Good afternoon. I am honored to be here this afternoon to welcome you to this great state
of Louisiana. As Dr. Davis just said, the happiest state in the union. We are an extraordinary,
one of a kind place. World class cuisine, music that moves you, and festivals that excite.
We're known for these things, but we'd love to be known for one other thing, and that's
excellent health. You've been here in New Orleans for, even if you've been here
for a couple of hours, you've already seen what I'm talking about. There's a festival
almost every weekend, an endless amount of delicious food and drinks to enjoy, but what
are we doing to change our health outcomes in the midst of all that revelry? As Louisiana's
Health Secretary, my number one goal is to change those health outcomes. Our work at
the Department of Health and Hospitals is singularly focused on moving our state forward
by improving the health of our residents and the sustainability of our programs. And that
goal really leads us to what I call the multi-billion dollar question: How do we improve health
outcomes for every resident of our state through the best and most sustainable use of public resources?
That's a very important question and because, as was mentioned already, Louisiana has major
challenges. We once again received an F from the March of Dimes Prematurity Report Card,
despite showing positive progress in all three prevention strategies. Our rate of premature
birth still lags the nation at 15.6 percent. Perhaps a driving force in that outcome, we
know that there are nearly 850,000 Louisiana residents who are smokers and more than 2.5
million Louisiana residents were exposed to secondhand smoke just in the last seven days.
We have 1.2 million obese Louisiana residents. It's more than the population of New Orleans,
Baton Rouge, Lafayette, and Shreveport combined. All of our major cities. That number of people
could fill the Superdome 16 times over every seat at every home game would be sold out
for the next two seasons. Estimated number of children under the age of five who are
obese or overweight could fill more than 1600 school buses. Those buses would stretch more
than 11 miles if lined up end to end. We're also troubled by the fact that Louisiana has
the second highest proportion of residents in the country on attention deficit hyperactivity
medication. Drilling deeply into our Medicaid claims data, we've learned that those children
who are the youngest in their class are far more likely to prescribe those medications.
So what's our solution as the state's health department? How do we address all these disparities?
All these significant challenges we face? The main thing we've had to do is learn to
utilize our resources more effectively. This includes using our immense stores of data,
and our technology, our partners in the community. One of our major endeavors over the last few
years has been a coordinated effort to tackle Louisiana's poor health birth outcomes.
A few years ago every birthing hospital in the state committed to end the practice of early
inductions. We also established extensive birth outcomes - thank you.
We established birth outcomes quality metrics
for our Medicaid managed care organizations to track and reward
plans for improvements in critical areas. And we got results. Independently verified
Medicaid claims data indicates 18,700 fewer NICU days between state fiscal year 2012 and 2013.
That's a 10 percent reduction and so many more babies going home with their moms
rather than staying in NICUs. We know these efforts are paying off, but we feel there's
still more to do. Earlier this summer, we entered our next phase of partnering with
our state's largest private insurer Blue Cross and together with Medicaid, we've both enacted
payment reforms that ended the practice of reimbursing providers for unneccesary early
elective deliveries all together.
Together those reforms will affect 90 percent of all
deliveries in this state. We've also increased our family planning services access
for men and women through our new Take Charge Plus program implemented this summer. The
new Medicaid state plan program expands access to family planning, sexually transmitted infection
testing and treatment to help reduce the number of Louisiana babies born to mothers with STIs,
that could cause premature birth and NICU days. As we continue to design public health
interventions, we have to let them be driven by data. That's why we partnered with a regional
university in this state to create a web-based environmental public health tracking system.
It provides data and information on various health and environmental indicators ranging
from asthma and birth outcomes to air and water quality. This website allows individuals
to track environmental and health indicators in their communities. Taking these tools one
step further, our Office of Public Health has developed a valuable and unique partnership
with our Medicaid program, merging claims and utilization data with public health
expertise. One example is what we've been doing tracking ADHD medication that I mentioned
earlier. Using innovative GIS technology and mapping tools, we've discovered that Louisiana
has high and low ADHD prescription rates within Medicaid populations, depending on geography.
We have some major hotspots in certain areas of the state, an indication that prescriptions
for ADHD medications are inconsistent and they can benefit from further discussions
on standardization of how to use those medications. And by using these tools, we can drill down
to determine which communities, schools and prescribers may be driving some of this overutilization
and then we can design specific interventions. It's a great example of how we can use our
technology to help us pinpoint where to use our resources. We've done the same thing with
our birth outcomes, pinpointing hotspots, finding neighborhoods, and then going into
those specific neighborhoods to work. We also know, everyone in here knows, that access
and provision of medical services really only contribute to 10-20 percent of overall health
and wellbeing of an individual and a community. It's our health behaviors, our personal choices,
and factors like income and employment, education, and where we live that play a much bigger
role. To unify all those efforts and give Louisiana residents a unified concept to integrate
into our culture, we devised a state-wide health initiative, called Well Ahead Louisiana.
Well Ahead builds upon the work of dedicated public health employees across the state and
empowers Louisiana residents to make healthier choices for themselves and with their communities.
With Well Ahead, our main goal is to change the cycle of poor environmental supports across
all sections with an initiative that promotes voluntarily changing without imposing new
taxes, creating new rules. This is about Louisiana's people, our leaders, our organizations, taking
actions simply because it's the right and healthy thing to do. How does Well Ahead work?
The Well Ahead program was built upon individuals, organizations, businesses, and schools making
small, sustainable improvements to make all Louisiana's spaces and places healthier places
to live and work. Within the initiative, there are three tiers of health practices deployed
in key places Louisiana residents spend much of their time. Child care centers, grade schools,
hospitals and health care facilities, local governments, restaurants, universities and
colleges and workplaces. Once designated, these environments are called Well Spots.
Well Ahead is really designed to be a road map. We want to provide resources and assistance
to those on their journey toward becoming a healthier entity, whatever that may be.
And as I've discovered, during my career in health care early on, it's all about support.
We're providing the support for entities that want to become Well Spots, and individuals
who want to be part of the Well Ahead Louisiana initiative. Health and wellness is a passion
of mine, and since you're here, I'm assuming you share that same passion. We feel our responsibility
is to instill that same passion in all of our residents, every one of us takes a responsibility
in making those changes. The wellbeing of our Louisiana residents and really the residents
of our nation depend on it and depend on you to change that trajectory. By adding just
a little more balance to the way we live our lives, we can potentially add $62 billion
to Louisiana's economic output by 2050. Making a commitment like Well Ahead can have long
lasting effects on our families and on our communities. Ultimately, good public health
policy requires that we implement wellness efforts in our communities and increase access
to resources that support healthy behaviors and environments and that's what the Well
Ahead initiative is all about. Initiatives that focus on individual and environmental
changes are the next best step we can take to make those opportunities possible. We have
to address that other 80-90 percent of those factors that affect our health care. We believe
our Well Ahead initiative is a framework that creates that change. I want to thank each one of you
for all you do every day. Changing health outcomes as you all know is a daunting challenge.
But I believe very strongly that even though we may not always agree on the solutions,
on the ways to get there, I believe strongly that if we work collaboratively, we will make
a difference, we will change those health outcomes, and when we come back and hopefully
you'll be here within the next 10 years, you will see those improved outcomes for Louisiana
and for the rest of our nation. Again, thank you for being here, welcome to Louisiana,
enjoy your time here, and please come back and visit soon, laissez les bons temps rouler,
thank you.