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Developing Accountable Care Communities in North Carolina

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Developing Accountable Care Communities in North Carolina APRIL 2019 PARTNERING TO IMPROVE HEALTH: Developing Accountable Care Communities in North Carolina COMMUNITY PARTNERS YOU INSURANCE HEALTH CARE LOCAL GOVERNMENT Funded by The Duke Endowment and the VISIT Kate B. Reynolds Charitable Trust NCIOM.ORG North Carolina Institute of Medicine 1 The North Carolina Institute of Medicine (NCIOM) is a nonpolitical source of analysis and advice on important health issues facing the state. The NCIOM convenes stakeholders and other interested people from across the state to study these complex issues and develop workable solutions to improve health care in North Carolina. The full text of this report is available online at: http://www.nciom.org North Carolina Institute of Medicine Keystone Office Park 630 Davis Drive, Suite 100 919.445.6150 Suggested Citation North Carolina Institute of Medicine. Partnering to Improve Health: Developing Accountable Care Communities in North Carolina. Morrisville, NC: North Carolina Institute of Medicine; 2019. Funded by The Duke Endowment and the Kate B. Reynolds Charitable Trust. Any opinion, finding, conclusion, or recommendations expressed in this publication are those of the Task Force and do not necessarily reflect the views and policies of The Duke Endowment or the Kate B. Reynolds Charitable Trust. Credits Report design and layout: Kayleigh Creech, Laser Image Printing & Marketing 2 Partnering to Improve Health TABLE OF CONTENTS 5 ACKNOWLEDGEMENTS 6 TASK FORCE ON ACCOUNTABLE CARE COMMUNITIES Co-Chairs, Task Force Members, Steering Committee Members 9 EXECUTIVE SUMMARY 14 DEFINITIONS 15 CHAPTER 1 Background CHAPTER 2 22 Collaborating for Better Health 27 CHAPTER 3 North Carolina Opportunities for Health 34 CHAPTER 4 Implementing Opportunities for Health CHAPTER 5 40 Evaluation and Process Improvement 43 CHAPTER 6 Funding and Financing Models 50 CONCLUSION 51 REFERENCES 55 APPENDIX A Full Task Force Recommendations 63 APPENDIX B Recommendations by Responsible Agency/Organization APPENDIX C 66 How Drivers of Health Affect Health Outcomes 71 APPENDIX D Examples of Accountable Care Community-Style Models North Carolina Institute of Medicine 3 4 Partnering to Improve Health ACKNOWLEDGMENTS The North Carolina Institute of Medicine’s (NCIOM) Task Force on Manatt Health Strategies; Robby Hall, MHA, Director of Social Services, Accountable Care Communities was convened in January 2018. Funding Richmond County Human Services; Beverly Hamilton, MHA, Director, for the Task Force was provided by The Duke Endowment and the Kate B. Government Contracts, Molina Healthcare of South Carolina; Lisa Macon Reynolds Charitable Trust. Harrison, MPH, Health Director, Granville Vance Public Health; Lanie Honeycutt, MHA, Product Manager, Son Information Systems, Inc.; The Task Force was co-chaired by Miles Atkins, Mayor of the Town of Claudette Johnson, RN, BSN, MNA, Vice President for Clinical Programs, Mooresville and Director of Corporate Affairs & Government Relations Emtiro Health; Zack King, MPH, CHES, Interim Public Health Strategist, at Iredell Health System; Reuben Blackwell, President & Chief Executive Catawba County Public Health, LiveWell Catawba; Laura Zink Marx, Officer of Opportunities Industrialization Center, Inc. and City Council President & CEO, United Way of North Carolina; Christine McNamee, Member in Rocky Mount, NC; Mandy Cohen, MD, MPH, Secretary for the MPA, Executive Director, Cape Fear HealthNet; Rhett Melton, MBA, CEO, North Carolina Department of Health and Human Services; and Ronald Partners Behavioral Health; Kevin Moore, Vice President of Policy, Health, Paulus, MD, MBA, President & CEO of Mission Health System. Their and Human Services, UnitedHealth Group; Steve Neorr, MBA, Chief leadership and experience were important to the success of the Task Administrative Officer, Triad HealthCare Network; Emma Olson, LMSW, Force’s work. MPH, Coordinator, Culture of Results Evaluation & Communications, North Carolina Center for Health and Wellness, University of North The NCIOM also wants to thank the members of the Task Force and Carolina-Asheville; Ann Oshel, MS, Senior VP, Community Relations, Steering Committee who gave freely of their time and expertise to Alliance Behavioral Healthcare; Ronald Paulus, MD, President and CEO, address this important topic. The Steering Committee members provided Mission Health; William Pilkington, DPA, MPA, MA, CEO and Director guidance and content, helped develop meeting agendas, and identified of Public Health, Cabarrus Health Alliance; Michelle Ries, MPH, Project speakers. For the complete list of Task Force and Steering Committee Director, NCIOM; Tish Singletary, Program Consultant, Division of members, please see Pages 6-8 of this report. Public Health, Chronic Disease and Injury Section , NC Department of Health and Human Services; Peter Skillern, MCRP, Executive Director, The Task Force on Accountable Care Communities heard presentations Reinvestment Partners; Robert Strack, PhD, Associate Professor, from multiple experts through the course of the Task Force work. We Department of Public Health Education, UNC Greensboro; Betsey Tilson, would like to thank the following people for sharing their expertise and MD, MPH, State Health Director & Chief Medical Officer, North Carolina experiences with the Task Force (positions listed are as of the date of the Department of Health and Human Services; Jenn Valenzuela, MSW, presentation given): MPH, Principal of Programs, Health Leads; Mary Warren, MS, Director, Triangle J Area Agency on Aging; Gloria Wilder, MD, MPH, Vice President, Calvin Allen, Director, Rural Forward NC, Foundation for Health Innovation and Preventive Health, Centene Corporation; Josie Williams, Leadership & Innovation; Marian Arledge, MPH, Executive Director, Project Coordinator, Greensboro Housing Coalition; Ciara Zachary, PhD, WNC Health Network; Miles Atkins, Mayor, Town of Mooresville; MPH, Health Program Director, NC Child. Katie Bartholomew, RN, CCM, Manager, Clinical Operations, Mission Health Partners; Stacy Becker, MS, MPP, Vice President, Programs, In addition to the above individuals, the staff of the North Carolina ReThink Health; Heather Black, NC 2-1-1 Statewide Strategy Director, Institute of Medicine contributed to the Task Force’s study and the United Way of North Carolina; Reuben Blackwell, President and CEO, development of this report. Adam J. Zolotor, MD, DrPH, President and Opportunities Industrialization Center, Inc.; Will Broughton, MA, MPH, CEO, guided the work of the Task Force. Berkeley Yorkery, MPP, Associate CPH, Coordinator, Office of Health Access, Brody School of Medicine at Director, helped guide the work of the Task Force and made significant East Carolina University; Christie Burris, Executive Director, NC Health contributions to the writing of this report. Brieanne Lyda-McDonald, Information Exchange Authority, NC Department of Information MSPH, Project Director, served as Project Director for the Task Force Technology; Brett Byerly, Executive Director, Greensboro Housing and was primary author of the final Task Force report. Chloe Donohoe Coalition; Mary Carl, Principal of West Coast Partnerships, Health Leads; served as a Research Assistant for the project. Kaitlin Phillips, MS, edited Anthony Carraway, MD, Medical Director/Chief Clinical Officer, Sandhills the final Task Force report and provided social media publicity for the Center; Edward Chaney, JD, Attorney, Schell Bray PLLC; Alisahah Cole, Task Force. James Coleman, MPH, assisted with research and reference MD, System Medical Director, Community Health, Atrium Health; Leslie coordination for the final Task Force report. Michelle Ries, MPH, provided DeRosset, MSPH, MPH, Program Manager, Improving Community guidance for the final Task Force report. Key staff support was also Outcomes for Maternal and Child Health, Division of Public Health, provided by Kisha Markham, Administrative Assistant and Don Gula, Women's Health Branch, North Carolina Department of Health and Director of Administrative Operations. Former staff, Anne Foglia, MS, Human Services; Roxanne Elliott, MS, Project Director, First Health of served as Project Director for the initial stages of the Task Force and the Carolinas; Deitre Epps, MS, Results Based Accountability (RBA) Maggie Bailey, served as Research Assistant for much of the project. and Equity Consultant; Ken Fawcett, MD, Vice President, Healthier Eduardo Fernandez, Summer Intern, provided background research for Communities, Spectrum Health; Robert Feikema, MA, President & CEO, the final Task Force report. Family Services, Forsyth County; Jocelyn Guyer, MPA, Managing Director, North Carolina Institute of Medicine 5 TASK FORCE ON ACCOUNTABLE CARE COMMUNITIES TASK FORCE ON ACCOUNTABLE CARE COMMUNITIES CO-CHAIRS Miles Atkins Mandy Cohen, MD, MPH Mayor, Town of Mooresville Secretary Director, Corporate Affairs & Government Relations NC Department of Health and Human Services Iredell Health System Ronald Paulus, MD, MBA Reuben Blackwell President & CEO President & CEO Mission Health System Opportunities Industrialization Center, Inc. City Council Member, Rocky Mount TASK FORCE MEMBERS Debra Collins, MS Director, Public Transportation Division Donna Albertone, MS NC Department of Transportation Senior Program Director Population Health Improvement Partners Kathleen Colville, MSPH, MSW Director of Healthy Communities Paula Avery Cone Health Project Coordinator West Marion Community Forum Giselle Corbie-Smith, MD, MSc Director, Center for Health Equity Research Blair Barton-Percival,
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