T.R. Reid

Group Health continues to capture the national spotlight for its innovations in health care. The most recent occurrence was last week, when a Public Broadcasting Service (PBS) crew spent time filming at Group Health for a documentary about America’s best-kept health care secrets.

The documentary crew was led by T.R. Reid, well-known health care reform author and filmmaker. On one day, he spent sunrise to sunset at Factoria Medical Center, the pilot site of our medical home model. Reid and the crew shadowed clinicians, staff, and patients throughout the day to show how Group Health is providing quality care while keeping costs down.

Reid spent another day talking with Rosemary Daszkiewicz, chair of the Group Health Board of Trustees, about what it means to be a cooperative, and rounded out the visit by interviewing Michael Soman, MD, chief medical executive. Reid and Dr. Soman talked about the need to align financial incentives with quality, and the importance of managing a system of care.

Reid is one of the nation’s best-known correspondents for his coverage of global affairs for The Washington Post, his books and documentary films, and his commentaries on National Public Radio. His recent book, The Healing of America, came out in 2009 and became a national bestseller. PBS Frontline produced two documentary films, Sick Around the World and Sick Around America, which followed Reid as he reported on that book.

The documentary is still in development and there is no set date for when it will debut.

“We know that part of the answer lies in doctors working together to create a system that is accountable for the health of each patient as he or she moves through the continuum of care — prevention, diagnosis, treatment, recovery and prevention again,” Group Health President and CEO Scott Armstrong said. “Within Group Health we have demonstrated that integrated care can provide distinctly better results. This is an exciting opportunity to extend participation in this more holistic approach to providers across the state.”

Bringing providers together, sharing responsibility for cost and quality, is called an “Accountable Care Organization” (ACO) in new state legislation and federal health care reform.

“When I sponsored Senate Bill 6522, my goal was to expand the concept of accountable care organizations by developing a functional accountable care model in those communities that cannot support the traditional integrated delivery network,” said Cheryl Pflug, State Senator, 5th District. “I’m excited to see the selection of Group Health as the lead organization. This next step will build upon their recent success with enhancing the coordinating role of the primary care provider. I look forward to substantial progress toward an efficient health system that is far more satisfying for patients and providers,” Pflug said

The pilots must be developed by January 2012 without using state funding. Group Health may seek federal funds and solicit grants, donations, and other sources of funding. The Group Health Research Institute (GHRI) and Douglas A. Conrad, University of Washington (UW) professor of Health Services and co-director of UW’s Center for Health Management Research, will help evaluate the pilot projects.

Scott Armstrong, Group Health President and CEO

This morning we woke up to the news that Scott Armstrong, Group Health’s President and CEO, was named #38 in Modern Health Care’s 100 Most Powerful People in Healthcare. The list was topped with President Barack Obama in first place and followed by Secretary of Health and Human Services, Kathleen Sebeliusl; and Speaker of the House, Nancy Pelosi.

The magazine featured a great interview with Scott as he talked about Group Health being in the national spotlight and recognized for its innovative work to bring down costs of health care and providing quality care.

Excerpt from the article:
“Managing all the changes coming fast and furious from Washington is top of mind for those who made it onto this year’s 100 Most Powerful list.

Scott Armstrong, president and CEO of Group Health Cooperative in Seattle, debuted at No. 38. Group Health was in the national spotlight last year as Congress pondered whether to replicate the health cooperative model in other states through the healthcare reform bill. The idea of setting up co-ops across the country to compete for health insurance business did not ultimately gain traction, but Group Health earned new admirers for its ability to improve quality while reining in costs.

“The question is how we implement it and make this real,” says Armstrong, who was also recently appointed as a commissioner to the Medicare Payment Advisory Commission. “I run a company that is demonstrating how to make this possible.”

Limeade

Group Health also joined the Limeade Alliance Member program, to help pilot Limeade with a select group of employers that purchase Group Health coverage in the coming year. The Limeade service integrates existing Group Health services such as health screenings, health coaching, and ongoing reporting and consulting services.

“To continue innovating to improve our members’ health and better serve the community actually starts with our staff and their families. We need to walk the talk,” said Lin MacMaster, Group Health’s VP of marketing.

“The future of health care isn’t just about insurance, doctors, hospitals and medications,” MacMaster added. “It’s about making real connections and tapping human potential – really giving individuals control to make smart decisions and live their best, healthiest life possible. Limeade gets that, and we saw them as a refreshing alternative to some other, more traditional offerings we’ve been researching.”

Group Health is using interactive, innovative technologies such as Limeade’s to help create better health for its members, and to create more financially sustainable health care models for its employer customers.

The Limeade wellness service is known for its positive, social, whole-person approach. Limeade CEO Henry Albrecht noted: “We’re thrilled to welcome Group Health as an employer customer and a Limeade Alliance Member. Group Health continually asks, ‘How can we best improve employee health, well-being and performance?’ We’re humbled and honored to be part of the answer.”

The exhibit guests will be encouraged to get their game on in the Fitness Play Zone, dodge flying particles at the Sneeze Wall, glimpse their future self with the interactive aging software and climb musical stairs to a second floor of discovery.

This is the Science Center’s first new permanent exhibit in more than a decade. It will address individual and community health and well-being at a time when preventable conditions such as obesity, and chronic diseases like Type II diabetes are on the rise and access to health care is a growing concern.

“Since 1947, Group Health has focused on helping to improve the health of our patients and of the communities we serve,” said Group Health President & CEO Scott Armstrong. “Helping the Science Center bring Professor Wellbody’s Health & Wellness Academy to life is a natural extension of our mission to help people in their journey to lead the healthiest, best life possible.”

Group Health was the first to provide a leadership gift, followed by a $1 million challenge grant from the Bill and Melinda Gates Foundation.

Rosemary Daszkiewicz, JD, Group Health Board Chair

Trustees from Group Health’s  Board elected Rosemary Daszkiewicz,to serve as chair of the Group Health for the remainder of 2010.The former chair of the Cooperative, Bobbie Berkowitz RN, PhD, resigned this month to pursue a new job as head of the Columbia University School of Nursing.

Daszkiewicz, who manages legal and human resources as the senior director of Plum Creek Timber Co., originally joined the Board in 2003.

The Group Health Board of Trustees – made up of 11 active Group Health members, also elected Dorothy Ruzicki, PhD, RN, of Mead, Wash., to fill the vacant trustee position through the end of 2010. Porsche Everson, current board member in Seattle, was also named vice chair, the previous position held by Daszkiewicz.

For more information on the 2010 Group Health Board of Trustees candidates, go to www.ghc.org and search for “2010 Annual Membership Meeting.”

Everyone’s invited to come meet Seattle Sounders FC starter Brad Evans this Saturday, June 19 from 11 a.m. to 12:30 p.m. at Group Health’s Bellevue Medical Center, 11511 NE 10th Street, Bellevue, WA 98004.

Bring your family and friends–and your Sounders or soccer gear for autographs.

Group Health is a presenting sponsor of Sounders FC Summer Youth Camps to promote soccer and a healthy, active lifestyle to kids all over Washington State. For more information about the camps, visit: http://www.soundersfc.com/Youth/Youth-Programs.aspx

Seattle Children’s, UW, and Group Health study 8,000 King County children

Children in King County, Washington, are more likely to be obese if they live in socially disadvantaged neighborhoods. This is according to a team of researchers at Seattle Children’s Research Institute, the University of Washington (UW), and Group Health Research Institute. Social Science & Medicine e-published the research this week in advance of printing it.

The researchers found obesity most common in children living in neighborhoods with the least-educated females, most single-parent households, lowest median household income, highest proportion of non-white residents, and fewest homes owned. Together, these five socioeconomic factors accounted for 24 percent of the variability in childhood obesity rates across neighborhoods.

“What we found confirms that it takes a village to raise a child,” said lead author H. Mollie Greves Grow, MD MPH, an assistant professor of pediatrics at the UW, Seattle Children’s, and Harborview Medical Center. “Children are raised not only at home but also in their community.” Disadvantaged neighborhoods may present many obstacles for children’s weight, such as less access to healthy foods and more unhealthy fast-food outlets. They also often lack safe places for children to play outdoors.

Paula Lozano, MD, MPH, Co-author

“Childhood obesity is not just a family problem, but a larger community and societal problem,” Dr. Grow added. “A disadvantaged environment can set families up for ill health, and it’s unfair to blame them for not taking enough ‘personal responsibility’ to manage their weight. We don’t yet know all of the factors that may create disadvantage, but we know it is present and associated with higher obesity.”

The research team collected anonymous, “de-identified” electronic medical record information on 8,616 children age 6–18 receiving care at Group Health Cooperative—and then correlated these data to the social and economic characteristics of Seattle-area census tracts.

This study of childhood obesity helped overcome the limitations of previous studies by using weight measurements pulled from medical records, not self-reported by study subjects. Self-reporting is often less accurate. This was the first study evaluating childhood obesity to use rigorous statistical methods of spatial modeling to smooth out differences based on arbitrary census tract lines. Using this technique helped provide a more accurate effect of neighborhoods on children’s weight.

“We were a little surprised that each of the census tract factors we included appeared to contribute, in a slightly different way, to the likelihood of childhood obesity,” Dr. Grow said. The likelihood of childhood obesity rose by 17 percent to 24 percent for each of three measures of neighborhood social disadvantage: each 10 percent decrease in female education and two-parent households, and each $10,000 decline in household income. Effects related to race and homeownership were smaller but still statistically significant.

Brian E. Saelens, PhD, Co-author

Overall, King County’s demographics resemble those of other urban U.S. areas. “But King County has one of the strongest public health efforts, a relatively walkable environment, and efforts to expand affordable access to healthy, fresh foods,” said Dr. Grow. So she and her colleagues expect the links between childhood obesity and neighborhood disadvantage may be even more pronounced elsewhere.

Dr. Grow and her coauthors are not only continuing to study how neighborhoods with low socioeconomic status raise the risk of childhood obesity. They are also contributing to solutions by leading programs to help overweight youth and their families:

• Dr. Grow helps lead ACT! (Actively Changing Together!), a YMCA of Greater Seattle program helping children and families increase physical activity and eat nutritiously. (ACT! was previously called Strong Kids Strong Teens.)
• Coauthor Paula Lozano, MD, MPH, an associate investigator at Group Health Research Institute and associate professor of pediatrics at the UW and Seattle Children’s, runs Group Health’s Family Wellness Program.
• Another coauthor, Brian E. Saelens, PhD, of the UW and Seattle Children’s, leads COMPASS, a study of a yearlong program at Seattle Children’s to help local families lose weight.

“I have seen some resilient families beat the odds by boosting their children’s health despite their environment, and I hope to help other families do the same,” Dr. Grow said. “Still, even more health gains would come from narrowing the inequality gaps that have been widening between rich and poor in this country. We should strive for all families to have access to walkable neighborhoods, safe parks, healthy grocery store options, and active schools. Tax dollars, voters, community planners, builders, and green spaces can all help make an impact.”

Drs. Grow, Lozano, and Saelens’s co-authors were Group Health Research Institute’s David E. Arterburn, MD, MPH, and Andrea J. Cook, PhD; and the UW’s Adam Drewnowski, PhD. This research started as a joint project between the UW Exploratory Center for Obesity Research (ECOR) and Group Health that was funded by a pilot grant from Dr. Drewnowski’s National Institutes of Health (NIH) Roadmap Initiative project. ECOR is part of the UW’s Center for Public Health Nutrition. The Health Resources and Services Administration (HRSA) also provided funding.

These latest findings build on research that Dr. Drewnowski’s group has conducted on so-called “fat ZIP codes.” For instance, in May 2010, he and a team of UW researchers released a study on economic access to healthy, affordable foods. The study revealed obesity rates by supermarket chain in King County and tracked where consumers go to buy groceries.

Sunset as doctors return to the clinic

Group Health has developed a long-term volunteer program that will send clinicians to provide medical care in Haiti throughout the rest of 2010. Led by a different doctor each trip, Group Health’s goal is to sponsor two one-week trips per month. Volunteers include physicians, physician assistants, nurses and nurse practitioners, and lab and pharmacy personnel.

Don Van Nimwegen, MD, a retired Group Health anesthesiologist, will lead the pilot trip to Haiti leaving on June 12. Working with Healing the Children, the experienced medical relief doctor already spent three weeks in Haiti looking for ways to assist the devastated nation. He found a starting place—a tent encampment near Port-au-Prince.

Dr. Nimwegen told us, “Our main goal is to provide daily clinics for the 15,000 people who live in this encampment. Then we want to work with local doctors to put together a medical infrastructure, to build something that will make a long-term difference to the people of Haiti.”

That vision includes establishing a pharmacy system, setting up medical records, and eventually being able to address the country’s chronic diseases, such as diabetes, HIV/AIDS, and heart disease.

Supplies

In addition to providing daily care for the tent encampment, future plans include recurring visits to a teaching hospital in Cap-Haitien to instruct local practitioners in various medical procedures. Small teams of clinicians from a variety of disciplines will visit every four to six months, depending on the needs of the hospital.

The HEI is an annual survey administered by the Human Rights Campaign (HRC) Foundation. It gathers voluntary information from hospitals and health care facilities around the country, focusing on key policies and practices to protect lesbian, gay, bisexual, and transgender patients and families. These policies include patient non-discrimination, visitation, and cultural competency training for staff.

Central Hospital was one of just a handful of health care facilities nationwide to be named a top performer. Of the 178 hospitals and clinics that voluntarily provided information on patient non-discrimination, visitation, and cultural competency training for staff, only 11 independent facilities and one network of 36 hospitals—Kaiser Permanente—ensure full protections for LGBT Americans.

“Group Health has a long history of providing non-discrimination protections in employment and health care benefits for domestic partners and families of LGBT staff,” said Chief of Medical Staff Desiray Bailey, MD. “Incorporating cultural competence around LGBT members into our practices enhances the quality of care our patients receive, positions us well for growth, and delivers on the Group Health promise of integrated, compassionate care.”

“The survey helped us see that our visitation policies needed to be revised,” said Hospital Administrator Erin Leff, MBA. “The policies now have a definition of family that includes spouses, domestic partners, and both different-sex and same-sex significant others, and the concept of parenthood is liberally construed without limitation for the purpose of visitation rights.”

“Health care that is free of prejudice is a fundamental human value, and a fundamental American value,” said President of the HRC Foundation Joe Solmonese. “Everyone has heard the horror stories of loved ones torn apart, already heart-wrenching decisions made even harder, and basic human rights denied. We commend Group Health for its leadership and its commitment to ensuring health care equality for LGBT Americans.”

The HEI 2010 follows President Obama’s memorandum in April directing Health and Human Services (HHS) to make rules that require all hospitals that receive federal Medicare and Medicaid funding—nearly every hospital in America—to protect the visitation and health care decision-making rights of LGBT people. It also comes as the Joint Commission, which accredits and certifies health care facilities, has announced new, fully inclusive patient non-discrimination standards as part of their accreditation process.

For more information on the Healthcare Equality Index 2010, or to download a free copy of the report, visit Healthcare Equality Index.