Integrating Prevention in Health System Reforms

Integrating Prevention in Health System Reforms

In the spring of 2019, the Vermont Public Health Institute received a grant from the Vermont Department of Health’s Office of Rural Health and Primary Care to survey Vermont’s critical access and rural hospitals on their institutions’ readiness to move to Value Based Reimbursement.  Hospitals were invited to voluntarily complete a Self-assessment promulgated by the National Rural Health Resource Center, “Performance Excellence Framework:  Key Questions for Rural Hospitals Assessment.”  Aggregated results from completed self-assessments will assist the Office of Rural Health in planning for use of FLEX (Medicare Rural Hospital Flexibility) and SHIP (Small Hospital Improvement Program) funds.

In addition to information from the self-assessment, each hospital has been asked to participate in an on-site meeting to discuss broad questions about FLEX and SHIP funding, how Community Health Needs Assessments have contributed to its strategic planning, and its experience of and expectations for the Accountable Community for Health initiative it its region.

All the results will be combined in a report that will be offered to all hospitals and interested others in early 2020.

Accountable Communities for Health Peer Learning Laboratory

VtPHI is providing facilitative support to ten (10) regional partnerships in a year-long peer-learning project to create Accountable Communities for Health. This project will bring together leaders from health care, public health, and community organizations partnering in emerging Accountable Communities for Health within Vermont to learn with and from one another and from national innovators about strategies to address the non-clinical social, economic and behavioral determinants of health and incorporate primary prevention efforts that address the health of the whole population.

VtPHI support includes identifying the practical steps in creating structures and sustainable funding to integrate clinical care and community wide prevention strategies. Support will include pulling together local leadership; identifying potential governance; reviewing existing data and systems; and determining opportunities for creating permanent structural changes.

The Plan for Integrating Population Health and Prevention in Health System Innovation

VtPHI has been hired to write for The Plan for Integrating Population Health and Prevention in Health Care Innovation in Vermont for the Vermont Health Care Innovation Project (VHCIP) – Vermont’s SIM Grant with the Centers for Medicare and Medicaid (CMMI). This plan will recommend a strategic pathway forward to integrate population health and prevention in future reforms aimed at saving money, ensuring health care quality and improving health. Specifically, the Plan will:

  • provide analysis of opportunities through the payment and care models being tested in Vermont’s health system reforms being tested through VHCIP
  • outline population health measures to be used in tracking the outcomes of VHCIP and to be incorporated in the new payment models;
  • recommend payment reform mechanisms, and promising new financing vehicles that promote financial investment in population health interventions; and
  • describe a pathway and alternate structures to improve population health through better integration of clinical services, public health programs and community based services at both the practice and the community levels.