Monday, April 16, 2018

A Balanced Portfolio Model For Improving Health: Concept And Vermont’s Experience

Health Affairs recently published an article by James Hester (IBHPC Stakeholder Advisory Board member) about Vermont's efforts to rationalize health care delivery over the past decade or so. Jim had a front-row seat for much of this dramatic activity as a staffer for the state and later for CMS. It is well-written, engaging, and makes a compelling case for considering a holistic approach to social welfare as a vehicle for improving health and health care.

Hester J. A Balanced Portfolio Model For Improving Health: Concept And Vermont’s Experience. Health Affairs; April 2018. https://doi.org/10.1377/hlthaff.2017.1237
Abstract: A successful strategy for improving population health requires acting in several sectors by implementing a portfolio of interventions. The mix of interventions should be both tailored to meet the community’s needs and balanced in several dimensions—for example, time frame, level of risk, and target population. One obstacle is finding sustainable financing for both the interventions and the community infrastructure needed. This article first summarizes Vermont’s experience as a laboratory for health reform. It then presents a conceptual model for a community-based population health strategy, using a balanced portfolio and diversified funding approaches. The article then reviews Vermont’s population health initiative, including an example of a balanced portfolio and lessons learned from the state’s experience.


Great work, Jim!

- Ben Littenberg

Friday, April 13, 2018

Site Recruitment milestone

As of today, 43 clinics are enrolled in the IBH-PC study! This is a big milestone as our study design calls for 40 sites. (I'm juiced that we have a few extras - statistical power is a numbers game.)  The randomization has yielded 21 Active practices and 22 in the Control arm. Baseline data collection has started and the data are starting to come in - very exciting!

Thank you to Juvena, Sylvie, Rodger and all the Cluster Leaders for making this happen.

-Ben Littenberg

Thursday, March 29, 2018

Update on the IBHPC

The first version of the IBHPC intervention is complete! It consists of:

  • the online curriculum
  • the toolkit, including
    • team management suggestions
    • a set of tactics for integrating behavioral and primary care
    • step-by-step templates for clinic process redesign
    • a guide for patient partners working on the redesign team at the clinics
  • remote coaching for practice facilitators
The curriculum is a series of 15-30 minute multimedia modules in the Canvas learning management system and comes with continuing education credit. It is tailored for specific audiences based on their roles in the clinic: primary care providers, behavioral health providers, nurses, care managers, administrative staff, facilitators, managers and patient-partners. The workbook is available online as a PDF document than can be printed for local use. The remote coaching is delivered via phone and web by a team of experienced practice coaches from a secret location at IBHPC HQ.

This is a major milestone and I'm very grateful to the cast of thousands, led by Connie van Eeghen, Daniel Mullin, CR Macchi, Yuna Berman, Jen Lavoie, Paula Reynolds, Doug Pomeroy and Gail Rose.

For now, the intervention is the heart of our study. When the study is over (and we have some idea of how well it works!), we will make it available for use in a clinic near you...

- Ben Littenberg