WESTERN MICHIGAN

Domain: 
Choosing High Performing Providers

Legend:
KB– Knowledge & Beliefs   M–   Motivation
SE– Self-Efficacy                NS– Normative Support

B.T 1 - CONSUMERS WILL BECOME AWARE OF WHAT HIGH QUALITY CARE MEANS.      

Employer strategies to support consumers

Provider strategies to support consumers

Health Plan strategies to support consumers

Community Leaders and Organizations

DRIVING FORCES:

·  Strong community coalitions

·  Community collaborative on specific health issues

·  Well-developed, multi-tiered public awareness strategies

·  Non-profit & community-based organization “health navigators”

·  Hospital planning & promotional activities

·  United Way Community Needs Assessment & planning

·  Countywide Multi-Purpose Planning Bodies

·  Health Plan information and promotion, including community health coverage programs

·  Large business wellness committees & activities

·  “Great Start” early childhood focus on 0-5 health

·  Chamber of Commerce health committees

·  FQHC Task Forces and focus on chronic disease management among low-income patients.

RESTRAINING FORCES:

·  High levels of managed care tend to limit choice and patient-physician interaction

·  Low level of cultural competence among providers create trust issues with minority populations

·  Weak media coverage, often one-dimensional in low-population areas

·  Competing hospital/provider advertising confuses consumers

·  Low educational attainment levels in many areas

·  Bias & pre-conceived notions about different health modalities, practices

·  Aversion to change, especially among seniors

·  Lowered priority to health in schools

·  Weakened public health departments

·  Uninsured/underinsured don’t perceive they have choices

·   Participate in development of key messages re: definitions, descriptions of high quality (KB)

·   Identify key health risk factors in their company (M)

·   Company leadership partner with their insurance vendors on educating employees re: best quality providers, based on their risk factors &/or health conditions (KB,M, NS)

·   Script employer/employee versions of key messages on quality care philosophy & strategies for regional employers, networks, franchises, affiliates & offer directly or through C of C:  why manage? What is quality? Where to access? (KB, E, NS)

·   Take messages directly to employee work force; face-to-face interactions within employee’s work environment & among peers (KB, M, E, NS)

·   Participate in development of key messages re: definitions, descriptions of high quality (KB)

·   Educate patients/consumers regarding what constitutes evidence-based practice (care processes) for their chronic conditions and age/sex appropriate preventive care (KB, 

·   Distribute to patients print materials and other tools that define quality, e.g., something developed or endorsed regionally. (KB, M)

·   Train and support office staff to provide key messages about what quality is to patients during their visits. (KB, M)

·   Refer patients & consumers to credible, "endorsed" websites that define and describe quality. KB,M)

·   Participate in development of key messages re: definitions, descriptions of high quality (KB)

·   Health plans maximize every touch point they have with the member to educate on what quality is, differences in quality, and discuss health risks and behavioral changes that a member can engage to impact health improvements.(KB, M, E, NS)

·   Health plans partner with external vendors to maximize member touch points as described above – i.e. pharmacies, durable medical equipment suppliers, labs. (KB, M, E, NS)

·   Lower co-pays for going to a certain provider because of quality. (E)

·   Participate in development of key messages re: definitions, descriptions of high quality (KB)

·   Use standardized, consistent info to avoid conflicting & confusing messages. (KB, NS)

·   Enlist Faith-Base Orgs:  deliver tailored messages in sermons, train parish nurses and Sunday School teachers; include in bulletins, other events. (KB, M, NS)

·   Enlist community “influentials” (elected officials, media celebs, Cmty-based org CEOs, employer CEOs, key retail and service business people, prominent community vols.) to help tailor key messages for different audiences & to participate in multi-tiered media/public awareness campaigns. (KB, M, E, NS)

·   Influence commercial media to increase exposure of local  health issues & publish quality information & to sponsor “health series” –stories, etc. (KB, M, NS)

WESTERN MICHIGAN

Domain: 
Choosing High Performing Providers

Legend:
KB– Knowledge & Beliefs   M–   Motivation
SE– Self-Efficacy                NS– Normative Support

B.T 2 - CONSUMERS WILL BECOME AWARE QUALITY DIFFERENCES IN HEALTH CARE.      

Employer strategies to support consumers

Provider strategies to support consumers

Health Plan strategies to support consumers

Community Leaders and Organizations

DRIVING FORCES: 

·          Existing quality improvement research

·          Hospitals publicize QI & QOC recognition

·          Increasing use of Internet to access health information; more quality health websites.

·          More television & radio shows, other media coverage with health & wellness themes.

 RESTRAINING FORCES: 

·          QI/QOC research/reports not readily accessible or comprehensible to average consumer.

·          Poor-light media coverage of health quality issues.

·          Lack of awareness that quality information is available

·          Lack of trust in the quality information that is provided

·          Lack of understanding of the practical application of quality information that is provided

·     Same as B.T. - 1

·     Modify on-site food service menus for healthier choices; include quality information. (KB, M, E, NS)

§      Provide patients with copies of quality of care reports--AFH once public reports become available; other reports (e.g., from the patient's health plan) in the interim; or alternatively, brochures informing patients of the existence of such quality reports and where/how to obtain them. (KB, M, E, NS)

§      When making specialist referrals, provide the patient with a rationale and evidence that the specialist is a high quality provider--reinforcing the notion of what quality is and that all providers don't perform at the same level. (KB, M, NS)

·     Same as B.T.- 1

·     Same as B. T. – 1

·     Research & build upon as appropriate other successful social marketing campaigns in W MI.  (KB, M, E, NS)

·     Ensure that key social marketing principles are embedded in all strategies, as appropriate. (KB, M, E, NS)

WESTERN MICHIGAN

Domain: 
Self-Management

Legend:
KB– Knowledge & Beliefs   M–   Motivation
SE– Self-Efficacy                NS– Normative Support

B.T 1 – CONSUMERS UNDERSTAND THAT BEHAVIORAL CHOICES CAN DETERMINE INDIVIDUAL HEALTH RISKS.      

Employer strategies to support consumers

Provider strategies to support consumers

Health Plan strategies to support consumers

Community Leaders and Organizations

DRIVING FORCES: 

·          Difficult to persuade/motivate people to solve problems they don’t acknowledge exist

·          Long-term behavior change much more difficult to sustain than short-term changes; high recidivism rates for risk behaviors

·          Media advertising heavily promotes some risk behaviors, especially tobacco, alcohol, unhealthy foods, sex.

·          Low-no budgets for public health marketing, particularly at local level.

·          Uniform approach to public health marketing

·          Cultural/ethnic, religious biases & beliefs about personal health practices & management 

RESTRAINING FORCES: 

·          Difficult to persuade/motivate people to solve problems they don’t acknowledge exist

·          Long-term behavior change much more difficult to sustain than short-term changes; high recidivism rates for risk behaviors

·          Media advertising heavily promotes some risk behaviors, especially tobacco, alcohol, unhealthy foods, sex.

·          Low-no budgets for public health marketing, particularly at local level.

·          Uniform approach to public health marketing

·          Cultural/ethnic, religious biases & beliefs about personal health practices & management 

·     Participate in development of key messages re: behavioral choices (KB, M)

·     Take messages directly to employee work force; face-to-face interactions within employee’s work environment & among peers. (KB, M, NS)

·     Modify on-site food service menus for healthier choices; include quality information. (E,NS)

·     Recognize individual employees who have improved their health; publicize their success stories. (M, E, NS)

·      Participate in development of key messages re: behavioral choices (KB, M)

·      Physicians and staff convey key messages to consumers/patients throughout the course of their visits and interactions. (KB, M, E, NS

·      Provide relevant, appropriate self-management education and tools to patients to help them manage their chronic conditions. (KB, M, E, NS)

·      Provide information about programs and services patients should look into--offered by health systems, health plans, community-based organizations, etc. (M, E, NS)

·     Participate in development of key messages re: behavioral choices (KB, M)

·     As Domain: Choosing Providers--Frequent, consistent messaging to the members & maximize touch points.(KB, M, NS)

·     Design benefit plans with incentives to motivate patient education & behavior changes, using lower co-pays, premium credits (M, E, NS)

·     Design coordinated benefit plans to increase  interactions with the member and promote coordinated education/care before coverage of selected services (M, E, NS)

·     Require the member to contact the health plan to receive coverage for certain services. (M, NS)

·  Participate in development of key messages re: behavioral choices (KB, M)

· Same as Domain:  Choosing Providers, plus…

· Ensure topical relevance to the specific audiences or populations being targeted; identify key risk factors & communicate around these. (KB, M, E, NS)

· Employ culturally & linguistically appropriate messages for resonance (M, NS)

· Use locally recognized, credible personalities & venues in promotions. (M, E, NS)

· Use culturally, linguistically and regionally appropriate delivery vehicles (NS)

· Lobby for reduced local advertising of unhealthy foods, lifestyles.  (NS)

· Engage Pre-12 educators: strengthen health curricula & priority on Phys. Ed.; standardize healthy choices for lunch & vending machines. (KB, M, E, NS)

·  Increase public health budgets for health promotions. (KB, M, E, NS)