Hot Topics in High-Value Health Care
A03, B03 | The Architecture of High Value Health Care national conference, co-directed by the High Value Practice Academic Alliance and the American Hospital Association, is a venue to share initiatives that improve quality, safety, experience and outcomes, while reducing total cost of care. This session will include innovative and practical projects from the 2019 conference to showcase exemplary value-improvement initiatives from different institutions. Anyone in health care interested in improving quality and affordability, including physicians, nurses, advanced practice providers, QI project managers, hospital leadership and trainees.
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Journeying from Volume to Value for Everyone C01 | How do organizations move toward population-based care for the entire spectrum of patients within their practices when reimbursement models often run counter to population-based efforts? This session will provide a real-world example of how Brigham Health Primary Care negotiates that complexity, while making the journey from individual-based reactive care to team-based proactive care. It will describe effort to create programs to support closure of gaps in care, high-risk care management, implementation of the IMPACT model for behavioral health, social determinants of health screening and management, and practice redesign in support of team-based care.
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Zen and the Art of Balanced Scorecard Maintenance
C05 | How do you build a quality improvement model that honors all stakeholders and all needs? How do you incorporate cultural transformation and Lean thinking? Payer needs? Provider needs? Patient outcomes? Revenue? Employee experience? Regulatory requirements? The perfect textbook answer is: Quality structures based on the IHI Triple Aim are emerging drivers of reimbursement. The reality is: We make mistakes. (But we learn from them, which is truly wonderful. More on that later!) This sesssion will show how success is aligning quality measures across payer contracts and within a balanced scorecard construct, allowing for a maximal return on resource investments.
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Code Green: The Economics of Acute Care Redesign
C16 | With shifting reimbursement paradigms, health care organizations must redesign care, but clinicians may not have the necessary financial information or skills. This session will demonstrate tools created to use in current reimbursement structures and in identifying gaps in payment and impact on patients’ out-of-pocket expenses. These tools assisted ACOs in reaching clinically and financially optimal outcomes, including hospital and emergency department utilization, cost of redesigned care, safety, and satisfaction.
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Reducing Readmissions Through Communication with Transitional Care Services
C17 | With the increased emphasis on value-based care and bundled payments, there is an expanding role of transitional care services and outpatient care navigation for patients who were recently hospitalized. This session will go over a readmission collaborative to improve ED communication in order to increase the rate of ED discharge. The improvement has been successfully implemented across 10 hospitals with an increase in the rate of ED discharge for patients with transitional care management after index hospitalization.
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Financial Toxicity and Health Care: An Invitation to Lead
C24 | Conversations about rising health care costs increasingly focus on the burden on patients and families. If, as Dr. Paul Batalden’s said, “Every system is perfectly designed to get the results that it gets,” how can we change the outcome? Several opportunities exist for health care organizations to effect change both at the system level and through advocacy at the policy level. Learn how organizations can address major drivers of financial toxicity among patients and employees.
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A System Quality Structure to Move to Value A17, B17 | Healthcare systems are at a crossroads. In order to sustain a viable healthcare system, it is imperative to reduce costs and improve quality. In a recent Vizient study, 81% of health system participants identified clinical variation as a barrier, due to disparate data systems and incentives. Standardization, governance and culture were identified as opportunities across the entire continuum of care. Spectrum Health became a health system more than 20 years ago, however the Quality, Safety and Experience departments remained separate. In 2018, Spectrum Health began systemness by aligning department structures and leadership in order to pivot to one standard of care. In this session, see how alignment goals were developed to engage the system in improving these metrics, with the ultimate goal to own the value equation for their consumers by lowering cost and improving quality and safety outcomes.
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Post-Acute Readmissions? Not with Your Nurse Practitioner in Charge A19, B19 | This session will provide you with strategies and initiatives to use in the post-acute setting to help lower readmissions; lower length of stay (LOS) in skilled nursing facilities (SNF); and greatly improve patient care, quality, and safety. Nurse practitioners (NPs) can play a large role in meeting your health system goals and ensuring that your outcomes are improved. Even if you are not ready to employ a nurse practitioner, we will discuss other initiatives that you can implement in your community. Examples include: developing criteria to set up preferred provider SNF networks, medication programs, nurse triage and case management/throughput solutions.This discussion will also include strategies to help you meet your health system Accountable Care Organization (ACO) and value-based contract goals to lower overall spend and cost for the patients you serve.
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IHI Alliance Driving Out Waste to Return the Money D05, E05 | This session will engage participants in a robust dialog around key drivers identified by the IHI Alliance for Reducing BIG Waste, both those achievable in the shorter-term where you work and practice, as well as through longer-ranging solutions. This session will offer attendees insights from leaders from two participating Alliance organizations, and the opportunity to learn from their local and shared IHI Alliance experiences in creating a common language, working across shared platforms, and achieving substantial cost savings while improving quality through strategic alignment and partnerships.
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Strategies to Promote High-Value Accountable Care D17, E17 | This session describes actionable tools and approaches that Accountable Care Organizations (ACOs) have developed for implementing care delivery improvements in a value-based payment environment. It will highlight: The Care Coordination Toolkit, the first in a series of publicly-available ACO Toolkits from the Centers for Medicare & Medicaid Services (CMS) that describes strategies to improve collaboration across care settings; seven case studies delving into ACO experiences developing and implementing successful initiatives to improve care delivery; and presentations and discussions from ACO-affiliated participants that engaged in more than 50 in-person meetings across the country to consider innovative solutions to pressing challenges.
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Transforming to a Safety-Net Accountable Care Organization (ACO) Using Lean D23, E23
| Cambridge Health Alliance (CHA) is a vibrant, innovative health system providing essential services to more than 140,000 patients north of Boston. When the Psychiatry Department identified barriers to care (including long wait times, extensive waitlists managed through cumbersome processes, decentralized scheduling, and low slot utilization all resulting in poor patient care), the team embarked on a 2-year Lean framework effort to streamline the referral, triage, and scheduling processes for improved access.This session will reveal how improvement methods and qualitative and quantitative analyses were implemented at an organizational level to achieve transparency, buy-in, and sustainability for a patient-centered model for equitable care across CHA.
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Coproduction Value Creation Simulation D24, E24
| Coproduction theory argues healthcare is not a product delivered to patients, but a service co-generated by the health care system and the people engaged in care. We have modified a value creation framework to develop a coproduction model for health care. The International Coproduction of Health Network launched a Community of Practice (CoP) of stakeholders to optimize the model and research a new assessment approach. We will share CoP case studies and conduct assessment simulations.
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Clinical Redesign: A Framework to Drive Value D27, E27 | The Clinical Redesign (CRD) method an innovative framework built on the Model for Improvement to drive value-focused improvement in evidence-based care delivery through rapid-cycle (90 day) projects at any size hospital or health system. CRD has evolved from a small team to a system-wide improvement engine; since April 2015, we have completed over 220 projects. Examples include reducing opioid prescriptions, removing wasteful inpatient laboratory testing, and incorporating real-time data in patient-centered clinical operations.
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Are Frequently-Admitted ED Patients in Fact MVPs? D28, E28 | Patients who frequently utilize the emergency department (ED) are among the most resource-intensive patients to manage and the most vulnerable. Our work focuses on multi-visit patients (MVPs), a more patient-centered term than super-utilizers. Multidisciplinary efforts to address medical and non-medical needs through an individualized care coordination plan reduced total ED visits, ED admissions, and 30-day readmissions. Our approach for MVPs has implications for hospital capacity while improving care for a population often left behind.
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