By Mike Sherry
KHI News
KANSAS CITY, Mo. — Leaders of an initiative aimed at coordinating and expanding healthcare services for the region’s poor need to sharpen its focus and do a better job measuring results, according to a review by an outside consultant.
The Regional Health Care Initiative, operates through the Mid-America Regional Council. Major funding has come through the REACH Healthcare Foundation in Merriam and the Health Care Foundation of Greater Kansas City in Kansas City, Mo.
The two foundations launched the initiative in 2007 and hired Health Management Associates of Lansing, Mich. to evaluate its progress.
Officials released the results of the review at a meeting here Monday. About 30 people were present including safety net officials that had been interviewed as part of the review.
‘Some successes, some missed opportunities’
“This is a story of some successes and some missed opportunities,” said Bill Moore, vice president of program, policy and evaluation for REACH.
The consultant tallied nearly $8 million in funding for the initiative since its start, including some from outside the foundations. The outside dollars were for a program intended to increase evening and weekend access to clinics that serve low-income patients and those without health insurance.
According to the report, the initiative “lacks a unifying strategic plan.”
Consultants told the group that members of various committees were unclear how their work fit within the initiative’s overall direction.
Their report suggested a plan be made to choose priorities based on anticipated results.
The consultants also found:
Results “have not been sufficiently measured or documented.”
Materials produced by the various committees of the initiative have had “varying levels of impact” within the community.
Differences in state policy and funding in Kansas and Missouri hindered cross-border coordination.
Moore said he considered the lack of outcomes data one of the biggest missed opportunities of the initiative. He said that finding highlighted the importance of evaluating all the programs the foundations fund.
Gaylee Morgan, a principal with the consulting firm, 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.
Evaluating an effort like the Regional Health Care Initiative is somewhat difficult, said Scott Lakin, the initiative’s director.
For example, he said, it would be hard to quantify how many people did not get sick thanks to 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.”
More hours at clinics
Among the successes noted by safety-net officials and included in the report:
• There were more weekend and evening hours at the clinics.
• A curriculum was established for training community health workers, specialists that help safety-net patients navigate the healthcare system
• There was enhanced training for dental assistants to expand access to oral health services
Participants in the initiative also noted that bringing together administrators from various organizations involved in it had established a rapport that did not exist before, 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.
Jagger said the initiative also apparently had forged some 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,” she said.