:00 Mindy Estes, M.D. Well, how about we just speak a little bit about innovation right now, particularly in nursing? 00:07:46:02 - 00:08:11:23 Roxanna Gapstur, Ph.D., R.N. Well, certainly virtual nursing is something that we have rolled out across our system, which has made a really big difference in the satisfaction of our nurses, both in the time they spend and documentation. But the amount of time they're able to spend with their patients. So that's one area. We've also have tiered huddles in our system. So each day, seven days a week actually we start with tiered huddles around seven in the morning. 00:08:11:23 - 00:08:33:23 Roxanna Gapstur, Ph.D., R.N. And those go until nine. At 9:00 is my huddle. So every day I know by 9:00 exactly what's happening in the system, and we're able to solve problems at the right level. So we have sort of tiers one through six. A lot of things are still at tier three and below or tier four and below, but those things that can't be are elevated to the senior leaders. 00:08:33:23 - 00:08:50:24 Roxanna Gapstur, Ph.D., R.N. And we put a team on it right then and there. So I would say compared to when I first arrived at WellSpan, that we solve our problems more in real time. We're more situationally aware and we're able to prevent problems from happening because we have that focus. 00:08:50:26 - 00:09:21:03 Mindy Estes, M.D. Well in solving problems where they're best solved. You know, is helpful for everyone. And you go away from that huddle knowing what you need to do and how you need to go forward. I think a lot of people perceive central Pennsylvania yet as a relatively homogeneous area, but WellSpan serves a diverse community. Can you discuss how you engage these diverse groups and provide resources while respecting their cultures and their autonomy? 00:09:21:05 - 00:09:53:15 Roxanna Gapstur, Ph.D., R.N. Yeah, absolutely. I think a lot of Not-for-profit health systems feel very connected to their community and have different strategies. And certainly in my other roles in other states, even, I felt that connection. WellSpan has maybe a deeper connection than any I've ever experienced. And we have different ways of showing that. So each of our counties and our regions has a healthy county coalition, and WellSpan actually leads most of those coalitions. 00:09:53:18 - 00:10:23:18 Roxanna Gapstur, Ph.D., R.N. But we don't try to do the work of the experts in our nonprofit organizations. Rather, we might be a convener, we might be a partner, we might be a funder. In some instances, we're working together alongside and with and the population across central Pennsylvania, as you mentioned, are more diverse. And I realized when I first arrived here, certainly the plan community is one of our largest stakeholders, and we serve a significant number of people from that population. 00:10:23:24 - 00:10:52:27 Roxanna Gapstur, Ph.D., R.N. We have special cultural liaison individuals who work with our planning community. It's really important to have those relationships, and we've done that for more than 20 years. We also have special bundle payment programs and other types of programs that fit culturally for that particular action. And I will say during Covid that Covid was difficult for that population because of the amount of family interaction they prefer to have in their health care experiences. 00:10:52:29 - 00:11:24:06 Mindy Estes, M.D. I want to skip to the notion of gun violence in workplace violence, workplace safety, community safety. You know, gun violence is a growing concern for all of us. And you've really taken an active role in addressing this issue in New York, Pennsylvania. And I really and I know our listeners would be interested in having you elaborate on when your efforts to reduce gun violence, the partners involved, the progress made thus far. 00:11:24:12 - 00:11:34:19 Mindy Estes, M.D. And my sense is that this is one of these issues, that the minute you take your foot off the gas, it comes back. So talk a little bit about what you've been doing. 00:11:34:22 - 00:12:01:00 Roxanna Gapstur, Ph.D., R.N. Well, I, I can't say enough about what the teams have done in this region on gun violence. It's an issue across all of our communities, but I would say probably more acute in New York County. And that's where we've done a significant amount of the work over the past three years. Probably the biggest piece of this has been understanding both our role and then what the role of others might be in helping prevent gun violence. 00:12:01:02 - 00:12:28:26 Roxanna Gapstur, Ph.D., R.N. I did feel when I first came to WellSpan that there was more we could be doing as a health system in prevention, but also that we can't do it all. And so we needed the right partners. I will say that that strong partners right now have been our local police departments, certainly our judges. We have a really robust treatment court here that works very hard to prevent incarceration and to get people to the right kinds of treatment. 00:12:28:28 - 00:12:52:01 Roxanna Gapstur, Ph.D., R.N. And we also have, in the last two years, a credible messenger program. This program first started on a grant and was a business partnership agreement between one of our local nonprofits and our WellSpan York Hospital, which is a level one trauma center. And the credible messengers are highly engaged individuals who support victims and families who enter York Hospital because of gun violence. 00:12:52:04 - 00:13:20:01 Roxanna Gapstur, Ph.D., R.N. They work to solve some of the deeper causes of violence in the community. And so they're they're very connected outside of the hospital setting. And so far in the last three years, we've seen a 43% reduction in gunshot wound patients at our hospital and a 71% reduction in homicides in our community, which is just gives you goose bumps to think about because it's such a problem for some of the younger individuals in our community. 00:13:20:02 - 00:13:30:12 Roxanna Gapstur, Ph.D., R.N. So I would say the credible messenger program in these partnerships with local non-profits have been the most impactful in addressing really root causes of gun violence. 00:13:30:14 - 00:13:33:16 Mindy Estes, M.D. Question or the credible messengers? Volunteers. 00:13:33:18 - 00:13:56:02 Roxanna Gapstur, Ph.D., R.N. Not the credible messengers, are paid on the grants that we received with the not for profit. But it has been so impactful that we've continued that payment, you know, after the grant. And so all of us in New York County are very invested in that program, both emotionally and financially, because we've seen such great results with it. 00:13:56:04 - 00:14:16:27 Mindy Estes, M.D. Well, the success rate has it's really been extraordinary in the numbers of live saved in families saved, you know, has to be a positive for the entire community. I want to look ahead. And when we look ahead, what do you see as your biggest goal for WellSpan health and what challenges do you anticipate in achieving it? 00:14:16:29 - 00:14:39:27 Roxanna Gapstur, Ph.D., R.N. Boy, that's a great question. I would say innovation is probably one of our biggest priorities. We really believe that the health care system, as great a job as we do in many things, needs some transformation and needs to meet the needs of the future. So we've worked really hard to think about people, process, and technology differently than we did in the past. 00:14:39:27 - 00:15:09:22 Roxanna Gapstur, Ph.D., R.N. And we've spent the last two years setting up for our next strategic plan, which is WellSpan 2030. An innovation and transformation will continue to be a big part of learning how we can use people, process and technology differently together. And, you know, I think all of us were a little taken by surprise a couple of years ago with the, generative AI changes, the Pandora's box that can kind of open as we think about how we might have safer care, more efficient care, etc.. 00:15:09:27 - 00:15:38:05 Roxanna Gapstur, Ph.D., R.N. And I would probably call out to that we've been heavily involved in. One is using artificial intelligence to improve the speed and accuracy of our radiology exams. WellSpan has deployed over 14 different applications for the last five years in radiology. I think we're leading the pack, and in terms of how we've deployed and how engaged our radiologists are with artificial intelligence. 00:15:38:07 - 00:16:06:11 Roxanna Gapstur, Ph.D., R.N. And as you know, Mindy, artificial intelligence requires a lot of work and effort and process in order to make it the most useful for care teams. Our teams have done that work, and we've seen 81% faster traditional review of our exams with our radiologists using using AI. And our physicians who read scans are 98% engaged with the applications. 00:16:06:13 - 00:16:30:25 Mindy Estes, M.D. That's very exciting. And I think you've you've enabled your radiologists to be part of the process because, you know, I think ultimately will help us make smarter decisions, faster decisions, but does not replace the physician. I think once we understand how to use that, and we're still learning and the technology is evolving, you know, we'll see more and more of it. 00:16:30:27 - 00:16:46:29 Mindy Estes, M.D. We are just about out of time, believe it or not. And I want to thank you for sharing your insights. Your leadership at WellSpan health clearly demonstrates how engagement can drive meaningful change and sustainable change. 00:16:47:02 - 00:16:55:11 Tom Haederle Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts. </details></div> Wed, 05 Mar 2025 00:36:47 -0600 Population/Community Health Case study: How Children’s Mercy Kansas City remodeled efforts to improve community health initiatives /news/headline/2025-02-28-case-study-how-childrens-mercy-kansas-city-remodeled-efforts-improve-community-health-initiatives A case study by the AHA's Community Health Improvement network explains how Children’s Mercy Kansas City created a new model to&nbsp;coordinate its community health efforts and make more progress at a faster rate. <a href="https://www.healthycommunities.org/system/files/media/file/2024/04/AHA-CHA-Childrens-Mercy-Case-Study.pdf" target="_blank">LEARN MORE</a> Fri, 28 Feb 2025 15:07:33 -0600 Population/Community Health 3 Ways Food Is Medicine Network Will Drive Change /aha-center-health-innovation-market-scan/2025-02-18-3-ways-food-medicine-network-will-drive-change <div class="container"><div class="row"><div class="col-md-8"><img src="/sites/default/files/inline-images/3-Ways-Food-Is-Medicine-Network-Will-Drive-Change.png" data-entity-uuid="814d257c-1ee9-496d-9643-a13f03d18f34" data-entity-type="file" alt="3 Ways Food Is Medicine Network Will Drive Change. Vegetable and fruit on a heart-shaped plate, a wooden scoop filled with red beans, a heart-shaped foam stress toy, blue rubber-coated hand weights, a stethoscope, a blood-pressure gauge, and tailor's measuring tape." width="100%" height="100%">Bringing greater rigor and focus to food is medicine programs — which use food to prevent, manage or treat certain medical conditions — has been gaining momentum.Take the case of the recently launched <a href="https://now.tufts.edu/2025/02/06/tufts-university-and-leading-health-care-organizations-launch-food-medicine-national" target="_blank" title="Tufts Now: Tufts University and Leading Health Care Organizations Launch Food is Medicine National Network of Excellence">Food is Medicine National Network of Excellence</a> at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, Boston.The network will develop, convene and share best practices in Food is Medicine (FIM) to improve well-being, improve health outcomes and increase efficiency in health care. But perhaps more importantly, the organization and its founders, including Kaiser Permanente and six others, aim to standardize efforts to use food to treat specific medical conditions and chronic diseases.<h2 class="marketscan">3 Guiding Principles for the New Network</h2>The network will collaborate to integrate nutritional interventions that both transform and adapt to existing treatment models, use the latest in research and training to enhance patient care and education as well as raise rates of patient buy-in and participation. The network will pursue three interconnected priorities.<ol><li>Members will develop frameworks to assess the impact of FIM interventions, measuring health outcomes and cost-effectiveness.</li><li>The network will share insights and identify opportunities to optimize program design and delivery.</li><li>Members will promote the effectiveness of food is medicine through field engagement and communication with policymakers and the public.</li></ol>The network’s other founding members, including CVS Health, Blue Cross and Blue Shield of North Carolina, Devoted Health, Elevance Health, Geisinger and Highmark Health, will support this effort.Emerging research suggests that food-based policies and programs — such as medically tailored meals, produce prescriptions and nutrition education — can reduce diet-related medical conditions and associated health care costs, Tufts officials note. Those costs are significant.Each year, suboptimal diets and food insecurity result in more than 500,000 deaths and cost the U.S. economy $1.1 trillion in health care costs and lost productivity, said Dariush Mozaffarian, cardiologist and director of the Food is Medicine Institute at Tufts University. By working together with its partners and others in the field, the institute plans to scale evidence-based nutritional interventions that will drive change and improve health while reducing disparities.Organizations like <a href="/press-releases/2024-07-18-boston-medical-center-awarded-2024-aha-foster-g-mcgaw-prize#:~:text=WASHINGTON%20(July%2018%2C%202024),for%20Excellence%20in%20Community%20Service">Boston Medical Center</a> (BMC), winner of the 2024 AHA Foster G. McGaw Prize for Excellence in Community Service, have been working to address these issues.BMC’s <a href="https://www.bmc.org/nourishing-our-community/preventive-food-pantry" target="_blank" title="boston Medical: Preventive Food Pantry landing page">Preventive Food Pantry</a>, founded in 2001, works to address nutrition-related illness and under-nutrition for its low-income patients and patients with cancer, HIV/AIDS, hypertension, diabetes, obesity, heart disease and other chronic conditions. Individuals with special nutritional needs are referred to the pantry by BMC primary care providers who write prescriptions for supplemental foods that promote physical health, prevent future illness and facilitate recovery.<h2 class="marketscan">Investments Flow to FIM Efforts</h2>In addition, earlier this year the National Institutes of Health awarded a five-year $3.8 million grant to <a href="https://thedaily.case.edu/food-is-medicine-program-awarded-3-8m-federal-grant-to-support-health-and-nutrition-of-low-income-high-risk-pregnant-women/" target="_blank" title="Case Western Reserve University: ‘Food is Medicine’ program awarded $3.8M federal grant to support health and nutrition of low-income, high-risk pregnant women">Case Western Reserve University</a> in partnership with the Greater Cleveland Food Bank, University Hospitals (UH) of Cleveland and MetroHealth Medical Center to provide health and support to low-income pregnant women. The Nourishing Tomorrow program will study 360 food-insecure pregnant patients from UH and MetroHealth.The funding will provide one of the first comprehensive, rigorous studies of medically tailored groceries as an approach to reduce food insecurity and improve both maternal and baby health outcomes.Elsewhere, the Food is Medicine Coalition, an association of community-based nonprofit food providers, last year released a 32-page FIM accreditation standard that focuses largely on medically tailored meals.The stringent requirements call for organizations to have one accredited full-time dietitian on staff for every 1,000 clients they serve. Accredited organizations can’t serve any foods with artificial sweeteners, preservatives or anything ultra-processed. They also are directed to cook foods in a way that “preserves the nutrient value of the food,” such as by “baking, braising and sautéing rather than frying.”The investment community also seems to be taking notice of advances in personalized nutrition.<h3 class="marketscan"><a href="https://www.faynutrition.com/" target="_blank" title="Fay homepage">Fay</a></h3>A nutrition startup that connects individuals with insurance-covered registered dietitians who provide personalized nutrition and lifestyle counseling, recently raised a $50 million series B round by Goldman Sachs at a $500 million valuation. Existing investors General Catalyst and Forerunner also participated in the round.<h3 class="marketscan"><a href="https://www.berrystreet.co/" target="_blank" title="Berry Street homepage">Berry Street</a></h3>This startup developed a nutrition counseling program for consumers and has a network of 1,000 registered dietitians. It secured a $50 million investment from Northzone, Sofina, FJ Labs, the founder of Revolut, a co-founder of Spring Health, a co-founder of Grow Therapy and the CEO of Found, among others. The funds will help the company add to its provider network and its suite of provider AI tools to "drive better health outcomes for patients.”</div><div class="col-md-4"><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } h2.marketscan { color: #9d2235; } h3.marketscan { color: #9d2235; } Tue, 18 Feb 2025 06:15:00 -0600 Population/Community Health