APPROACH AND METHODOLOGY
PACT is committed to:
1. Creating the 'tool kit' necessary to provide training and technical assistance to healthcare delivery systems wanting to integrate CHWs into their primary care teams. This packet includes CHW training syllabi, interventions guides for CHW delivery of health promotion services to patients, patient workbooks, management training syllabi, operations manuals, HIT systems for data collection and continued quality improvement monitoring, and monitoring and evaluation guidelines. The finalized tool kit, along with PACT's training and technical assistance services, will be marketed to community health centers across the country via online communities, as well as through the Agency for Healthcare Research and Quality, Health Resources and Services Administration, and Centers for Health Care Strategies. These connections will lead to the broad implementation of PACT's model and the hiring of more CHWs nation-wide.
2. Finding partnerships in healthcare delivery systems to pilot and scale the model over the next 3 years. Together with the impact of training and technical assistance services, PACT's goal is to create 25 permanent CHW jobs and 5 support management staff jobs in the next 3 years.
3. Leveraging PIH's reputation as well as connections at Harvard Medical School, Harvard School of Public Health, Harvard Business School, and health delivery and policy and research experts in Massachusetts to make a case for cross-disciplinary and rigorous evaluations and analyses of the pilot. Dissemination of PACT's pilot results will serve to advocate for health care finance reform that will enable integration of CHWs into accountable care organizations.
IMPLEMENTATION, TIMELINE, AND DELIVERABLES
1. PACT will finalize a draft of the above tool kit in November - December 2011.
2. PACT will identify and partner with a Community Health Center as a demonstration site, implement its care model in which CHWs are integrated into the clinic-based primary care team and demonstrate the acceptability, feasibility and efficacy of this model of care. The demonstration and evaluation will take place January 2012 - December 2014.
3. PACT's PR campaign will begin January 2012 and will be ongoing. This will include dissemination of the results of the demo to make the case for health care finance reform geared toward the integration of CHWs into Accountable Care Organizations.
The health care industry in the United States is an unsustainable $2.5 trillion annual business accounting for $1 out of every $6 spent in America. According to the Centers for Medicare and Medicaid Services, health care costs will continue to rise faster than inflation, and by 2016 spending on health care will total over $4 trillion, representing $1 out of every $5 spent in the economy. Despite this cost, health outcomes for poor, marginalized and chronically ill patients are not improving. A disruptive intervention is in order. It needs to be patient-centered, community-based, holistic, and preventative. It needs to create jobs and lower cost to the healthcare system while improving health outcomes. PACT's CHW intervention will do all of these things.
PACT currently provides direct service to Boston's sickest HIV/AIDS patients by employing CHWs to perform health promotion and directly observed therapy in the patients' homes. PACT's direct service program has been extremely successful in improving health outcomes while decreasing Medicaid expenditures by better connecting its patients to their PCPs, improving adherence to ART regimens and cutting down on its patients' needs to visit the ER. PACT believes that CHWs are the key to managing chronic illness in complex populations. This is why PACT is moving toward integrating CHWs into the CHC clinic-based model, rather than CHWs being an add-on or wrap-around service.
SEEKING: Financial Resources, Implementing Partners, Media/Marketing Opportunities
1. PACT is seeking funding sources for capacity building in iplementing the demonstration site.
2. Areas in which PACT is still seeking implementing partners include population stratification and tiering and the automation of risk assessment.
3. PACT is interested in a partner to aid in building a media movement toward change in the way we deliver healthcare domestically.
OFFERING: Funding, sharing best practice information, publicity
1. PACT can offer a partnering Community Health Center the Training and Technical Assistance necessary to integrate CHWs into the clinic-based primary care team.
2. For the last 15 years, PACT has been evaluating and refining its CHW model, creating evaluation tools, training materials, patient workbooks, and curriculum for trainers, managers, supervisors and CHWs. PACT has published papers on Health Promotion and Directly Observed Therapy--two strategies demonstrated to help vulnerable patients reengage with the healthcare system and improve adherence to medications. Thus PACT's best practice information would be a valuable offering.