Providence St. Peter Hospital - CHOICE Regional Health Network

Overview

CHOICE Regional Health Network is a nonprofit collaborative of membership organizations dedicated to improving community health in Central Western Washington through collective action and planning of health care leaders. CHOICE was founded in 1995 by health care leaders from throughout a five-county region interested in working collaboratively to improve health care in Thurston, Grays Harbor, Lewis, Mason, and Pacific counties. Shortly thereafter, CHOICE began helping low-income clients access health and other social services in an effort to increase access to care for the region’s most vulnerable populations. More recently, CHOICE began operating client programs with specific health emphases that fill critical gaps in care for low-income individuals and families, such as the Access to Baby and Child Dentistry program, the Mental Health Access Program, and Thurston County Project Access (donated care services).

CHOICE also has a number of capacity-building initiatives that focus on health delivery and quality improvement projects in the region. The organization has partnered for years with the region’s medical providers, local governments, and a large number of social service agencies and community organizations on a wide range of community health improvement initiatives. Most notably, CHOICE operates the Emergency Department Consistent Care Program (Consistent Care), which effectively reduces inappropriate emergency department (ED) utilization, and the CHOICE-led Emergency Cardiac and Stroke Initiative, which successfully standardized treatment protocols in a five-county region.

Impact

Through the years, CHOICE client services have helped thousands of individuals and families access health care and other social services. Last year, CHOICE served more than 4,000 clients by providing health coverage, access to health care services, and connection to other social services. CHOICE’s specialty medical and mental health programs served more than 1,000 of those individuals, and obtained $6.8 million in donated care. For every dollar invested in those programs, $37 of care was delivered to the most vulnerable individuals in our region.

On average, 400 frequent ED users a year have had care plans developed by a multidisciplinary team through CHOICE’s Consistent Care. A 2010 evaluation of the program determined an average reduction in ED visits by 50 percent. A more recent evaluation showed similar results. The program is now operating in every county in the CHOICE service region. Consistent Care was a 2011 American Hospital Association NOVA Award winner.

Challenges/success factors

In addition to the programs highlighted above, CHOICE successes include development work that contributed markedly to the creation of a federally qualified health center and new medical, dental, and mental health donated services programs. CHOICE has brought millions of dollars into the area for region-wide and local health initiatives in all five counties.

A challenge at this moment for CHOICE and other health care organizations in our region is long-term planning. The implementation of health care reform is exciting, yet the specific impacts on our programs are difficult to predict. While we are certain there will be major changes in insurance status for many of the low-income individuals we serve, how these changes will impact the regional system of care and alter the landscape of our direct client services programs remains to be seen.

Future direction/sustainability

CHOICE is continuing to expand Consistent Care, which is now operating at eight hospitals in the region. Also, a regional effort is underway that focuses on implementing consistent best practices to improve care transitions of patients between health care settings. CHOICE has also been approached by the Washington State Department of Health and is now assisting with the implementation of a primary care medical home initiative in our region. We anticipate that our direct client services programs will continue to operate, while at the same time, we will facilitate the transition of low-income individuals and families from charity programs into health coverage through the State’s Health Benefit Exchange.

CHOICE’s annual operating budget is between $1 million and $1.5 million. Core funding for CHOICE operations comes from member organizations. Members pay dues based on their net operating expenses, which makes the support equally weighted among all member organizations. Program initiatives and projects are funded through grants and private donations as well as fee-for-service contracts.

Advice to others

Taking the following steps will contribute to the program’s success:

• Focus on honest communication about how to combine community health with shared organizational value.
• Provide a neutral, safe forum for difficult community conversations about collective planning and action.
• Estimate the return on investment for sponsors when soliciting funds, and work to track actual return using agreed metrics.
• In most communities, hospitals are the entity with the needed influence to rally key community leaders around the development of a collaborative network similar to CHOICE. Hospitals should be co-owners of the effort and should contribute CEO-level leadership on the network board.

Contact: Winfried Danke
Executive Director
CHOICE Regional Health Network
Telephone: 360-493-4550
E-mail: dankew@crhn.org