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Site Profile: Inland Empire Collaborative

What stands out among the Inland Empire Collaborative is its scale. Everything about the collaborative is large – its service area, its scope of partners, its ambitions, and how quickly it has developed. The collaborative’s commitment to testing sustainable financing innovations on a large-scale contributed to the Inland Empire’s selection as a participating site in Bridging for Health: Improving Community Health Through Innovations in Financing, supported by the Robert Wood Johnson Foundation.

This collaborative is comprised of stakeholders in Riverside and San Bernardino counties in California.

The Needs Are Great

Combined, Riverside County and San Bernardino County cover more than 27,000 square miles and have a population of approximately 4 million residents. It is a diverse geographic area encompassing mountains and desert; as well as both urban and rural areas. Despite the natural beauty, the area has challenges promoting healthy living and access to health services for all of its residents.

Current Standing: Riverside County ranked 24 out of 57 counties in the state for health outcomes, while San Bernardino County’s overall rank was 37 of 57, according to County Health Rankings.

Leader of the Initiative: Inland Empire Health Plan, a not-for-profit Medicaid and Medicare health plan was the initial convener of the collaborative.

Collaborative: In addition to the three partners responsible for the collaborative’s backbone support— Inland Empire Health Plan, Partners for Better Health, and Impact for Health—the collaborative consists of diverse participants representing public health, hospitals, education, the faith-based community, and housing.

Potential Financing Mechanism Being Explored: The collaborative is currently exploring blending and braiding mechanisms, in addition to wellness trusts.

Community Goals: The Inland Empire’s primary goal for Bridging for Health is to improve population health by rebalancing and aligning investments focused on diabetes and obesity prevention initiatives across the two counties.

 

Both counties rank in the bottom half of California counties in health measures and face higher than average rates of unemployment and poverty and lower than average educational attainment. The area is also philanthropically underserved, compared to other counties in the state.

Both counties have completed community health needs assessments and accompanying implementation plans that set priorities through 2020. The plans share a recognition that access to care needs to be improved and that addressing health challenges requires focusing on upstream drivers of well-being, including education, economic opportunity, and safety.

Riverside County identified the following priority areas.

  • Creating healthy communities – Creating safe physical and social environments that promote health
  • Promoting healthy behaviors – Ensuring healthy and active living by addressing preventable and treatable health conditions such as obesity, chronic disease and mental health
  • Connecting and investing in people – Achieving health equity, eliminating disparities, and improving the health of Riverside County residents by connecting and investing in people
  • Improving access to care – Ensuring healthy and active living by improving and increasing access to care

The priority areas identified for San Bernardino county include:

  • Education – Increasing the high school graduation rate and the percentage of students who are proficient readers by 3rd grade.
  • Economy – Decreasing the percentage of individuals and children living in poverty and increasing industry employment.
  • Access to health – Increasing the percentage of residents who have a usual source of care and health insurance coverage, while decreasing the percentage of residents who delayed or did not get medical care in the past year.
  • Wellness and safety – Decreasing the crime rate per capita, the juvenile crime rate, and the number of gang members, while increasing positive relationships between residents and police and fire departments.

“There are multiple regional efforts to improve health outcomes across the Inland Empire,” says Roger Uminski, director of health administration for the Inland Empire Health Plan. “Bridging for Health provides a framework to build on that work, focus attention on a single issue at a time, and bring new resources to bear in order to attain meaningful and sustainable improvements.”

A New Collaborative

Over the years multiple collaboratives have worked on health-related issues in the Inland Empire. The group assembled to work on Bridging for Health build on other regional work already underway. The group was convened by the Inland Empire Health Plan, a nonprofit, rapidly growing Medi-Cal (Medicaid) and Medicare health plan in California that serves more than 1.2 million residents in the two-county area.

The Inland Empire’s Bridging for Health collaborative brings together a broad coalition of multisectoral stakeholders and remains committed to assessing whether it has the right groups represented. Since the initial convening, the Inland Empire Collaborative quickly engaged key players including the two local health departments, the hospital association, the local United Way affiliate, the school system, community-based organizations, and the faith-based community.

Additionally, the Inland Empire Collaborative quickly established a strong governance structure that includes a steering committee, formal backbone support (professionally managed by Partners for Better Health and Impact for Health), and active workgroups addressing the areas of policy, financing, and strategy.

Fertile Ground for Innovation

The Inland Empire is uniquely suited to Bridging for Health’s mission of identifying sustainable financing innovations that address upstream drivers of health, as local partners are already transitioning from traditional reimbursement towards global payments with a focus on population health.

The collaborative is currently exploring financing mechanisms of blending and braiding and wellness trust, as well as the accountable health communities model and strategic investment of hospital community benefit funds.

In parallel with exploring the sustainable financing mechanisms, the collaborative is narrowing in on an intervention strategy related to preventing progression of obesity and prediabetes among individuals in the community.