Faced in July 2011 with a mandate from the federal government to assess the health care needs of Northeast Florida, five nonprofit health care companies that operate hospitals in Jacksonville did what competing hospitals rarely do.
They decided to work together as the Jacksonville Metropolitan Community Benefit Partnership while compiling a Community Health Needs Assessment as required by the Affordable Care Act.
Tuesday, the partnership, which consists of Baptist Health, Brooks Rehabilitation, Mayo Clinic Florida, Shands Jacksonville Medical Center and St, Vincent’s HealthCare, as well as the Duval, Clay, Nassau and Putnam county health departments, announced the results of the year-long assessment.
What impressed Meade Grigg, the Florida Department of Health’s deputy secretary for statewide services, was not only the information in the 190 page report but also the process by which it was produced.
“The significance of what this community has done can’t be overstated,” Grigg said. “This can truly be a model we can use throughout the state of Florida and throughout the nation ... We need to use this kind of process everywhere.”
“The collaboration among the health systems in this community is close to unique in this state,” said Baptist Health CEO Hugh Greene.
Under the leadership of the Health Planning Council of Northeast Florida, representatives from the five care organizations and the four health department spent a year studying the health care needs of Northeast Florida.
They identified access to health care “as the single most important issue in Northeast Florida.”
The primary barriers to that access are inability to pay and a lack of public transportation.
About 92 percent of households have at least one member covered by insurance. But that leaves eight percent with no one covered and many of those who have some coverage are receiving it through government programs like Medicaid and Medicare.
Lack of coverage or inadequate coverage leads many people to delay seeking treatment. Ten percent of respondents said that during the 12 months they needed medical care but had difficulty finding a doctor. Five percent of respondents with children said they needed medical help for a child but couldn’t get it.
Of the people who lacked insurance, 69 percent said they can’t afford it, 38 percent said they were unemployed and 11 percent cited preexisting conditions.
Many of them, after delaying health care, ended up making emergency room visits. Only 27 percent of the people seen in emergency rooms during the 12 month period had commercial insurance, the report noted. About 36 percent had coverage from Medicare or Medicaid. Most of the rest were what is called self-pay, which in most cases means can’t pay. Presumably, the self-pay category will shrink was the Affordable Care Act goes into effect.
One of the goals of the programs that will be instituted following this needs assessment will be evolve from the “system of sick care to one based on wellness and prevention,” the report said.
Based on the results of the needs assessment, each health care group’s board of directors approved a list of areas of emphasis to be pursued over the next three years.
Baptist Medical Center, for instance, has heart disease, stroke and diabetes at the top of its list. Brooks Rehabilitation listed stroke, head injury and spinal cord. The Mayo Clinic will put its emphasis on adult obesity. St. Vincent’s Medical Center Southside will emphasize infant mortality, heart disease, and childhood and adult immunizations. Shands Jacksonville’s list is topped by infant mortality, heart disease and stroke. Wolfson Children’s Hospital has infant mortality and childhood obesity as community priorities.
How effective each health care group is at meeting those goals will affect its compensation from government programs. In three years, another needs assessment will take place.
“This is a marathon and we are at the mile marker,” said Moody Chisholm, CEO of St. Vincent’s HealthCare.
“This process is more metric driven, more outcome focused,” Green said. “We’ll be able to come together and compare outcomes.”
Working together on the needs assessment has already had a favorable outcome for the health care companies, said Dawn Emerick, CEO of the Health Planning Council. By working together on the assessment rather than each doing its own assessment, the five groups saved about $500,000.
Read more at Jacksonville.com: http://jacksonville.com/news/health-and-fitness/2013-02-12/story/jacksonville-health-care-organizations-cooperate-needs#ixzz2Kmj4Q2N9