1. Silos to Circles A New Continuum Conversation How Do We Go From Here……To Here? Silos Acute/ Ambulatory Public Health Home and Community Based Services Long-Term Care + ++ +++

3. © 1996-2009 Brokenness to wholeness Statement for invitation: We will work collaboratively on shared priorities that will foster wholeness for our currently fragmented continuum. Our opportunity is to collectively promote health at all life stages with services that are integrated, culturally appropriate, equitable, sustainable and that honor our shared humanity. Core Group Vision for invitation – drafted 1.5.2015 Silos to Circles Promote health with upstream stability Capacity for our shared humanity Measuring health and well-being at all life stages Collaborative, integrated, respectful and culturally appropriate New map of health Brokenness to wholeness to thriving to living to being Fragments to continuum Household Person Centered Thinking Value health as people define health Sustainable reward for those providing care Prioritizes and supports preventive practices Consider social determinants, transportation, food, education and impact on 1 or others Daily living needs are met Economic stressors Defining measurable outcomes Maximizing life at all life stages Well-being is redefined and central to work (measurement too) Healthy body, mind, soul Treated with respect Community that is collective, active, and sustainable Collaborative, holistic solutions Integrated, culturally meaningful system of wellness Seamless network that makes a continuum New map of health care Working together on important priorities Choose areas with greatest opportunity to create something new

4. 4 Cause And Effect: Where to Channel Our Efforts to Realize Our Vision Cause And Effect: Where to Channel Our Efforts to Realize Our Vision Promote health at all life stages with services that are integrated, culturally appropriate, equitable, sustainable and that honor our shared humanity. Value: Cost/Quality Value: Cost/Quality Transparency/Info / Data/Technology/ Interoperability Shared Language / Culture / Fear Navigation/ Coordination/ Trusted Advisor Shared Priorities Shared Priorities Regulations Reimbursement / Funding Communication Across Trust / Control / Choice We will work collaboratively on shared priorities that will foster wholeness for our currently fragmented continuum, so that we can collectively:

5. 5 How We Utilize the Cause And Effect Diagram Hypothetical Focus Areas

6. 6 Questions

7. 7 Community Health Data MDH CHNAs 1 MHA CHNAs 2 HealthEast Community Conversations 3 Mental HealthObesity Alcohol/Sub Abuse Patient Edu / Wellness / Nutrition Tobacco Use Chronic Disease Prevention Access to Healthy Foods Domestic Violence Transportation Financial Vulnerability ✔✔ ✔✔ ✔ ✔✔✔✔ ✔✔✔✔✔ Access to Care & Resources ✔ 1 MDH data includes 25 CHBs (8 Metro, 7 SE, 2 SC, 3 Central, 2 NE, 3 NW. 2 MHA data includes CHNAs from 84 hospitals spanning the state 3 HealthEast data includes a synthesis from East Metro Health and Well-being Community Conversations

8. 8 Shared Prioritization Criteria Greatest opportunity to collaborate Greatest potential to empower consumer Siloed-ness Readiness for change Greatest ability to impact Builds collective infrastructure Screens out that which supports the status quo Environmental – Threats or Opportunities Gap area—not overly duplicative of existing measures Prohibited by public policy Easy versus hard Impact/reach largest population

9. SHIP Statewide Health Improvement Plan Cross-Continuum Activities Minnesota Senior Health Options (MSHO) Hennepin Health Generation Next Southern Prairie Community Care East Metro Mental Health Roundtable Integrative Health / Catalyst SIM (State Innovation Model grant) vision Integrated Health Partnerships RFP (DHS) Accountable Health Communities RFP (MDH ) Center for Community Health Back Yard Initiative Healthy Communities Partnerships Diabetes Collective Impact project Healthy Minnesota Partnership Health Care Delivery System demos (e.g., NW Alliance) Pioneer ACOs NCQA ACOs Health Care Homes Aligned Incentive Contracts ICSI MN Community Measurement Community Projects RARE Honoring Choices Choosing Wisely ACT on Alzheimer’s Citizen Engagement ICSI/Citizens League / TPT MN 2020 Long Term Care Imperative Aging Services & Stratis Futures work LSS “My Life My Choices” Altair Social Services ACO Policy Ideas Health Outcome Trusts Community Health Business Models Many change initiatives underway—could they be better connected and leveraged? How can successful models be taken to scale faster? A Partial View: Public HealthAcute / AmbulatoryLong-term Care Social Services

10. 10 What’s Next Populate design teams Share more information about what is going on in each focus area Using data and considering existing initiatives, design collaborative initiative in focus area (6-12 month duration) and set measures of success Track and evaluate progress in PDSA format Report on progress and identify implications of learnings (e.g., policy implications arising from initiative)

11. 11 Leadership and Supporting Structure: Questions to Explore Leadership and Supporting Structure: Questions to Explore Core Group: – What is the responsibility of this Core Group? i.e.: Provide direction for the overall project. Communicate with key stakeholders. Identify and help to secure human and financial resources for on-going work. – How are new members added to the Core Group? – Do they make a formal commitment to participate and is there an agreed upon term? – Is it OK to have more than one person from an organization on the Core Group? Do we need one person to chair or have a distinct role in connection with the Lab? What is the relationship of the Core Group and design groups? Do we need any rules regarding conflicts or boundaries (off-limit topics/areas, e.g., lobbying)? Are there any specific terms of engagement we have not addressed? (confidentiality, interaction, decision making) Do we need to set any guidelines regarding competition vs. collaboration?