Health Policy Institute of Ohio (HPIO)
Updated materials originally presented to interested foundations in late February, 2003
How the Project Arose
The Health Foundation of Greater Cincinnati’s Board felt it was time for us to do more policy-oriented work
We began a process of talking with health policy officials, researchers and funders across the state
Several themes arose, and a number of researchers, officials and sister foundations encouraged us to look at forming a policy institute; a proposal was written
What We Found: Policymaker Issues
Because of term limits, legislators have lost the history and their knowledge bases about Medicaid
Lobbyists are the only source of information, and their information always supports their causes; no independent sources
State officials are hard-pressed to generate information and analyses
In-state studies not ready when neededMore Medicaid coverage decisions have been
delegated to the state
What We Found: Researcher Issues:
MEDTAPP (program of Medicaid & Board of Regents) is funding only a few projects
Most research is clinically-oriented rather than policy-oriented
Most researchers working on Medicaid and the uninsured are isolated
This work has low priority and prestige in academic departments – partly because it is poorly funded
Little research reaches legislators
What We Found: Ohio Health Policy Research Centers
UC: Institute for Health Policy & Health Services Research
U of Akron: Institute for Health and Social Policy
Federation for Community PlanningOSU: Center for Health Outcomes, Policy &
Evaluation Studies
CWRU: Center for Urban Policy & Social
Change
What We Found: Health Advocacy Issues
It is hard to get good information out of the state system
Important issues do not get attention because there is no way to back them up
Most advocates do not have the ability to do analytic work directly
What We Found: Foundation Issues
Most health & community foundations do not act to influence state policy – but policy is critical for sustainability of local programs
No coordination of policy efforts among health foundations
Policy efforts are isolated; hit-and-miss for priorities, and last-minute
What is Different About Our State
Ohio is one of four states that have multiple urban centers
No single city dominates the state
What is Different About Our State
Ohio is one of three states that have multiple urban centers
No single city dominates the state
Our cities differ in their cultures
No statewide health grantmaker
Work in Other States
At least 1/3 of states have, and 11 states plan a health policy center
Three foundations in Colorado just announced creation of a center
They did substantial research prior to acting, and we have borrowed liberally
Three Models for Health Policy Centers
1. Subsidiary of a health foundation
2. University-based center
3. Independent center
What We Are Proposing
An independent center that works to improve the health of all Ohioans through research, analysis and communication about vital health concerns affecting the state, with particular emphasis on the Medicaid, uninsured and underinsured populations, and issues of public health in Ohio
What is Different About Our Proposed Center
More emphasis on communication with and education of policymakers
Less emphasis on data warehousing or clearinghouse functions (we can link to existing sources in Ohio)
Multiple local funders joining to fund a state policy center as a way to advance regional interests through state-level interventions
Success Issues
Quality of HPIO leadership:– Competent with research, economic
analysis– Non-partisan, no political agenda– Communication and relationship skills to
interact with policymakers
Success Issues
Stable funding during start-up (or we won’t recruit well and money issues will distort the work selected)
Board that represents the state, but has no vested interest (i.e., no income to them or their organizations from changes in state policies)
Work of the Institute: Health Policy Research Agenda for Ohio
Generate through state-wide inclusive process
Working closely with ODJFS Ohio Health Plan (Medicaid), Ohio Department of Health and others
Attuned to issues likely to arise and to closing gaps in useful information
Work of the Institute: Reports
Informational Brochures (2/year)– Such as Ohio Medicaid Basics
Issue summaries (12/year)– Translate studies done across the state
into materials understandable by policymakers
White papers (3/year)– In-depth research or analysis
Work of the Institute: Reports
Biennial district and local reports– Bringing abstract issues into focus in a
legislator’s district
Report to the Community– The Center’s annual report (but done
biennially)
Work of the Institute: Meetings
Legislative BriefingsResearch Conferences & RoundtablesPublic meetings for setting policy
agendaMedia Briefings
Governance
The Board will consist of appointees of the Founders during the starrt-up years
Broader participation will be engaged through advisory groups convened by the Institute
The Institute will convene:
The Ohio Health Policy Advisory Group… to develop
consensus about state policy research issues & priorities
The Institute will convene:
Ohio Health Policy Researchers Advisory Group… to develop researchers
to share work
to simplify work
to enhance health policy work in Ohio
The Institute will convene:
Scientific Review Advisory Group... to review the
Institute’s scientific activities and to oversee a formal evaluation process in Year Four
HPIO Benefits for Ohio:
Decisions affecting Medicaid & uninsured will be more data-driven
Hare-brained solutions may wither sooner
Contentious issues will be examined more thoughtfully, with better understanding of consequences
Opportunities for reform will be used
Useful Information from Ohio Medicaid Basics
Publication by the Health Foundation of Greater Cincinnati and the George Gund Foundation - as an example of potential HPIO output and impact(Report available at www.healthfoundation.org/publications)
How does Ohio compare?Ohio’s per member per month (PMPM) costs for most Medicaid-eligible populations are at or below national
averages
Other Things Being Equal, Decisions about Medicaid coverage will balance:
• Covering the optimum number of people
• Providing the optimal services• Maintaining Ohio’s financial integrity• Promoting family & community self-
sufficiency, self-determination, & health
Health Policy Institute of Ohio: Benefits for Foundations
Permits foundations to inform policy based on what they learn from their local projects
Research and analysis can help foundations choose and focus projects for best impact
Source of health outcome studies and indicators for evaluating own work
Health Policy Institute of Ohio: Benefits for Foundations
Source of expertise for getting certain types of projects done
Allows Ohio health grantmakers to collaborate
Will keep us out of crisis-driven and fragmented policy work
Permits state-level interventions that we have not used up to now
HPIO Funder Status 2003 2004 2005 2006 2007 20085-Year Total (excl. Yr 0)
Health Fdn of Greater Cincinnati $190,000 $300,000 $300,000 $300,000 $300,000 $300,000 $1,500,000Gund Foundation * # $100,000 $125,000 $125,000 $125,000 $125,000 $125,000 $625,000Anthem Fdn of Ohio/Greater Cincinnati Foundation * ## $100,000 $100,000 $100,000 $100,000 $100,000 $500,000Mt. Sinai Health Care Fdn # $100,000 $100,000 $100,000 $100,000 $100,000 $500,000St. Luke's Foundation ** # $100,000 $100,000 $100,000 $100,000 $100,000 $500,000Srs. of Charity, Canton & Cleveland * ## $100,000 $100,000 $100,000 $100,000 $100,000 $500,000Cleveland Foundation ^ $63,000 $0
* has a three-year grant length constraint indicates a projection for which there is no commitment presently** has a one-year grant length constraint indicates an award made# intends to fund an additional cycle(s) indicates proposal still being processed## willing to fund an additional cycle(s) ̂cannot commit further at this time due to
strategic realignment in process