March 10, 2022
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CENTRAL HEALTH EQUITY-FOCUSED SERVICE DELIVERY STRATEGIC PLANNING: VOICE OF THE COMMUNITY SUMMARY
SAFETY-NET COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
CENTRAL HEALTH BOARD APPROVES NEW PLAN TO TACKLE HEALTH CARE INEQUITIES
As the hospital district serving Travis County, Texas, Central Health creates access to care, and coordinates health care services, so residents with low income have the opportunity to get well and stay healthy. Central Health’s mission is to improve the health of the community by caring for those who need it most. To better fulfill this mission, in 2020 the Central Health board of managers adopted a strategic priority to improve access to care by building an equity-focused, comprehensive, high-functioning and affordable system of care.
The Episcopal Health Foundation provided Central Health $600,000 in June 2021 to support Phase I of this work. This funding allowed Central Health to hire a consultant, Guidehouse, Inc., to help develop an Equity-focused Service Delivery Strategic Plan (the Plan). The Plan is based upon three assessments: A community health needs assessment (CHNA) focusing on the needs of the Travis County population with annual household incomes less than 200% FPIL ($27,180 for an individual or $55,500 for a family of four); an extensive Voice of the Community in-person and virtual engagement involving patients, patient-serving advocacy groups and Central Health partners; and an analysis of the safety-net health care system’s capacity and gaps. The Plan was initially presented to the Central Health board of managers Feb. 9 and formally adopted Feb. 23.
The value of this work in improving the Travis County safety-net health care system cannot be overemphasized. Prior to this engagement, a health needs assessment focused specifically on Travis County’s low-income populations had never been conducted. Building on Central Health’s prior biennial demographic reports and gathering and analyzing a multitude of public and proprietary datasets, Central Health now has a better understanding of the disparities faced by its patient population including barriers to accessing care and managing chronic health conditions. A diverse group of community members actively participated in the development of the Plan, providing valuable insight into the challenges of navigating the safety-net health care system and opportunities for long-term improvements. This public engagement has strengthened the partnership between Central Health and the community members it serves, and builds public buy-in as Central Health works to implement the Plan’s strategies in the coming years. Finally, Central Health was able to utilize the experience and expertise of its consultancy team to create system benchmarks to assess how the organization compares to the other large urban hospital districts in Texas. The knowledge gained in this benchmarking exercise—in addition to a clinical gap analysis of eight key service categories, which identified areas of moderate to significant gaps such as provider shortages—was critical to developing the plan as well as implementing and measuring the success of Central Health’s efforts.
Central Health’s Equity-focused Service Delivery Strategic Plan is founded upon a goal and four strategic imperatives:
- Access and capacity – increasing the number of providers and care teams;
- Care coordination – optimizing how patients transition between care settings (e.g. hospital to home);
- Member engagement – enhancing engagement for Central Health Medical Access Program (MAP) enrollees and expanding enrollment in high-need regions; and
- System of care – joint service-delivery planning and timely sharing of health care data.
By addressing these imperatives, Central Health will achieve its service delivery strategic goal to develop an equitable system of care that is comprehensive and accountable, while maximizing the collective use of capabilities and resources to serve Travis County’s safety-net population. Each imperative has enabling and supporting goals and objectives to measure progress and support accountability. Further, these goals and objectives will serve as the means by which the organization measures its success over the next five to seven years in achieving its mission.
Next steps for Central Health include informing community members and stakeholders of the results of the Plan and launching a subsequent operational implementation and financial sustainability planning process. This work will include developing immediate recommendations regarding Fiscal Year 2023 proposed service delivery budget priorities as well as longer term recommendations on how Central Health can achieve the board’s adopted vision, to ensure this new model of care succeeds. Central Health will seek a qualified consultant to assist the next phase of planning, with a targeted completion date of March 2023.