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Innovations in Rural and Community Health: Lessons From the Front Line May 9, 2017 Aaron George, DO Family Physician Summit Primary Care

Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

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Page 1: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Innovations in Rural and Community Health:

Lessons From the Front Line

May 9, 2017Aaron George, DOFamily Physician

Summit Primary Care

Page 2: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Innovations in Rural Primary Care

Local Context

State Context

Global Perspective

Page 3: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Chambersburg, PA

Page 4: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Value Doesn’t Come from a Value Meal

Page 5: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Health Maintenance

Shifting Roles and Trust

Vaccinations, annual &

screening labs

DEXA & mammograms

Colonoscopy

Page 6: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Shifting – Increased Clinical Role

Insulin Teaching

Smoking Cessation

Diabetic Foot Exams

Wound Care

Vitals

Warfarin Adjustment

Depression Screening

*Healthy lifestyle counseling

Page 7: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Tool #1: Finding Value in Your WorkBuild Your Personal Game Plan

Page 8: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local
Page 9: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local
Page 10: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Pennsylvania Hospital Systems

Page 11: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Health Innovation in Pennsylvania(HIP)

Page 12: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Statewide Approach to HIP

Page 13: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Health Innovation in Pennsylvania(HIP)

1) Accelerate transition from volume to value

2) Achieve price and quality transparency

3) Redesign rural health care delivery

Page 14: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Global Hospital Budgeting

Page 15: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Global Context• Comprehensive approach to payment and delivery

Page 16: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Comprehensive Primary Care Payment Calculator

Step 1: Design or clarify services

Step 2: Identify the population

Step 3: Risk adjust

Step 4: Measure quality and utilization

Step 5: Define a comprehensivepayment

Page 17: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

AAFP Proposal for Advanced Primary Care Payment Model (APC-

APM)

Page 18: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local
Page 19: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

AAFP Proposal for Advanced Primary Care Payment Model (APC-

APM)

Page 20: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Trends in Rural Care Delivery

• Focus on comprehensive delivery • Funding through comprehensive payment

mechanisms• Health care is local• Many paths to the same goal• All involve increased primary care investment• Enhancing health care teams and resources

Page 21: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Tool #2:Finding Value in Community

Health Landscapes

http://www.countyhealthrankings.org/Healthlandscapes.org

Page 22: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local
Presenter
Presentation Notes
Underserved areas in PA The borough’s median household income ($41,751 a year) is 20 percent less than the medians for the county and state. Its poverty rate is higher. More than 20,500 people live in the borough. Chambersburg’s ethnic and racial breakdown: 77 percent white, 15 percent Hispanic, 9 percent black, 1 percent Asian, 8 percent other races and 3 percent two or more races.
Page 23: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local
Presenter
Presentation Notes
% of state migrant students reporting, 4.7%
Page 24: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local
Presenter
Presentation Notes
Diabetic prevalence per county, CMS data, percent, 29.6%. The PA “T”
Page 25: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local
Presenter
Presentation Notes
Rate of males age 40-64, who are 400% below the federal poverty line, and uninsured. 21.3%
Page 26: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Tool#2: Finding Value in Community

Health Landscapes

countyhealthrankings.orghealthlandscapes.org

Page 27: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Tool #3: Finding Value in Community

Practical Playbook

practicalplaybook.org

Page 28: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Tool #4: Connecting the DotsHealthdoers Network

healthdoers.org

Page 29: Lessons From the Front Line - Duke University...Lessons From the Front Line Aaron George, DO May 9, 2017 Family Physician Summit Primary Care Innovations in Rural Primary Care Local

Aaron George, DOContact Info: Email: [email protected]: (717) 658-3958


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