By David A. Kindig, MD, PhD
Last week, I addressed the issue of population health resource allocation. I asked, “Where would you put the money?” and mentioned (among other possible approaches) the concept of a multi-sector “super-integrator” to take the lead in identifying and harnessing resources for population health improvement. I was delighted to hear from reader Catherine Kolkmeier, who directs the La Crosse Medical Health Science Consortium here in Wisconsin. Catherine was intrigued by the super-integrator concept and curious as to my opinion of whether the consortium fits this model.
I first floated the “super-integrator” concept back in 2010, after expressing skepticism that a single sector could take lead responsibility for population health improvement, rising above their own paradigmatic or practical limitations (such as health care organizations placing too much emphasis on clinical approaches or governmental public health being under-resourced) to truly serve as an effective neutral convener.
The La Crosse Medical Health Science Consortium is an independent 501(c)(3) that was founded in 1993 by a cross-sector alliance of two regional health systems and three institutions of higher education, including the University of Wisconsin La Crosse, Viterbo University, Western Technical College, Gundersen Lutheran Health System, and Mayo Clinic Health System-Franciscan Healthcare. The consortium has since expanded to include the School District of La Crosse and the La Crosse County Health Department. In creating the consortium, the founding organizations hoped to develop a space that was ruled by collaboration rather than competition, especially with regard to measuring and sharing outcomes related to health care workforce development. While healthcare workforce issues remain prominent on the consortium’s agenda, the board of directors decided in 2009 to expand its focus to include population health. From this vision broadening has emerged an initiative that aims to make La Crosse County the healthiest in Wisconsin by 2015, with implementation of programs and policies across County Health Rankings factor areas, from transportation and tobacco to food security, obesity, and others.
Resource alignment is imperative for population health improvement, especially during periods of fiscal austerity, and I think this is a natural role for “super-integrators.” According to Catherine Kolkmeier, the ethic of resource conservation, alignment, and stewardship permeates the La Crosse Consortium from the Board of Directors down. Board and committee members actively strategize how best to use available resources with the goal of maximizing impact and avoiding duplication of resources. This is no small feat in practice, given that multiple grants are administered by various partner organizations throughout the community. But, staying oriented to the big picture and having a collective commitment to resource stewardship will undoubtedly prove extremely beneficial in the long run, particularly as new, sustainable funding mechanisms emerge.
I am not naive about the potential challenges of a “super-integrator” model, but optimizing our communities’ health will almost certainly require a coordinating authority of some type. The La Crosse Medical Health Science Consortium is certainly pointing in the right direction and I suspect that it represents just one of many “super-integrator-like” structures that are developing across the U.S. We look forward to finding more examples inspired by diverse initiatives, including the original healthy communities efforts and diverse federal and foundation projects such as our own County Health Roadmaps. Many thanks to Catherine Kolkmeier for bringing the consortium to our attention. We would love to hear from other readers as we continue to broaden the dialogue by holding up real-world examples that help us think about and work toward improving population health.
David A. Kindig, MD, PhD is Emeritus Professor of Population Health Sciences and Emeritus Vice-Chancellor for Health Sciences at the University of Wisconsin School of Medicine and Public Health. Follow him on twitter: @DAKindig.
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