Population and Public Health
Michael Zaroukian, MD, PhD, talks about his unique connection to the Flint water crisis, how population health, analytics and EHR data played roles in its discovery, and what health IT should take away from one popular hypothesis of the incident.
Todd Dunn, Director of Innovation at Intermountain Healthcare, talks about healthcare innovation and leadership.
Barely a year after announcing its ambitious plan to tie reimbursement to quality of care, the U.S. Department of Health and Human Services announced Thursday that 30 percent of Medicare payments are now tied to alternative payment models, such as ACOs.
(SPONSORED) We've been hearing about the major changes coming with the introduction of value-based care, yet statistics indicate that many organizations only have a toe in the water.
(SPONSORED) From a provider perspective, analytics, interoperability and value-based care are critically important, especially in relation to population management, care plans for patients and reduced readmissions.
LAS VEGAS -- When Inova Health saw that Affordable Care Act initiatives for value-based care would cut 7 percent, or $220 million, out of the $3 billion health system’s successful fee-for-service revenues, the northern Virginia provider knew it needed to change, said President and COO Mark Stauder.
“Thinking through our strategic plan, we are a fee-for-service community of chiefly independent private practicing physicians,” Stauder said during HIMSS16. “We were a great fee for service; we needed a new revenue source.”
The result was a partnership with Aetna and the creation of a new health plan called Innovation Health.
[Also: See photos from Day 1 of HIMSS16]
From 2012 to 2014, the partnership has realized an 8-20 percent cost reduction per employer; 17 percent reduction in the number of unnecessary hospital days after surgery; 15 percent fewer hospital admissions; and 21 percent fewer hospital readmissions, Stauder said.
Despite the success Stauder said he feels the health system is still in “Population Health 101.”
“This is a difficult journey that’s going to take us another five years or more to get good at it,” Stauder said.
The strategic plan through 2020 focuses on population health, individualized wellness and the aggressive pursuit of personalized medicine, Stauder said.
In 2012, the health system had no risk. Today it’s 50 percent.
There are 90,000 commercial risk patients and the system purchased a Medicaid health plan from Amerigroup of 60,000 members.
“We wanted to build critical mass with covered lives and build a shared savings construct,” Stauder said. “We’re in a market with many commercial payers. We needed to broaden market share.”
The goal by 2020 is to have a million covered lives.
Aetna provides health plan administration; claims and customer service; analytics; technology and care management programs.
Inova provides a nationally recognized healthcare system, and more member management at the primary care level of chronic conditions and lower unit costs.
Innovation Health began in September 2013 and has grown to 180,000 members.
The health system’s narrow network is supplemented by the national Aetna network, he said.
“It’s about empowering the physician providers,” Stauder said, emphasizing the need to get their cooperation.
Care coordinators steer members towards appropriate programs and there are alerts given if any members are in network hospitals, he said.
For post-acute care, there are transitional programs; post-discharge community placement; and medical home for 30 days for high risk for readmission patients. The system is currently building out an advanced illness model to include home-based physician visits and EPIC community based visits.
Analytics and IT tools include using, a fully integrated EMR through EPIC, a MyChart portable EMR patient engagement driver, telemedicine; analytics for risk stratification and predictive data analytics for clinical quality.
The Aetna platform also interfaces with Epic.
Twitter: @SusanJMorse
This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.
One success story is the Colorado Rural Health Center partnered with Cyberscience Corp. to speed up processes, a move that has saved time and money.
The new software combines analytics, patient outreach, telehealth and administrative tools to help providers adjust to new reimbursement reality with a 'lifecycle' approach to value-based care.
CHIME touts OpenNotes partnership, early success of National Patient ID Challenge; opening keynoter talks challenges and opportunities of patient-generated data.
Providers range from linking some payments to the effective management of a population to full population-based management.