CCA Featured Members: February 2013

Every month, CCA features the work and contributions to the population health industry of some of its members. This brief highlights are shared through the CCA Connect: Voice of Population Health monthly newsletter.

Using a Calendar Approach to Drive Clinical Outcomes

Over 100M Consumers on the Move. Are You Prepared?

Today’s clinical leaders are looking for ways to optimize consumer communications and drive results.

Personalized, targeted and relevant information is key to helping members make better health decisions. When communicating with individuals,  it is essential to deliver highly personalized, scalable, and dynamic interactions, in a caring and compelling manner, around topics that impact day-to-day health.

One of the strategies we recommend to meaningfully impact care is a calendar-based approach to communications. This type of planning allows clinical leaders to be a thoughtful partner in care with communications designed from the member’s point of view. A well-planned schedule of outreach maximizes the effectiveness of clinical messages and avoids overwhelming or overlapping requests for action sent to the member.

Sometimes it isn’t possible to avoid asking people to do more than one thing in the same time period. For example, when an individual has multiple gaps in care, they may be targeted by multiple communications in a short time frame. In these cases, we recommend taking extra care to identify the affected individuals and deliver highly personalized outreach with a high-touch approach.

The communications calendar typically includes a broad set of calendar-based campaigns and trigger-based outreach that occurs more frequently, such as to provide support when a new medication is first prescribed. It may also include specialized campaigns, such as a multi-channel campaign designed to support seniors across a range of Star topics.

For more on Silverlink’s approach to smarter health engagement, visit www.silverlink.com.

Long Time on the Road of Accountability

HealthPartners is among six organizations to receive a new accreditation as an Accountable Care Organization from the National Committee for Quality Assurance, a leading non-profit organization dedicated to improving health care quality.

“ACO accreditation demonstrates that HealthPartners model of care is achieving the three aims of improving health, delivering an excellent experience and lowering the cost of care,” said Beth Waterman, HealthPartners chief improvement officer.

HealthPartners has been on the road of accountability for a long time.

In 1995, HealthPartners developed the Total Cost of Care measure to bring awareness of health care costs to providers and patients, and to drive improved value for the health care dollar.

According to  the Agency for Healthcare Research and Quality (AHRQ), HealthPartners’ population-based Total Cost of Care and Total Resource Use measures provide valuable information to health plans and providers on how to make health care more affordable without sacrificing quality or experience. Health plans and providers can use cost and resource use data to identify areas where they can lower cost by improving resource use or shifting to less expensive, yet equally effective resources — for example, use of a surgery center instead of a hospital where it is medically appropriate, without negatively impacting quality. Evidence supports this idea as depicted in various studies on diabetes care, in academic medical centers, across metropolitan statistical areas and in group practices in Minnesota. These studies conclude that increased cost does not result in increased quality, while quality is not sacrificed when resource use is optimized.

A key benefit of HealthPartners’ population-based Total Cost of Care and Resource Use measures is the identification of potential overuse and underuse of health care services. For example, a primary care physician may be referring back pain patients to an orthopedic surgeon. Rather than managing the back pain in primary care, these patients may have increased specialist costs and potentially more back surgeries than would be expected for their population. Overuse of health care services has led to wide variation in health care cost and use across geographies. Studies suggest that Medicare spending would be decreased by almost 30 percent if medium and high spending geographies consumed health care services comparable to that of lower spending regions. Experts agree that reducing overuse can make care safer and more efficient.

The HealthPartners Total Cost of Care and Resource Use measures for identifying healthcare cost drivers and opportunities to address them were the first of their kind to be endorsed by the National Quality Forum (NQF).

As NQF-endorsed standards, the HealthPartners Total Cost of Care and Resource Use measures complement existing quality measures to provide a much-needed, common reference point supporting the development of accountable care organizations (ACOs) and payment reform models. Providers, insurers, government agencies, employers, consumers and other organizations can use the measures to manage costs, drive affordability and improve delivery of healthcare.

To learn more about their programs, visit www.healthpartners.com.

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