Identifying alternative care and payment models that align incentives for individuals, providers, and payors (including employers) will accelerate delivery system transformation. These changes give us our greatest opportunity to positively impact population health, costs, and outcomes both in Missouri and across the country.
In partnership with the Tiger Institute, MU Health Care is positioning itself for success in a value-based system where payment is increasingly linked to outcomes and cost. We are focused on transforming the care delivery system, where most of the value is created and where most of the costs are incurred. We have five strategic initiatives that serve as foundations to executing our strategy. Together, these initiatives support quality programs and produce improved outcomes at a lower cost.
To effectively manage a defined population, it is necessary to have a way to systematically identify and track the care and health outcomes of those individuals and of the populations as a whole.
A registry provides clinicians insights into patient panels, allowing them to optimize care and identify and close gaps in care. A registry is also essential to population-based quality measurement and improvement efforts.
Using Cerner’s HealtheIntent platform and HealtheRegistries solution, our initial focus is on six chronic conditions and a number of adult and pediatric care measures.
A comprehensive care management model enables more effective management of patients within and across care settings based on patient complexity and co-morbidities.
The Care Coordination Taskforce is building on our longstanding experience with primary-care embedded nurse care managers (e.g., CMS LIGHT2 grant, MO Health Home initiative). We are also pursuing innovative partnerships to expand care coordination efforts, including payment reform models with the UM System and commercial payors.
The Tiger Institute partnership is invaluable to implementing innovative care delivery and payment reform models that position UMHS and our partners to achieve the best outcomes, experience, and value at the patient and population level, thus advancing our thought leadership position at the national level.
— Keith Mandel MD, Chief Clinical Integration Officer
Managing the health of populations requires effective and efficient communication of information as patients transition within and across settings.
When providers are armed with timely and comprehensive information during transitions, better decisions can be made and care is delivered more efficiently (e.g., less likelihood of duplicating expensive tests).
We are defining a standard information set and communication process that is simple and reliable to access by referring providers. We are exploring different health information exchange technologies to automate this process and enhance knowledge of past care provided to patients.
Measurement and Analytics
The Measurement and Analytics Taskforce is building a population health analytics infrastructure that supports clinical and financial improvement efforts within MU Health Care and among clinical integration partners. This includes identifying and prioritizing measures to facilitate quality improvement initiatives and new payment reform models. These measures encompass those needed for registries, population health scorecards, and local, regional and statewide clinical integration partnerships.
To support these efforts, we are expanding our internal data infrastructure through the Health Analytics Library (HAL), HealtheIntent, and HealtheRegistries. These tools provide the foundation for quality improvement analytics for MUHC initiatives and those involving our external clinical integration partners.
We recognize that the individual is at the center of any population health effort. When provided with information, consumer-friendly tools, and aligned incentives, individuals will help drive better care delivery, utilization, and spending.
We are piloting benefit redesign, wellness incentives, and using our existing patient portal to support University of Missouri employees’ efforts to proactively manage their health. This initiative also includes a new “narrow network” health plan option.
Join Keith Mandel MD, Chief Clinical Integration Officer – MU Health Care, at the Cerner Health Conference for his presentation entitled Leveraging Strategic Partnerships to Accelerate Value Based Transformation on November 3, 2014 at 2:15 PM.
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