New community health approach aims to combats chronic disease, empower patients, reduces costs

The groundbreaking effort supported by the Centers for Disease Control and Prevention unites medical, public health and social science professions, nonprofits and faith-based and community organizations for an "all-hands-on-deck" approach to public health. Eventually, communities across the country will be able to apply this new model toward public health, reducing the tremendous negative impact chronic disease has on their economies, said Dr. Janine Janosky, head of ABIA's Center for Community Health Improvement, who is leading the effort described in a white paper released today.

The news comes just weeks after an Institute of Medicine report called for a new public health approach based on "enhanced collaboration among the public health, health care and community non-healthcare sectors" to address the challenges of chronic disease. The World Health Organization refers to the growing impact of chronic disease as "a global epidemic" reaching crisis levels. The Robert Wood Johnson Foundation estimates that by 2030, half the U.S. population will have at least one chronic condition.

The ABIA, along with national experts and more than 60 Akron organizations, have been collaborating for more than a year on a new, integrated, and measurable strategy to community health that could be replicated in other U.S. communities. The ACC approach detailed in the report "Healthier by Design: Accountable Care Community" utilizes a unique "impact equation" that measures the benefits of a seamless approach to community health, including metrics for a patient empowerment and market value of health, said Dr. Frank L. Douglas, ABIA president and chief executive officer.

"The amount spent on healthcare and health initiatives in the United States should translate into good health for the community and its residents. Unfortunately, America's public health continues to lag behind other nations. Further, we are now in an era of debate about how to reverse the unsustainable cost trends and improve the health outcomes and quality of life for our fellow man," Dr. Douglas said. "The development of this inventive Accountable Care Community model, which not only speaks of the need for collaboration but actually enables all parties to be on the same page with an integrated, measurable strategy, promises to improve the health of millions of patients."

In Akron, the ACC approach uniquely aligns public, private and philanthropic resources in a coordinated fight to improve community health by identifying and closing gaps in health education, access and delivery. The group's initial pilot project focused on diabetes self-management. Ultimately, participants changed their behaviors and took increased control over their disease. Significant results included decreases in blood sugar and bad cholesterol levels, weight loss, decreased body mass, and a decline in emergency room visits. An additional program demonstrated nearly a total of $225,000 of cost savings or cost avoidance for local healthcare institutions through the use of volunteers and community services to monitor and serve low-income, medically underserved patients with diabetes.

The ACC measured the improvements using a unique health and public health-based formula that calculates impact based on changes in patient health, the number of patients affected and the burden of the disease as determined by the cost of care. The Impact Equation outlined in the white paper is a new and crucial way to evaluate community health initiatives, Dr. Janosky said. "The equation is crucial to a sustainable effort that other communities can implement," she said.

The vast majority of cases of chronic diseases are caused by a small number of known and preventable risk factors, including unhealthy diet, physical inactivity and tobacco use, Janosky said. "We are convinced a collaborative approach to enhance patient empowerment and improve personal lifestyles will address the community challenges of chronic disease," Janosky said.

"The Austen BioInnovation Institute in Akron's Accountable Care Community is taking an important step to improve public health in Summit County by studying the best means of treating and preventing chronic diseases while reducing overall costs. Dr. Frank Douglas, Dr. Janine Janosky, and the sixty partners involved with the ACC are to be commended for their collaborative approach to improve the health and well-being of local residents and communities by uniting public health professionals and the clinical community," said Senator Sherrod Brown of Ohio.

"We believe that our model of an all-inclusive approach to empowering patients and coordinating and improving access can be replicated by any community by first starting the conversation about what priorities matters most to your communities," said Dr. Cynthia Capers, Emeritus Professor and former dean of The University of Akron College of Nursing. "Once you identify your priorities and targets, then performance measurement is an important cornerstone."

In the next phase of the ACC development, organizers will foster community health leadership development, investigate regional health programs, analyze the impact of new health policy such as tobacco-free living, active lifestyles and healthy eating and identify areas of greatest need in Summit County.

"Building a responsible partnership between the clinical care professionals and public health colleagues is a key to success," said Dr. Hugh Tilson, adjunct professor of Public Health Leadership, Epidemiology and Health Policy, University of North Carolina and adjunct professor of medicine, Duke University, who contributed to the white paper. "Particularly exciting for me as a career public health professional is to witness the strong functional collaboration between the local public health agency and the accountable care organization – a true model for the accountable caring community. I know this is the winning formula for our reformed health care system, with the emphasis on health."

According to Dr. William Keck, past president of the American Public Health Association and retired City of Akron Director of Health, "Although chronic diseases are among the most common and costly health problems, we know that they are also among the most preventable. It is vital that the increasing importance of chronic disease is anticipated, understood and acted upon urgently. This requires a new approach by both medical and community health professionals, and community leaders, who are in a position to strengthen chronic disease prevention and control efforts."

Provided by Austen BioInnovation Institute in Akron