Transcript Participant - Illinois Hospital Association

Transforming Health Care
Delivery in a Rural Setting
February 12, 2013
Please note that the views expressed by the conference
speakers do not necessarily reflect the views of the
American Hospital Association and Health Forum.
Overview
Lori Williams,
Illinois Hospital Association
Vice President, Small & Rural Hospital Affairs
Illinois Hospital Association
• Offices in Naperville,
Springfield and
Washington, D.C., an
advocate for 200
hospitals and health
systems
• 88 are considered
Small & Rural
• 51 are Critical Access
Hospitals
4
Hospitals as Leaders in Rural
Communities
Small & Rural Hospitals in Illinois:
• Provide 65,380 direct and indirect jobs
• 1 of the top 3 employers in most rural counties
• Contribute $9.9 billion to rural economies
• Leading health care transformation
5
Meeting the Triple Aim
Adopted by the Centers for Medicare and Medicaid
(CMS), the goals of the Triple Aim are defined as:
• Improving Health Care
• Patient Experience
• Quality
• Improving Health & Wellness
• Reducing cost
6
Building Value Based Systems in rural
communities
Rural Hospitals:
• Expanding access to primary care
• Focusing on Prevention & Wellness
• Developing care coordination services
• Using technology in new ways
• Moving from inpatient to outpatient services
• Partnering with other health providers
7
Value-Based Care
Health Screening
& Assessment
Disease
Management
Stephanie McCutcheson and Associates, 2011
Health
Coaching
Compliance and
Community
Support Services
Medical Home
Better Health!
Lower Costs!
Integrated Health Advocacy Program®
Advocating for Superior Healthcare
Harry Wolin, Administrator/CEO
Mason District Hospital
Havana, Illinois
9
Integrated Health Advocacy Program®
IHAP is a disease
management program that
allows employers to reduce
their healthcare costs,
reduce future liabilities,
and maximize the health of
the highest utilizers in an
organization.
10
11
Mason District Hospital
We exist to serve the health care needs of the
community in a cost effective manner with a
constant striving for the highest quality care, to
maintain a strict standard of professional and
ethical behavior, and to always place the patient
at the center of our activities.
Service Population
Mason County
• With 14,666 people, Mason County
is the 77th most populated county
in the state of Illinois out of 102
counties.
• In 2010, the median household
income of Mason County Residents
was $42,461.
• 15.5% of Mason County residents
live in poverty.
• The median age for Mason County
residents is 44.0 years young.
• The largest Mason County
racial/ethnic groups are White
(97.5%) followed by two or more
races (0.9 %) and Hispanic (0.8%).
US Census Bureau, 2010 Census
13
Mason District Hospital is...
– 269 Employees:
• 9 active medical staff members/physicians
• 198 total physicians/allied health care providers
• 55 volunteers
– $24,068,598 Annual Budget
– 1,466 Annual Admissions
– 14,370 Annual Ambulatory Clinic Visits
– 24,338 Annual Hospital Outpatient Visits
– Serves more than 18,000 people in west-central IL
14
The Burden of Healthcare
• Healthcare is the largest component of
employee benefit costs
• 80% of healthcare dollars are used by 20% of
benefit plan participants
• The largest amount of healthcare dollars are
spent by those with multiple chronic illnesses
or about 5% of people
• This 5% spends half of the healthcare dollars
and incurs the largest claims each year
15
Anderson, G. (2010) Chronic Care: Making the Case for Ongoing Care. Robert Wood Johnson Foundation.
Anderson, G. (2010) Chronic Care: Making the Case for Ongoing Care. Robert Wood Johnson Foundation.
Anderson, G. (2010) Chronic Care: Making the Case for Ongoing Care. Robert Wood Johnson Foundation.
Unique Solution To A Growing Problem
Lowers risk
future liabilities
Reduces
Healthcare
Costs
19
Tested
Strategy
with Sustained
Outcomes
Improves
Participants’
Health
Educates and
Supports
Employees
The IHAP® “Core Team”
Primary
Advocate
Psychosocial
Advocate
Medical
Advocate
20
Primary Advocate /
Registered Nurse
Psychosocial Advocate/
Counselor, Psychologist or
Social Worker
Medical Advocate /
Medical Doctor/Mid Level
Participant and Advocate Responsibilities
• Productive
Participation
• Calendars/ Diaries
• Regular Instruments
Participant
21
Team to
Participant
• Confidentiality
• Education
• Empowerment
• Cost Effectiveness
• Documented
Progress
• Outcomes Reporting
Team to
Plan
Projected ROI
• Risk assumes the average of the minimum and
maximum potential claims liability of an
identified group of high-risk individuals
• Cost is a calculation of Company ABC’s historical
claims data (2008-2010) plus the cost for 36
months of the IHAP program (assuming 100%
participation)
Risk
Cost + IHAP Costs for 36 Months
22
=
Projected
Return on Investment
Mason District Hospital participant health
care costs 2009-2011
23
What Have We Learned
 Data supports the money saved:
• Every $1 spend saved $4
o Reinvested the money into
preventative care
 Positive Outcomes
• Decreased Absenteeism
• Self Directive Testing
• Patients feel better
24
Characteristics of IHAP® Participants
Length of employment
25
2 to 36 years
Number of current health problems
1 to 13
Current medications
2 to 17
Hours of sleep per night
3 to 12
Chronic health issues/conditions
reported by IHAP Team
14 to 27
“A focus on a small population of
intensive users could have the
potential for improving care for all.”
R. Blendon (Harvard School of Public Health),
C. Shoen (The Commonwealth Fund), et. al.; Project Hope,
The People-to-People Health Foundation, Inc., 2003
What Our Customers Are
Saying About IHAP®
“The program DOES change people’s lives
and has proven to be replicable
across teams/organizations.”
“The program is helping people and the spirit
of the program is aligned with our
values as an organization.”
“The philosophy, principles, and impact of the program make
me proud to sponsor these teams.”
27
Thank You
28
MDH LifeSteps©
McDonough District Hospital in Macomb, IL
Kenneth Boyd,
Chief Executive Officer
McDonough District Hospital
Mission Statement
The mission of McDonough
District Hospital, in partnership
with its Medical Staff, is to
provide health services with a
personal approach to care that
enhances the quality of life.
Vision Statement
To be your First Choice for First Class
Health Services
Core Values
Honesty and Integrity, Respect,
Exceptional Service, Commitment to
Excellence and Teamwork
McDonough District Hospital is...
 72 Staffed Bed General Medical Surgical Hospital
 Hospital services include: behavioral health, cancer care,
cardiopulmonary, diabetes education, home health,
hospice, dialysis, laboratory, radiology, transitional care,
food nutrition, emergency room, surgery, and wound
management.
 Outpatient rehab services include Physical Therapy,
Speech-Language Pathology, Cardiac, Pulmonary,
Industrial & Sports Rehab. Inpatient rehab services
include physical, occupational & speech therapy.
McDonough District Hospital is...
 620 Total Employees:
• 38 active medical staff members/physicians,
• 85 consulting medical staff, 48 telemed staff, 35
allied health providers for a total of 206 “providers”
on staff
• 150 active volunteers
 Annual Budget - $143M gross/$71.8M Net
 2,350 Annual Admissions
 30,000 Visits to employed physician offices & 7,300 to
our Convenient Care Clinic
 48,000 Annual Hospital Outpatient Visits
Primary & Secondary Population
Information...
The PSA has an estimated total population of 31,998 (2011) which has
the following demographic characteristics:
 Median age: 24.7 years
 Median household income: $34,990
 Racial and ethnic distribution: 88% Caucasian, 5% African American, 3%
Asian, 2% Hispanic of any race, 2% all other
The SSA has an estimated population of 16,769 (2011) which has the
following demographic characteristics:
 Median age: 44.0 years
 Median household income: $41,694
 Racial and ethnic distribution: 97% Caucasian, 1% Hispanic of any race, 2%
all other
Expanded Service Area Information
MDH has identified 68 zip codes surrounding the primary and
secondary service areas as potential growth opportunities.
Residents of this expanded service area (ESA) contribute 8% of
the hospital’s inpatient admissions and 5% of its ER visits.
 The ESA has an estimated population of 104,356 (2011) which
has the following demographic characteristics:
• Median age: 40.7
• Median household income: $41,081
• Racial and ethnic distribution: 90% Caucasian, 5% Hispanic of
any race, 4% African American, 1% all other
MDH LifeSteps© Program
Voluntary Program rolled out to McDonough District
Hospital Employees in August, 2012
Core components of MDH LifeSteps© Program:
1. Biometric Screening; Full Gamut of Laboratory Tests then 6 month
screenings thereafter
2. Online Health Risk Assessment; Software Program
 Purchased with partnership
 Identifies top risk factors of population
 Participants receive access to patient portal
3. Online health resource library, monthly newsletters and challenges, and
wellness activities
4. 3 Mayo Certified Wellness Coaches
MDH LifeSteps© Program
Summary Findings of First Cohort:
 301 Active participants
 Overall, participation rate of 53%; 65% of management staff
 98% “Very Satisfied”
 Top three modifiable risk factors; Physical activity, Weight
Management; Osteoporosis risk
 Goal: Reduction of top 3 modifiable by 30%; over three years
MDH LifeSteps© Program Incentives
 Focusing on Life Style Choices – Health Improvement –
Personal Responsibility
 Cash Incentives for:
• Annual Health Screenings
• Flu Shots
• Exercise Programs
• Wellness Challenges
• Full participation in MDH LifeSteps© program = zero
increase in employee out of pocket cost in health
premium responsibility
What’s Next...
Trial partnerships with small to medium sized employers
within MDH service area
 McDonough Telephone Cooperative: secured
 Other identified partners for approach: City of Macomb, McDonough
County (Board and employees), McDonough County YMCA.
 Allowing Business Partners reduced cost for trial as well as choice of
program components
 Analyzing Data Collection
 Development of company wellness plan specific to Business Partner’s
employee population & business model
 Opportunity to integrate MDH LifeSteps© with Business Partner’s
insurance carrier and health plan design
Questions for the Panel
Thank you!
Contact Information:
Harry Wolin,
Administrator & CEO
Mason District Hospital
[email protected]
(309) 543-8575
Kenneth Boyd,
Chief Executive Officer
McDonough District Hospital
[email protected]
(309) 833-4101
Lori Williams
V.P. Small & Rural Hospital Affairs
Illinois Hospital Association
[email protected]
(217) 541-1164