Striving Toward a Culture of Health: How Do Non-Medical Needs Factor into Alternative Payment Models? Topic Profile: Data and Population Metrics AcademyHealth and the Network for Regional Healthcare Improvement hosted a two-day workshop, “Striving Toward a Culture of Health: How Do Non-Medical Needs Factor into Alternative Payment Models?”, which convened five multi-sector teams, comprised of health care sector and non-health care sector partners, and led by regional health improvement collaboratives. The workshop provided information from content experts and fostered shared learning across communities to inform next steps in their own specific community-based collaborative projects. The workshop focused on four key topic areas and the related barriers that potentially influence the conditions and collaborations necessary to support non-clinical community-wide population health services. This profile highlights one of these topic areas, the issue of data and Emerging Issues population metrics related to measuring non-clinical interventions, Workshop participants discussed what to consider when addressing along with the barriers and lessons learned from the workshop. the data and population metrics needed by organizations seeking to support improvements in population health. Recognizing the importance of data in their collaborative efforts, health care systems and community social service organizations cited an interest in un- derstanding best practices for establishing, governing, and evaluating successful data sharing partnerships across sectors. In particular, the central issues in this area raised by meeting participants included: • How should health systems and community social service providers begin the process of collecting, sharing, and analyz- ing data? • What are the key components of a successful data sharing partnership? • What entity is the most suitable to receive, analyze, house and report out data/information? Community First, Hilo, Hawaii • What problems are communities trying to solve using the data? Greater Detroit Area Health Council, Detroit, MI Health Care Improvement Foundation, Philadelphia, PA • When should organizations “build versus buy” their own tools The Health Collaborative, Cincinnati, OH and platforms for data integration? Washington Health Alliance, Seattle, WA Genesis of this Brief: With support from the Robert Wood Johnson Foundation, AcademyHealth’s Payment Reform for Population Health (P4PH) initiative aims to develop a comprehensive understanding of current efforts and successes related to payment reform activities that support community-wide (i.e., geopolitically-based) population health improvement. To inform this effort, AcademyHealth collaborated with the Network for Support for this program was provided by the Robert Regional Healthcare Improvement (NRHI) to explore challenges and barriers related Wood Johnson Foundation. The views expressed here to how health care purchasers, plans, and providers could support strategies for do not necessarily reflect the views of the Foundation. sustainable investment in non-clinical community-wide population health activities. Topic Profile: Data and Population Metrics Key Barriers Identified • Data Measures Lessons Learned – Data collection and analysis efforts within the health care • Ground efforts to collect and use data within a shared system often focus solely on measures of cost and utilization understanding across partners of what fundamental goals all rather than social determinants of health, making it are trying to achieve and why. difficult to identify population needs and measure progress. Clinical-community collaborations need to supplement • Use available data as an acceptable starting point in order to administrative and clinical data with non-clinical data to set the stage for larger-scale projects (e.g., if you have claims better understand population health. data, start with that; if you have clinical data, start with that). • Data Sharing • Stay pragmatic and realistic when establishing expectations Health systems and their community-based partners often: between partners. – Hesitate to share data across sectors due to lack of trust, • Identify the most effective data platform for collective use that which limits collaboration opportunities; includes key elements such as identity management between – Lack common data definitions for specific measures; and partners, a shared set of data definitions, and a user-friendly – Face technical interoperability as well as legal/privacy challenges interface. when attempting to integrate data sets such as electronic health records and claims data which collectively limits the ability to • Establish a governance process for data collection, sharing, and share, integrate, and analyze data for a common purpose. analysis between partners. • Data Infrastructure • Identify a target population that lends to short-term results (i.e., Health systems and their community-based partners often: low-hanging fruit) in order to build momentum. – Lack the financial resources necessary to make investments in the health information technology and workforce needed to build and maintain collaborative data efforts; These five regions will use the information, along with additional – Are resistant to being the primary investor in these efforts briefs on other topics discussed, and work collaboratively within and assume a majority of the costs; and their communities to apply them to their individual situations. – Lack knowledge regarding the selection of adequate data sharing platforms to support collaborative efforts. To learn more about these projects, visit www.academyhealth.org/p4ph About RWJF About AcademyHealth About NRHI For more than 40 years the Robert Wood AcademyHealth is a leading national The Network for Regional Healthcare Johnson Foundation has worked to organization serving the fields of health Improvement is a national organization improve health and health care. We are services and policy research and the representing regional multi-stakeholder working with others to build a national professionals who produce and use this groups working towards achieving better Culture of Health enabling everyone in important work. Together with its mem- health, better care, and reduced costs America to live longer, healthier lives. bers, AcademyHealth offers programs and through continuous improvement. NRHI For more information, visit www.rwjf.org. services that support the development and all of its members are non-profit Follow the Foundation on Twitter at and use of rigorous, relevant, and timely organizations, separate from state govern- www.rwjf.org/twitter or on Facebook at evidence to increase the quality, acces- ment, working directly with physicians, www.rwjf.org/facebook. sibility, and value of health care, to reduce hospitals, employers, health plans, and disparities, and to improve health. patients using data to improve health care. 2 | April 2017