Choose Health Delaware aims to integrate care

Big changes are in the pipeline for healthcare services, payment models and delivery in Delaware.

Supported by a $35 million grant from the Center for Medicare and Medicaid Innovation, in 2014, a statewide healthcare commission created the Delaware Center for Health Care Innovation to distribute federal funds with the goals of reducing spending and improving population health by streamlining care.

During a recent public forum at the CHEER Center in Georgetown, leaders of the center introduced a broad-based plan to overhaul healthcare in Delaware that includes practice transformation and integration, workforce education and re-training, conversion to integrated electronic medical records, new payment models and a renewed focus on community health and accessibility.

Patients and consumers
As one of 12 members of the center’s board of directors, Delaware Department of Health and Social Services Secretary Rita Landgraf also serves as chairperson of the Patient and Consumer Advisory Committee, one of five committees established by the center to help guide transformation. Landgraf said the changes to practices, access, patient experience and payment are focused on achieving and maintaining wellness.

“What we are asking is ‘How do we support people in their own wellness?’” she said. “You will be partners in making these decisions.”

Landgraf said as part of the transformation, behavioral health monitoring and interventions will begin moving into primary care practices, and the center is examining barriers to care, including transportation. Integrated access to housing, employment and mental health for individuals at or below the poverty level are also important aspects in the planning and implementation process, she said.

Practice transformation
The statewide conversion to integrated electronic records, payment for wellness and other aspects of altering practice dynamics will require education, training and retraining the workforce.

As chairperson for the center’s workforce and education committee, Kathy Janvier said the workforce will be retrained as technology and payment models are shifted from the current fee-for-service model to payment for outcomes.

“We are currently practicing transformation, and two things are happening,” Janvier said. “There will be a two-year retraining of the current workforce with educational opportunities, and we also need to train the future workforce so they can continue to meet the demands.”

She also said the center will be working to streamline licensing and credentialing so employers can more easily fill positions.

Healthy communities
Center Chairman Matt Swanson also heads the healthy neighborhoods committee, which has divided the state into 10 geographic communities to identify pressing needs in different areas, encourage healthy activities, involve community leaders in health and increase accessibility to screenings and care.

“The needs are different in each community,” Swanson said. “Healthy neighborhoods is about what’s going on at a community level.”

He said community leaders would be called upon to play an important role in creating healthier communities by identifying the particular needs of each neighborhood, such as designing access to healthier foods at corner stores, maintaining safer parks and offering more or better nutrition in schools.

“You are all stakeholders in this,” Swanson said.

Payment models
Finally,  board member and Treasurer Thomas Brown addressed costs and savings from avoiding duplicate tests and centralizing electronic medical record as co-chair of the payment model monitoring committee. Brown said the coalition is working to create payment models that reward practitioners for better outcomes and offer consumers care at the appropriate levels in an appropriate setting.

“The goal of the payment committee is saving money and making us more efficient,” Brown said. “The key is wellness.”

The center is asking for input from the public as it unveils and develops a comprehensive healthcare system.  The next public forum is slated to be held at 5 p.m., Monday,  July 11, at the Modern Maturity Center, 1121 Forrest Ave., Dover.