defining value and measuring impact - phmc...2018/10/17 · defining value and measuring impact...
TRANSCRIPT
![Page 1: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/1.jpg)
Defining Value and Measuring Impact
October 17, 2018
![Page 2: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/2.jpg)
Starting a national movement
www.nationalcomplex.care
![Page 3: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/3.jpg)
It started with one phone call…..
![Page 4: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/4.jpg)
4
Andrew Rae. “The Tangle of Coordinated Care.” New York Times. April 13, 2015.
The First Patient Story
![Page 5: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/5.jpg)
5
$1.3 million reduction in unreimbursed care
Transformation
![Page 6: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/6.jpg)
6
Patient
Innovation at all Scales
![Page 7: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/7.jpg)
Key Components•Focus on changing the system
•Intervene whether the patient engages or not
•Increase effect of existing resources
•Change root causes in the system, population, communityPatient is connected to the
appropriate intervention
Complex Care Center
![Page 8: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/8.jpg)
Data Analysis“Frequency as systems failure”
![Page 9: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/9.jpg)
Root Cause Analysis: Patient StoryMedical, Behavioral, Social and System
![Page 10: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/10.jpg)
Case ConferencingCarrying the patient story cross continuum
![Page 11: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/11.jpg)
Complex Care Map©
Plan of care linked to EMR pop-up alert
![Page 12: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/12.jpg)
12
• Policy and Process Improvements
• Interagency Relationships
Common Subpopulations
![Page 13: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/13.jpg)
What if patient population needs are greater than what one
health system or multiple systems can offer?
![Page 14: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/14.jpg)
Community CollaborativeSolving complex problems with shared resources
![Page 15: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/15.jpg)
15
Hardin, L., Kilian, A., Muller, L., Callison, K., & Olgren, M. (2016). Cross-Continuum Tool Is Associated with Reduced Utilization and Cost for Frequent High-Need Users. The Western Journal of Emergency Medicine, 18(2), 189–200. doi:10.5811/westjem.2016.11.31916
Net Revenue Reduction 42%
Direct Expense Reduction 47%
Operating Margin Increase $632k
High FrequencyPopulation
Management
Patient Economics
Outpatient Visit Reduction
19917%
Emergency VisitReduction1,498
43%
Admissions Reduction
19544%
Hospital Utilization
Outcomes –339 patients in 24 months
![Page 16: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/16.jpg)
16
Hardin, L., Kilian, A., Muller, L., Callison, K., & Olgren, M. (2016). Cross-Continuum Tool Is Associated with Reduced Utilization and Cost for Frequent High-Need Users. The Western Journal of Emergency Medicine, 18(2), 189–200. doi:10.5811/westjem.2016.11.31916
Length of Stay 41%
CAT Scans 62%
ED/Urgent Care Minutes 49%
High FrequencyPopulation
Management
Patient Utilization
Insured
16%
Primary Care Physician
15%
Patient Housing
14%
Quality Measurements
Outcomes –339 patients in 24 months
![Page 17: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/17.jpg)
The Impact of changing the system…
![Page 18: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/18.jpg)
Scale within Trinity Health
![Page 19: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/19.jpg)
Complex Care Business PlanFinancial Performance
(c) 2015 Trinity Health Michigan dba Mercy Health Saint Mary's. All Rights Reserved. No Reproduction Without Prior Authorization
Proposal
Actual Financial Performance
• Proposed investment of $3 million over 5 years• Estimated return on investment of 28% within 5 years• Targeted population of 900 patients
• Actual investment of $760,000 over 2 years• Actual return on investment of 23% over 2 years• Actual patient population exceeded 1,000
Outcomes Over a Two Year Time Period
![Page 20: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/20.jpg)
Where Could you Start?
![Page 21: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/21.jpg)
Shifting our Focus
![Page 22: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/22.jpg)
Underneath the SurfaceSocial Determinants of Health
•Housing•Transportation•Food Insecurity•Social Isolation•Legal Issues•Health Literacy/Language•Safety
System Barriers:•Access•Disorganized Services•Disconnect bw medical/social/behavioral services•Complex Health Problems – fragmented treatment silos
![Page 23: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/23.jpg)
Traumatic Life Experience
![Page 24: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/24.jpg)
![Page 25: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/25.jpg)
From the Navigator to the Advocate
![Page 26: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/26.jpg)
Where Could you Start?
![Page 27: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/27.jpg)
Complex Care Committee
![Page 28: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/28.jpg)
• Internal System Collaborative• Interprofessional• Data Review of High-Utilizers• Root Cause Analysis• Patient Intervention• Process Improvements Complex Care
Committee
![Page 29: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/29.jpg)
InteragencyCase
Conferencing
![Page 30: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/30.jpg)
• Focused on System Gaps• Interprofessional• Interagency• Root Cause Analysis• Shared Plan of Care• Patient Intervention• Process Improvements
InteragencyCase Conferencing
![Page 31: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/31.jpg)
Project Restoration
Lake County CA
![Page 32: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/32.jpg)
• Cross Sector Collaborative• Shared Metrics & Intervention• Community Root Cause
Process Improvements>50% reduction in Utilization
>60% improvement in financial performance
1.3 Million InvestmentProject Restoration
![Page 33: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/33.jpg)
Finding your Focus
![Page 34: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/34.jpg)
Asset MappingUnderstand the strengths in the organization, the possibilities for partnership and the opportunities to build something new.
Data AnalysisUnderstand the Population and the opportunity.
Co-DesignInformed by data and asset mapping – answer the question “What is the problem we are trying to solve?” Co-design the solution.
![Page 35: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/35.jpg)
Data AnalysisWho is your population?
![Page 36: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/36.jpg)
Asset MappingWhat are the resources for the population?
![Page 37: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/37.jpg)
Asset MappingWhat are the resources for Complex Patients?
Asset MappingWho are your key partners?
![Page 38: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/38.jpg)
What is the problem we’re trying to solve?
![Page 39: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/39.jpg)
Measuring Impact
![Page 40: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/40.jpg)
Top Five Strategies for the Business Case
Four Quadrant Outcomes360 Degree View
What is the Why?
Partners and Shared Data
Patient/Provider Story
![Page 41: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/41.jpg)
Cost
Utilization
Quality Improvement
Satisfaction
Four Quadrant Outcomes
![Page 42: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/42.jpg)
What is Possible….
![Page 43: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/43.jpg)
•Hardin, L., Kilian, A., & Spykerman, K. (2017). Competing health systems and complex patients: An interprofessional collaboration to improve outcomes and reduce healthcare costs. Journal of Interprofessional Education and Practice, 7, 5-10. http://jieponline.com/article/S2405-4526(16)30103-3/pdf
•Hardin L, Kilian A, Muller L, Callison K, & Olgren M. (2016). Cross-Continuum Tool is Associated with Reduced Utilization and Cost for Frequent High-Need Users. The Western Journal of Emergency Medicine, 18(2), 189–200. doi:10.5811/westjem.2016.11.31916
•Hardin L, Kilian A, & Olgren M. (2016). Perspective on Root Causes of High Utilization that Extend Beyond the Patient. Population Health Management. doi:10.1089/pop.2016.0088
•Hardin L. (2016). Restoring Dignity for Vulnerable Populations: Changing the System for Complex Patients. Health Progress, January-February, 28-32. https://www.chausa.org/docs/default-source/health-progress/restoring-dignity-for-vulnerable-populations-changing-the-system-for-complex-patients.pdf?sfvrsn=0.
![Page 44: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/44.jpg)
Putting Care at the Center 2018December 5 – 7, 2018 | Chicago, Illinoiswww.centering.care
Ai-jen PooExecutive Director, National Domestic Worker’s AllianceCo-Director, Caring Across Generations
Keynote Speaker
Tickets are on saleEarly Bird: $595 • General Admission: $695Student Rate: $350 • Student Hotspotting Current and Alumni: $250
![Page 45: Defining Value and Measuring Impact - PHMC...2018/10/17 · Defining Value and Measuring Impact October 17, 2018 Starting a national movement It started with one phone call….. 4](https://reader034.vdocuments.mx/reader034/viewer/2022042311/5ed9febc28db2d5ca249383b/html5/thumbnails/45.jpg)
Resources for Learning
•https://www.nationalcomplex.care/
•https://www.bettercareplaybook.org/