Alliance Community Hospital on a mission towards Clinical Transformation (1) - PowerPoint PPT Presentation

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Alliance Community Hospital on a mission towards Clinical Transformation (1)

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Innovative initiatives that made Alliance Community Hospital a step ahead towards clinical transformation by providing better care delivery to its community. For more details visit: – PowerPoint PPT presentation

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Title: Alliance Community Hospital on a mission towards Clinical Transformation (1)


1
Clinical Transformation Initiative by Alliance
Community Hospital
2
About Alliance Community Hospital
  • Alliance Community Hospital, an independent
    104-bed hospital with an attached 78-bed skilled
    nursing facility.
  • One of the largest employers in the community.
  • Does not have any risk-based contracts.

3
  • For Alliance Community Hospital, a stand-alone
    hospital in Alliance, Ohio, with no risk-based
    contracts (other than the self-insurance
    arrangement for its own employees), clinical
    transformation means creating a care coordinator
    network for patients experiencing significant
    social and economic barriers that affect their
    care, helping local employers increase primary
    care access to reduce emergency department (ED)
    use, and analyzing claims data for its own
    workforce to identify opportunities for improved
    care.

4
Key Features
  • Alliance Community Hospital started innovative
    initiatives to improve care delivery. They are
  • Health coaches
  • Expanded access
  • Data into information

5
Health coaches
  • Alliance Community Hospital started a
    health-coaching program last year using local
    university students.
  • Target was to
  • Keep people out of Emergency Department.
  • Reduce Hospital readmission.

6
  • Each university student was assigned to patient
    who is suffering from a chronic condition and
    having other challenges like low income, lack of
    food and other problem.
  • The goal is to understand the barriers of keeping
    them good in health and help them to overcome the
    challenges.

7
Expanded Access
  • A large number of employer in Alliance community
    found that their employees had high rates of ED
    visits.
  • 80 of the employees dont have primary care
    physicians.
  • Alliance community Hospital opened a onsite
    primary clinic for employees to increase access
    the primary care.

8
Data into information
  • Alliance community Hospital recently tied knot
    with VitreosHealth, a predictive prescriptive
    risk analytics company, to analyze insurance
    claims of its employees and their dependents.
  • The analysis found that about 20 of its
    employees their dependents are high risk/ high
    cost, causing 1,179 a month in healthcare costs.
  • 35 of its workers are high-risk/low-cost,
    accounting for 58 per month in expenses.

9
  • VitreosHealth also found that nearly 40
    employees are falling into Hidden Opportunity
    category.
  • Although their cost for healthcare was low last
    year but there are gaps in care. For example, a
    patient diagnosed with diabetes but no claims for
    corresponding medication.

10
  • VitreosHealths analysis on 3 years claims data
    showed that how many employees and their
    dependents moved from high-risk/low-utilizers
    to high-risk/high-utilizers during that time
    period and why they are called Hidden
    opportunity.
  • The hospital administrators planned to share
    patient centric data with the physicians, so
    that they can work with the patients proactively
    to manage their chronic illness effectively.

11
  • VitreosHealths analysis on claims data also
    showed that Alliance Community Hospital could
    save more than 850,000 or 12 of their total
    healthcare spending, if
  • The patient with chronic conditions received more
    timely care management.
  • Physicians had cost data about the drugs they
    prescribe.
  • Employees had cost information so that they could
    shop wisely for prescription medicines.

12
Course of action
  • The Alliance Community Hospital includes four
    physicians in their executive team who worked
    with hospital administrators for years.
  • According to Alliance Community Hospital
  • New analytics system or access to big data and
    all the comparative information isnt as
    important as trusting relationship.
  • Being able to decide how you are going to use the
    information and figuring out new processes is
    just as important as having the data.

13
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14
  • Source
  • Alliance Community Hospital
  • HFMA Article
  • http//www.hfma.org/Content.aspx?id25738
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