Improvements suggested for regional health initiative

 

A consultant has recommended improvements to the Regional Health Care Initiative, which includes a number of committees, including the one on mental health shown above. (File photo by Mike Sherry/Hale Center for Journalism)

Leaders of a key initiative to coordinate and expand healthcare services for the region’s low-income residents must sharpen its focus and do a better job of measuring its outcomes, according to a review by an outside consultant.

Known as the Regional Health Care Initiative, the effort operates through the Mid-America Regional Council. Major funding has come through the REACH Healthcare Foundation in Merriam, Kan., and the Health Care Foundation of Greater Kansas City in Kansas City, Mo.

The two foundations launched the initiative in 2007, and they hired Health Management Associates, of Lansing, Mich., to evaluate its progress.

Officials released the results of the review at a meeting Monday in Kansas City, Mo. The roughly 30 attendees included safety net officials interviewed by HMA as part of the review.

“This is a story of some successes and some missed opportunities,” said Bill Moore, vice president of program, policy and evaluation for REACH.

Budget figures compiled by the consultant tallied nearly $8 million of funding for the initiative since its inception, including some funding from outside the foundations for a program aimed at increasing evening and weekend access to safety-net clinics.

Strategic plan

According to the report, the initiative “lacks a unifying strategic plan.”

Officials with the consulting firm, who walked the audience through the report, said members of various committees within the initiative were unclear about how their work fit in with the overall direction of the initiative.

The report suggested development of a plan to identify and prioritize priorities based upon anticipated impact.

The consultants also found that:

• Impacts and outcomes of the various programs within the initiative “have not been sufficiently measured or documented.”

• Materials produced by the various committees within the initiative have had “varying levels of impact” within the community.

• Differences in state policy and funding in Kansas and Missouri hindered coordination efforts.

Moore said he considered the lack of outcomes data one of the biggest missed opportunities of the initiative. He said that findings in the report highlighted to both foundations the importance of building in evaluation components to all the programs they fund.

Gaylee Morgan, a principal with the consultant, said interviewers heard a lot of anecdotes about how this committee or that committee had achieved success. “We just didn’t have the data to be able to substantiate and say, this is the impact on access, this is the impact on coordination and quality,” she said.

Director responds

Evaluating an effort like the Regional Health Care Initiative is somewhat difficult, said Scott Lakin, the director of the initiative. It’s hard to quantify, he said, how many people did not get sick because of the efforts of the initiative.

As for the overall report, Lakin said, “We are going to take it and work not only with HMA and the foundations, but the stakeholders to continue to move forward to do what we are supposed to do, and that’s increase access and improve the quality of care.”

According to the report, specific successes noted by safety-net officials included:

• The after-hours initiative that added weekend and evening hours.

• Establishment of a curriculum to train community health workers, specialists trained to help safety-net patients navigate the healthcare system.

• Education efforts around trauma-informed care, a caregiving model that takes into account various experiences, such as abuse and neglect, a patient might have endured.

• The effort to enhance training for dental assistants to expand access to dental services.

In general, too, participants in the initiative noted that bringing together administrators from various organizations had established a rapport that did not exist prior to the initiative, said Sarah Jagger, a senior consultant with HMA.

“I think what has been pointed to by the majority of the people we interviewed – the most important thing that they can attribute to the RHCI is that there has been a foundation of trust built,” she said.

Respondents, Jagger said, noted that the initiative has even forged cooperation among providers that might have considered themselves competitors in the past. “So, they brought those stakeholders around the table and started having discussions about how we can move the system forward.”