UNM Summit Focused on Innovative Health Care Solutions

Summit Goals and Key Outcomes

The summit highlighted New Mexico's pressing health care needs, focusing on access and clinical gaps in care. With 32 out of 33 counties recognized as “Health Professional Shortage Areas,” fully utilizing the health care workforce is critical. Advanced Practice Pharmacists (APPh) were identified as pivotal in bridging these gaps. Key discussions included:

1. Identifying health care access and clinical care gaps, especially in underserved areas.
2. Describing current and future models for APPh’s in New Mexico and other states.
3. Integrating APPh’s into team-based primary and specialty care settings.
4. Developing innovative strategies for collaboration between patients and interprofessional health care teams.
5. Creating and sustaining business models that support interprofessional health care teams.

Keynote and Panel Discussions

The summit featured keynote presentations on patient care gaps nationally and within New Mexico, setting the stage for panel discussions covering:

1. Understanding what consumers need and want from the health care system.
2. Reviewing various APPh models across the U.S. and their impact.
3. Evaluating financial models and exploring enhanced partnerships.

Breakout Group Insights

Breakout sessions focused on identifying bridges and barriers to achieving the summit's goals. Key areas included:

1. Addressing gaps in care through effective collaboration.
2. Creating viable business models for team-based care.
3. Improving communication within interprofessional teams.
4. Developing training and protocols for expanding prescriptive authority.

The Prescription of Trust: Innovations in Health Care Roles

In a presentation titled "The Prescription of Trust," health care expert John McHugh, PhD, an assistant professor in the department of health policy and management at Columbia University’s Mailman School of Public Health, discussed the evolving dynamics of power within health care and the critical role of primary care. Recent moves by corporate giants like CVS and Amazon into primary care signify a transformation. CVS's acquisition of Oak Street Health and Amazon's purchase of One Medical illustrate a trend where non-hospital entities are emphasizing population health.

McHugh outlined three major pressures on the health care delivery system:

1. Value-Based Payment Models: Changing how care is paid for, focusing on cost and quality outcomes. The value-based care market could reach a trillion dollars in the next five years, but adoption among primary care physicians remains limited.
2. Patient Complexity and Polypharmacy: Managing patients outside of hospital settings is crucial, especially for those 65 and older. Pharmacists play a significant role in reducing polypharmacy.
3. Primary Care Shortages: The shortage of primary care physicians is projected to worsen, necessitating innovative solutions to fill the gap. Pharmacists and allied health professionals could play expanded roles in patient care.

McHugh presented survey findings from pharmacists, providers, and patients, revealing key themes:

• High levels of trust in pharmacists, recognizing their potential to manage medications and prescribe for chronic conditions.
• Growth in technology reallocates resources, allowing pharmacists more time for direct patient care.
• Expanding training and education to prepare pharmacists for broader clinical roles.

McHugh emphasized that pharmacists can significantly contribute to better health outcomes, particularly in value-based care models. Integrating pharmacists into care teams can address primary care shortages and improve patient care quality.

New Mexico Faces Significant Health Care Workforce Challenges

Michael Richards, MD, MPA, senior vice president for clinical affairs at UNM Health Sciences Center, discussed New Mexico's health care system, highlighting severe workforce shortages exacerbated by socio-economic factors and an aging population. Key issues impacting health outcomes were outlined, along with proposed innovative solutions.

Health Beyond Health Care

The conversation emphasized that only 10% of health outcomes are influenced by health care, while 90% are driven by social determinants such as community environment, education, economic stability, and personal behaviors. New Mexico ranks 49th in the economic hardship index, reflecting significant socio-economic challenges.

Declining Health Rankings

New Mexico's health ranking has plummeted from 14th to 43rd nationally. Economic instability, low education levels, and high adverse childhood experiences drive this decline, underscoring the need for systemic interventions.

Workforce Shortages

New Mexico experiences a critical shortage of health care professionals. Although data suggests the state has 138 primary care physicians per capita, access to primary care remains problematic, particularly in underserved areas like Valencia County. National benchmarks inadequately assess local needs.

Tools and Strategies for Workforce Planning

The Health Resources and Services Administration (HRSA) National Center for Health Workforce Analysis provides tools for projecting health care workforce needs. These tools indicate substantial shortages across various health professions. By 2035, New Mexico will require an additional 1,400 physicians and 5,000 nurses.

Innovative Solutions and Policy Changes

To mitigate these shortages, New Mexico must adopt innovative health care delivery models and policy changes. This includes expanding roles of allied health professionals, leveraging technology, and improving reimbursement models. Point-of-care testing and treatment by pharmacists could alleviate primary care pressures.

Health care leaders advocate for enhanced training programs and creative workforce distribution strategies to ensure statewide accessibility, particularly in rural areas. Collaborative practice agreements between providers can optimize resource utilization and improve patient outcomes.

Conclusion