Advisory committee discusses Ballad population health requirements


BLOUNTVILLE, Tenn. (WJHL) — The COPA Local Advisory Council (LAC) discussed how many population health factors Ballad Health should be measured on when it met with Tennessee Department of Health (TDH) and Ballad officials Tuesday. Council members also discussed time limits for public input at the LAC’s quarterly meetings and its annual meeting, which is set for Jan. 7, 2020, and learned that Ballad had submitted its annual report to TDH late Monday.

Some members wanted to slim the population health list down from the current 25, saying it would be better for the state to measure Ballad on a few focused areas — or at least to align more closely with the 13 areas the state of Virginia is measuring. “Do we have so many that we’re destined to be ineffective?” LAC member Dennis Phillips of Kingsport asked.

COPA Local Advisory Committee member David Hawk.

At least one member, though, supports a broad array of measures. “Overall population health in Tennessee, I think we need to measure as many outcomes as we possibly can,” State Rep. David Hawk (R-Greeneville) said after the meeting. “If we differ from Virginia that’s fine.”

Three of the selected measures will be reported by Ballad. TDH will gather the rest through other data sources. They generally center around what are termed the “Tennessee Big Four,” behaviors that are seen as directly influencing six of the top 10 leading causes of death in Tennessee: Tobacco use, obesity, physical activity and substance abuse.

Ballad will receive an annual score from TDH related to its success in meeting the terms of the COPA, or Certificate of Public Advantage. Half of that score will come from its performance on the population health measures, with access to health care accounting for 30 percent and quality accounting for 20 percent. The system will receive a “pass/fail” grade on cost. Sanctions or even an unwinding of the merger that created Ballad can result if the system does not earn sufficiently high scores.

The list of measures on which Ballad Health will be scored.

Progress on improving the population health measures from an established baseline in Ballad’s region will be compared to progress from baselines at the statewide level, the national level and also from 11 “peer counties” with a total population similar to Ballad’s Tennessee footprint. Ballad is also required to invest $75 million of new money in population health efforts over the next 10 years.

If the Ballad group improves at a better rate than the other measured groups, TDH’s Judi Knecht said, the system can get “extra credit.”

One idea that got a good deal of traction involved bringing East Tennessee State University and other colleges and universities into the effort to improve population health. Many factors impact population health beyond those that can be controlled by physicians and other clinicians, LAC member Linda Latimer said. ETSU’s College of Public Health has resources that could help impact the results, she said.

“A takeaway I have is that we should connect with ETSU,” TDH’s Jeff Ockerman said. “We have not, and I think that would be a good idea.”

Hawk agreed. “I do like the advice we received where we empower East Tennessee State University to give us some anecdotal information as to where they see we are now,” Hawk said. “I think ETSU can help us create a baseline and then we work from there as we’re making those measurements. But I feel that we need to make as many measurements as we can in Tennessee.”

In other business, the committee agreed to set time limits for public comment. At quarterly meetings such as Tuesday’s public comment will be limited to 30 minutes, with each speaker allowed up to three minutes. The total time available for the annual meeting will stretch to 90 minutes, with three minutes the maximum per person.

TDH’s Ockerman said Ballad’s annual report, minus any proprietary information that would be redacted, should be in LAC members’ hands soon. It will also be posted on the TDH website.

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