1. UW Foster School of Business / Premera
Economic Disruption in Healthcare II

2. Anatomy of a Crisis…
35
30
25
20
15
10
5
0
Percentof
GDP
1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080
Year Projected Tax
Revenues
Actual Projected
Interest on the debt
All other non-interest spending
Social Security
Medicare, Medicaid, CHIP, Exchange Subsidies
Source: CBO and George Mason University © 2012 Premera / Scott Forslund (425) 918-5070

3. Our Challenges
Health Threat
Healthcare Cost Threat
Economic Threat
Growing Faster in
Snohomish County

4. Coalition Steering Committee

5. Status Review: 2013-15 Strategic Plan
Strategic Goals
 Form coalition, set direction, create organizational structure and
formally launch
 Build awareness, interest and appetite for support through
coordinated communication and outreach
 Successfully execute first two proof-of-concept initiatives: youth
activity and palliative care
 Set stage for expansion into new initiatives and replication of model
across state and region

6. Palliative Care
Initiative

7. Coalition Palliative Initiative: 3-Pronged Approach
2. Integrate existing community efforts (local, multi-state collaboration)
3. “Sector” strategy – community-based, self-sustaining models
1. Combined consumer and physician/ARNP education

8. 2013-14 Measurable Objectives
First Focus on Advanced Planning
 Convene organizations around a mutual goal to educate 1,500
Consumers
 20% (300) advanced directives generated
 CME-education for 130 Physicians (plus ARNPs, etc.)
 23% of physicians in relevant specialties
 Create a 1:4 scale model – community-based, self-sustaining
 Integrate diverse efforts of multiple players
 Demonstration models in >2 sectors: faith community & senior services orgs

9. Community-Set Desired Outcomes
• Identify relevant personal values & goals if facing
a life threatening illness
• Understand common life-sustaining treatments,
palliative care, hospice
• Identify your preferences for medical care
• Understand this requires communication,
documentation, and advocacy
• Take specific actions to ensure EOL care will
reflect personal values
Demographics, contact information
• Received opportunities to address questions in class and supplemental

10. Youth Activity
Initiative
9

11. Strategic Objectives
10
What This Initiative Aims to Deliver
HYSActivity/HealthMetrics
Grade 5 Grade 6
Current path
Desired results

12. Partnering Organizations
11

13. What the kids see…
12
Fifth Graders’ View

14. “Grown-up” view of engagement, variation
A closer look…
Multi-channel Engagement Strategy:
• Gear Up & Go! Community
Collaboration
• Sqord platform expansion
 Feature roll-outs
 Real-time feedback integration

15. Participation…Engagement…Potential!
Avg Daily Activity Points
• School district activity levels vary by up to 30%
• Classroom activity: top quartile has 2-3x the activity of bottom quartile
Early data shows promise – strong overall activity levels AND
significant variation suggesting many ‘best practices’ to share

16. 2013-14 Approach and Timeline
Oct 2013 June 2014Jan 2014
Participation
Insights & Collaboration
Engagement
Wave 1: 7,000 students, 900 staff
Wave 2: 2,300 students, 300 staff
Oct 2014
Wave 3: Summer/Community
HYS 2014
Feb 2014 Dec
Build community
My school My districtMe, my class

17. Evaluation Partnership
Allen Cheadle, Director
Center for Community Health Evaluation
Group Health Research Institute
Tao Kwan-Gett, MD, MPH, Director
Northwest Center for Public Health Practice
UW School of Public Health
Coalition Analytics Committee co-chairs
Gary Goldbaum, MD, Director, Snohomish Health District
Oscar Lucas, Strategic Programs Director, Premera Blue Cross
Premera Corporate Informatics group

18. Collective Impact Framework
Key Indicators
 Personal Health indicator(s)
 Physical, mental
 Lifestyle, behavioral
 Healthcare cost / trend indicator(s)
 Relative to income
 Individual, employer, community
 Economic indicator(s)
 Individual, employer, community
 Civic Health indicator(s)
 Social determinants of health
 Other e.g., civic health TBD