Albert Terrillion, DrPH, CPH

ASTHO

…the national nonprofit organization representing the public health agencies of the United States, the U.S. Territories, and the District of Columbia, as well as the 120,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to assuring excellence in state-based public health practice.

Vision: Healthy people thriving in a nation free of

preventable illness and injury. Mission: To transform public health within states and

territories to help members dramatically improve health and wellness.

55% 45% FreestandingIndependentAgency

Under a LargerAgency

State Health Agency Structure

Principles for Successful Integration of Public Health and Primary Care:

a shared goal of population health improvement; community engagement aligned leadership sustainability the sharing and collaborative use of data and analysis.

Reference: Institute of Medicine. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC. The National Academies Press. 2012

Degrees of Integration

July 2012; Washington DC - Joint meeting of IOM/ASTHO/United Heath Foundation – development of the Strategic Map, four “tracks of work”.

December 2012; Boston, MA - Integration and Infectious Disease Control

April 2013 - Chicago Conference – NACCHO/CDC May 2013,Baltimore – NGA/ASTHO/NAMD Other conferences ?

• Develop a strategy to strengthen and support public health and primary care integration

• Prioritize efforts in the integration of public health- primary care infrastructure

• Identify collaborations and partnerships between primary care and public health to strengthen resources to achieve higher quality of care, lower costs in healthcare, and improved health for populations

Successes Value Proposition /Business Case Measures Resources

Co-leads

Lloyd Michener, Duke University

Sharon Moffatt, ASTHO

Mike Barry & Paul Bonta, ACPM

Michael Fine, SHO-RI

Judith Monroe, CDC David Sundwall, University of UT

Gail Janes, CDC Paul Targonski,

Mayo Clinic

Current Committee Members

Merle Cunningham (NYAM) Jim Galloway (CDC) Heidi Gullett (ACPM) Rachel Hawthorn (ACPM) Jim Hester (CMMI) Fik Isaac (J&J) Casey Korba (AHIP) Barbara Lardy (AHIP) Jeff Levi (TFAH) Liana Lianov (ACPM) Andrea Lowe (ACPM) Bob Moser (SHO-KS) John Snyder (HRSA) Lara Snyder (Duke) Lorine Spencer (CDC) Sharon Stanley (Assoc. of Public Health Nurses) Julie Wood (AAFP) Stephen Woolf (VCU)

Brian Castrucci (de Beaumont) Merle Cunningham (NYAM) Jeff Engel (CSTE) Jan Genevro (AHRQ) Jim Galloway (CDC) Heidi Gullett (ACPM) Ed Hammond (Duke) Seiji Hayashi (HRSA) Willliam Kassler (CMMI) Deborah Porterfield (UNC) Rebecca Roper (AHRQ) Mina Silberberg (Duke)

Marc Babitz (Utah Dept of Health) Christina Cadrecha (Deloitte/CDC) Stephen Cha (CMS) Merle Cunningham (NYAM) Stephanie Harrison (PCA) Jim Hester (CMMI) Steve Holloway (PCO-CO) Bill Kassler (CMMI) Jeff Levi (TFAH) Sarah Linde (HRSA) Michelle Lyn (Duke) Kathleen Nolan (NAMD) Bob Phillips (ABFM) David Rabinowitz (Deloitte/CDC) Lara Snyder (Duke) Paula Staley (CDC)

Natasha Coulouris (HRSA) Merle Cunningham (NYAM) David Dyjack (NACCHO) Malika Fair (AAMC) Jim Galloway (CDC) Carrie Horwitch (ACP) Yumi Jarris (Georgetown) Arthur Kaufman (UNM) Denise Koo (CDC) Jose Montero (SHO-NH) Bob Moser (SHO-KS) Larry Prybil (UKY) Karyl Rattay (SHO-DE) Doug Scutchfield (UKY) Lara Snyder (Duke) Stephen Woolf (VCU) Ted Wymyslo (SHO-OH) Matthew Wynia (AMA)

Progress to Date

• Online story collection form launched in March.

• 86 stories submitted. • Story follow-up and

analysis in progress. • Moving Forward: Story

analysis; continue coordination with Duke/deBeaumont playbook.

• Literature review of sources from IOM Report

• Value Proposition Case Study – Immunizations

• One Pagers on Value of Integration for Primary Care and Value for Public Health

• Identify a family of metrics to capture parameters of integration based on the IOM report.

• Environmental scan of relevant projects

• Created a matrix of key elements

• Created a framework for considering the matrix and are continuing to move forward on that

Successes Value Proposition /Business Case Measures Resources

• Produced a review of resources in IOM report.

• Conducted research on sustainable funding models in the US

• Guidance document on resources assessment and utilization in the field.

Reference: Institute of Medicine. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC. The National Academies Press. 2012

Degrees of Integration

www.astho.org/success

The ASTHO-supported Primary Care and Public Health Collaborative ◦Over 50 partners ◦Over 100 persons

New Workgroups/ Committees to manage (see Dr. Jarris presentation)

New tools

The ASTHO-supported Primary Care and Public Health Collaborative Newsletter

The ASTHO supported Primary Care and Public Health Collaborative

The De Beaumont/ Duke Playbook ◦ Co-creator of the Capturing Successes Tool

(www.astho.org/success) ◦ Multimedia format- including written materials and

video presentations ◦ Partnered in creation and beta-testing

The CDC/ CMS Million Heart Initiative ◦ 9 States and D.C. ◦ ABCs (2013- Blood Pressure- The %of patients 18‐85

years of age who had a diagnosis of hypertension and whose BP was adequately controlled during the measurement year.

Thank you

aterrillion@astho.org