PA Alumni Association Newsletter - Fall 2012

Alumni Association Newsletter Issue 5, Fall 2012

Bringing alumni together for social networking, knowledge sharing, and professional development

Issue 5, Fall 2012

Message from the Editor: Greetings Alumni and Friends!

It has been a full year since we first started publishing this newsletter! And what a great year it has been. We have heard from practitioners in the field as they identify and implement innovative solutions to public sector problems. We have kept in touch with alumni as they serve the public and flourish in their careers. Our readership has grown, as has the membership in the Alumni Association.

But we are not done! This issue’s content comes courtesy of incredible alumni and PA Division faculty. We catch up with Jessica Struyk, MPA (courtesy of the Oregon Emerging Local Government Leaders), learn about the grants awarded to Dr. Jill Rissi and her team for healthcare outcome research, and receive Erin Fairbairn’s insights on how the Supreme Court ruling on healthcare reform will impact health services in Oregon.

Thank you to all of you alumni and friends who have contributed and supported this newsletter. I look forward to another great year of networking, learning, and growing!

Cheers,

Amanda Lamb, MPA

ABOUT THE NEWSLETTER

This is the PSU Public Administration Alumni Association newsletter, published twice a year. The topics and authors will vary, but will always be relevant to the study and practice of public administration and public health. Drawing from multiple fields of study, we aim to provide you with relevant content, and are always seeking input on the newsletter (format and substance) as well as article contributions. For more information, see page 7.

In this Issue

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Alumni Spotlight: Jessica

Struyk

Faculty Spotlight: Dr. Jill Rissi Evaluates Health

Outcomes in Oregon

How to Get Involved in the Alumni Association

Division of Public Administration

Alumni Association Portland State University

Mark O. Hatfield School of Government

Page 6 Public Administration in Practice: Erin Fairbairn on Federal Healthcare Reform

Alumni Association Newsletter Fall 2012

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Alumni Spotlight: Lightning Round with Jessica Struyk

The Emerging Local

Government Leaders (ELGL) group does a regular series called the “Lightning Round”, where professionals throughout Oregon answer fun questions about their life and profession. Many of these Rounds feature PA Alumni from PSU! One such Round occurred with alumna Jessica Struyk.

Favorite book of all-time: It is hard for me to pick just one. I love non-fiction– especially inspiring true stories.

Some of my favorites are:

• Strength in What Remains and Mountains Beyond Mountains by Tracy Kidder

• The Geography of Bliss by Eric Weiner

• Half the Sky by Nicholas Kristoff

• Anything by Jon Krakauer

Book that is on your nightstand right now:

Fire at Eden’s Gate: Tom McCall

Originally Published by the Emerging Local Government Leaders Group of Oregon

and the Oregon Story by Brent Walth. It’s great so far!

(Fill in the blank) When you wake up in the morning, you are motivated by………

Opportunities to learn new things and challenge myself.

If you ran for elected office, what position would you run for?

I’m not interested in running for any office- that aspiration faded after being Senior Class President in high school (and having the ongoing responsibility of planning reunions). I much prefer to be on the staff side!

Your best piece of career advice:

“Follow your bliss” – if you’re unhappy in your job, you’re probably not in the right one. Other than that I would say work hard, be genuine and actively listen.

Your favorite social media outlet:

It’s a tie between Facebook and Pinterest!

Which actor/actress would play you in a movie?

Maybe Kristin Wiig from SNL- I loved her in Bridesmaids!

What is the home page on your web browser?

Good old Google.

Biggest issue facing local government:

Lack of public understanding of local government services and their value.

Two things that people will say about you at your retirement party:

Hopefully something about working well with and encouraging others and probably something like “now where will we get all of our unsolicited sports news?”


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First concert that you ever attended:

Aerosmith-it was epic!

Name three of your mentors:

• Joe Gall, City Manager of Sherwood – he taught me how important connections are and encouraged me to get involved with professional organizations like OCCMA, ICMA and ELGL.

• Erik Kvarsten, City Manager of Gresham – I have learned so much in the short time I have worked with Erik. He has an incredible knack for positively interacting with and showing appreciation for staff – I am convinced he knows all 500+ employee names!

• Dr. Phillip Cooper, Professor of Public Administration at PSU – Dr. Cooper was an great mentor during grad school and helped me find my way into local government.

Who is at the dinner table if you could invite any three people (dead or alive)?

• Hillary Clinton,

• Dr. Martin Luther King Jr.

• and to keep it interesting Chris Farley. Maybe we can meet in a van down by the river?

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(Fill in the blank) Government is…

Where to be if you want to positively impact a community.

(Fill in the blank) ELGL is…

My go-to resource for the local government scoop and a wonderful way to get to know staff from other

jurisdictions! ♦

A special thank you to ELGL for allowing the PA Alumni Association to republish this Lightning Round!

To view more Lightning Rounds, visit ELGL’s website.

Hatfield News The PSU Center for Public Service announces the creation of the Public Service Innovation Lab!

Those of us in the public sector know all too well the challenges we face. And we are continuously called upon to identify solutions, but that call does not include the resources to successfully do that. The Lab will be a place where public service leaders can seek resources to identify solutions, implement those solutions, and evaluate the effectiveness of those measures. The goal of the Lab is to serve as a catalyst for public sector innovation.

For more information, visit the call for letters of interest, courtesy of ELGL.

Dr. Erna Gelles and other faculty and staff of the Master of Public Administration program complete the self-study for accreditation by the National Association of Schools of Public Affairs and Administration!

Every seven years, our alma mater must get reaccredited by NASPAA. Since the last reaccreditation in 2005, NASPAA had added the component of “competency-based evaluation”, which was included in the self-study. The study will be evaluated, a site visit will occur, and a decision on accreditation will be issued sometime in the spring.

To read the results of the self-study and more about the competencies evaluated by Dr. Gelles, view the full report at the Division website.


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Faculty Spotlight: Dr. Jill Rissi,

Professor of Public Health

Healthcare is certainly a hot-

button issue these days. Not only do we hear the horror stories of individuals who either cannot access the healthcare they need because of cost or lack of access, but we also watch legislatures at the state and national level in a gridlock over how to fix it. In spite of the doom and gloom nature of the national conversation, progress has been made, at both the state and national levels. New programs are always coming up, with the goal of improving healthcare quality and health in general. Some of these initiatives are happening here in Oregon, and PSU, the College of Urban and Public Affairs, and the Hatfield School of Government are at the forefront in evaluating their impact on the system and the citizens it serves.

Dr. Jill Rissi, who started her career as an emergency room nurse and now teaches in both the Public Health and Public Administration programs in the Hatfield School, is working with healthcare agencies

Dr. Rissi Receives Grants to Evaluate the Outcomes of Healthcare Reform in Oregon

and research foundations to evaluate the current status of healthcare in Oregon and the impact current initiatives have on healthcare outcomes.

Coordinated Care Organizations

In Oregon, Coordinated Care Organizations, or CCOs, are essentially a network of healthcare providers that work together to provide comprehensive care to low-income children and adults (under Medicaid). The purpose is to combine care for basic physical health, mental health, addiction treatment, and even dental care into one system with the goal of preventing major health crisis and managing chronic conditions. Not only are these systems meant to save money by preventing costly emergency room visits, but also to contribute to a healthier population.

As part of partnership that includes PSU, the Providence Center for Outcomes Research and Education (CORE), and the Oregon Health Authority, Dr. Rissi will be evaluating the effects of that legislation and the creation of

CCOs, including cost, utilization, and health outcomes. The research will be comprised of multiple areas of study, including a large survey designed to assess patients’ satisfaction levels and health outcomes; analysis of the “All Payer All Claims” database to evaluate healthcare utilization patterns and costs; and a qualitative study assessing the characteristics and functions of the CCOs themselves.

The overall goal of the research is to determine whether or not health has improved within this population. If the research suggests that health has improved, Dr. Rissi’s next objective will be to determine if the CCO model can be tied to those improved outcomes and, if so, what specific attributes of the CCO model lead to that positive impact.

Patient-Centered Primary Care Homes

To further the integration and coordination of care (similar and related to the CCOs), the Oregon legislature passed a bill creating a


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Patient-Centered Primary Care Home (PCPCH) model. The goals of the program are the same as those for the CCOs – to provide preventative care and manage chronic illnesses in an integrated, cost-effective, and patient-centered manner. These homes are an integral part of a comprehensive healthcare system, particularly for individuals that require multiple kinds of care (physical therapy, pain management, etc.) to manage their health conditions.

In order to become designated as a primary care home, certain criteria must be met. Dr. Rissi, in partnership with other PSU faculty (including Dr. Sherril Gelmon and Dr. Neal Wallace) and CORE, will conduct a study of the PCH model, including effects on cost, utilization, patient satisfaction and health outcomes. The study will include interviews, site visits and a survey of existing PCHs, and an analysis of documents that chronicle implementation of the PCH model.

Health Engagement Model

Dr. Rissi will also be engaged in analyzing the outcomes of efforts to reduce healthcare costs by incentivizing healthier lifestyles. As part of a nationwide trend toward “value-based benefit design” in healthcare coverage, the Oregon Public Employees Benefit Board (PEBB) began the Health Engagement Model program (HEM), which seeks to incentivize better health among public employees by offering lower health

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insurance premiums to those who avoid or end risky behaviors (e.g. smoking). Essentially, employees completed an online health assessment (weight, waist size, diet, etc.), and were encouraged to reduce risky behaviors and engage in a healthier lifestyle through financial incentives. Although the program was not mandatory for state employees, those who did not participate paid a higher premium. Dr. Rissi and her partners in the School of Community Health and at CORE will evaluate that program by surveying participants and those who opted out of HEM to determine its effects on health, healthcare costs and employee satisfaction.

Conclusion

All of these programs are about a national conversation about healthcare quality and cost – and health outcomes. Because they integrate the best of survey, claims analysis, and qualitative research methods; these research projects are able to assess variation in outcomes and to understand the relationship between what these new models of healthcare delivery are actually doing differently and how those differences affect individual and population health outcomes. ♦


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The Supreme Court’s landmark

ruling on health care reform this past June accomplished two important tasks: it put to rest concern over the legality of the “individual mandate” whereby Americans will either have to obtain health care insurance or pay a fine (i.e. a tax) and; it limited financial penalties that might accrue to states in the event they choose not to expand their Medicaid programs. As a result of the second decision, current estimates from the Congressional Budget Office are that six million people less will have access to Medicaid than originally proposed, but of these, approximately fifty percent are expected to be able to afford subsidized health insurance through the new health care exchanges implemented under the Affordable Care Act (“ACA”).

Hospitals

In Oregon, “state reform has eclipsed federal reform” in its relevance and immediacy, according to Robin Moody, Director of Public Policy for the Oregon Association of Hospitals and Health Systems and a MPH ’10 graduate. The passage of the ACA was a “happy day” for Oregon hospitals. Like most hospitals

across the United States, Oregon hospitals are systems of last resort health care for the under- and uninsured, and have seen rising uncompensated care costs (currently averaging 10% at Oregon hospitals) as well as reductions in commercial health insurance. These trends have stressed hospital’s operating margins, forcing them to find more areas to reduce expenses while still offering high quality care to their patients. Further, hospital data and health care economists have long supported the view that the uninsured are the most costly to treat, primarily because they delay seeking health care services until their conditions are severe, and because they utilize emergency rooms at a higher rate. As a result, the prospect of an estimated 250,000 new Medicaid enrollees in the state is viewed as a positive addition; assuming new enrollees are given the education and tools they need to maximize the health benefits they receive once they have insurance. A recent study on the question of health care outcomes and healthcare costs for newly insured Medicaid enrollees in Oregon provides some initial information on this front, primarily that these enrollees are healthier overall, but also that the upfront cost of treating them is definitely higher than in treating the

uninsured.

Frances (Symons) Favela, MPH ’09, a Research Associate and Tobacco Cessation Counselor at OHSU, reflects Moody’s optimism over the ACA in that she believes over time the major changes expected from health care reform will eventually increase overall health in the U.S. However, she feels cautious in the short-term. “Hospitals are already understaffed in many care areas, i.e. nurses, CNA’s, social workers,” stated Favela. “A lot of people are very sick, have been for a while and come to OHSU to feel better, but most of them cannot afford the care they are given…more sick people means very full hospitals, waiting for services and very overworked staff, who are already overworked.” Favela believes that expansion of health care insurance may lead people to feel like they have more control over their health status (a trend reflected in the results of the Oregon Health Study mentioned above). For those who are very ill, with costly medication, it is a constant source of stress to find ways to pay for their medication and/or pay the physician and hospital bills which result from their inability to afford and thus continue taking their medication. In her own work, Favela foresees a brighter future where insured individuals

Public Administration in Practice Public Health Alumna Erin Fairbairn discusses the

impact of federal healthcare reform and the Supreme Court ruling on key provisions of the law

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tortor.


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can take advantage of smoking cessation education and programs which are covered under their insurance at a much earlier date then they might have otherwise, reducing the overall damage to their health of smoking long-term, which in turn equates to higher healthcare costs.

Insurers

As a result of healthcare reform, healthcare insurers will be required to shift how they manage their bottom line. The true cost of health care, not their company profits, will now drive the costs of premiums charged to their enrollees. What this means is that when insurance rates increase it’s because healthcare providers’ costs are also increasing. Further, the states have been given additional financial support by the Federal government to monitor compliance by insurers with what is estimated to be “a ten-fold increase in the level of transparency” by Brian Sikora, MPA-HA ’10 (who speaks personally and not on behalf of the organization he works for). Insurers are “about to be crushed with data reporting expectations” which are the result of new standards required of insurers under healthcare reform which allow potential enrollees to compare costs, services, quality and outcomes amongst other relevant data points between insurers, particularly with Medicare insurance. This will lead to the realization of added expenses and over time, Sikora notes, insurers will need to learn how to conduct business more efficiently.

Managed Care

On the care delivery side, managed care organizations will be charged with figuring out how to meet the new and incoming demand of insured patients within the existing care delivery structure. Sikora believes there is currently a disconnect between (a) the new revenue anticipated to be received from Medicaid and those enrolled in the new affordable healthcare insurance marketplace, and (b) the cost of providing the actual care. It will be necessary for healthcare providers, insurers, suppliers and other segments of the healthcare industry to form alliances aimed at improving efficiency and quality in the care delivery model while simultaneously reducing costs.

Moody concurs. “We are moving towards a care model which is team-based, heavier on nursing, with providers practicing at the top of their licenses, and preserving specialty care.” What this means ultimately is the elimination of perceived waste in healthcare system that operates in the U.S. In the words of the head of the Centers for Medicare and Medicaid Services, Don Berwick, it “is possible to markedly reduce the costs without depriving any patient of any needed service. No rationing needed at all. We just need to get serious about examining all the ways US health care spends money without benefiting patients.”

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Email Amanda Lamb, MPA ‘10 Newsletter Editor [email protected]


The Alumni Association is expanding! There are now many ways to get involved, including:

• Attend alumni events: Watch for communication of time/location for monthly gatherings and other events! All are welcome!

• Check out our Facebook page! Here you will learn of alumni social hours and other upcoming events.

• Join our group on LinkedIn or the listserv: The Alumni Association LinkedIn page allows you to connect with hundreds of alumni, remain informed of upcoming events, and receive the newsletter.

• Provide feedback: This Alumni Association is OURS. We can build it the way we want. Make sure your voice is heard.

The Alumni Association will continue to grow, and your participation is the key to our success. Thank you for your support!

We are now soliciting contributions for the spring edition of the newsletter. Want to contribute to the content?

For more information, to join the listserv, or to provide feedback, email [email protected]

Documents

PA Alumni Association Newsletter - Fall 2012