May 8, 2013

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In order to align health care resources with community needs and address population health, local health planning is instrumental. Local health planning can also promote the development of needed services, discourage the adoption of costly and duplicative services, and can help prevent or better manage crisis situations.

While there is growing support for this level of planning, it is important to learn from previous local health planning attempts to improve upon the already-tested models. The Public Health and Health Planning Council has proposed the creation of Regional Health Improvement Collaboratives (RHICs), 11 new entities tasked with health planning on a local basis. During the discussion, three speakers shared their perspectives on the ingredients for successful implementation of RHICs:

Jeff Kraut, Senior Vice President for Strategy, North Shore-LIJ Health System, and Vice Chair, Public Health and Health Planning Council

Karen Lipson, Former Director, Division of Policy, Office of Health Systems Management, New York State Department of Health

Sylvia Pirani, Director, Office of Public Health Practice, New York State Department of Health

Population health is at the heart of local health planning and establishment of RHICs. As Karen Lipson put it, “we need to focus on health planning, and move away from health care planning.” The discussion illuminated how various stakeholders, given the shift to population health, should also expect a shift in roles now that more parties will be risk-taking entities and more are incented to manage the health of populations. This transition to population health, while proven to be valuable, will also be challenging.

Another challenge in the formation of RHICs is determining how to tackle the unique structure of each region, accounting for distinct local characteristics and the need for micro-delivery systems. The speakers recognized the fabricated nature of the regional boundaries, and encouraged local health planning to take place both within and among the appointed regions. In addition to the challenges of interregional collaboration, there are intraregional issues to be worked out. For example, the New York City region is under ongoing debate about how to take into consideration the discrepancies within and among the different, distinct boroughs.

Other key themes that emerged from the discussion included the need for good data to be prepared in a neutral way; the need for leaders to step forward who can be neutral conveners; and the importance of local input involving a range of different stakeholders, including elected officials. With common goals and strategies, the formation of RHICs can lead to a unified approach to improving the population’s health and, ultimately, can yield a much greater impact.

Attendees included a state government official, health care insurers, providers, consumers, researchers, and funders. An important takeaway message for the audience, in the words of Mr. Kraut, was “don’t compete over the health of the population—work together to build up the infrastructure to better serve patients.” In moving forward, local health planning and RHICs will depend on regional collaboration and cooperation, which will, in due course, lead to improvements in our population’s health.

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