rural health transformation from surviving to thriving
TRANSCRIPT
Rural Health TransformationFrom Surviving to Thriving
Toby Freier, PresidentNew Ulm Medical Center
2.5 million people
Rural Advantage
Strengths Challenges
- Medical Homes before the buzz
- Comm. Relationships &
support
- Employee & Physician
Engagement
-Cost Efficiency
- Patient Experience
- Quality Measures
- Specialization of healthcare
- Scale and low volume
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Defining Success - Triple Aim
Care Experience
AffordabilityHealth Outcomes
• Readmits• Core Measures• Diabetes• Cancer Screening
• Smoking• Obesity• BP• Cholesterol• Physical
Activity• Nutrition• Stress
• Pricing• Utilization• Coverage• Employers
New Ulm Medical Center Fact Sheet
• CAH w/ 25 Acute + 20 beds for Mental Health & Substance Abuse
• 50+ Physicians & Providers• Allina Health has hospital, clinic, home
medical equip, homecare, hospice, ambulance, pharmacy, eye care
• 590 employees/physicians
• $80 million revenue• 2300 admissions• 10,500 ER visits• 1900 surgeries• 100,000 clinic visits
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Recognized Performance and Value
Top 20 Rural Hospital Last 3 Years Minnesota Hospital
Association Innovation of the Year and Top Community Health
Initiative
Joint Commission Top Performer on
Key Quality MeasuresAHA NOVA Award
5 Time iVantage Top 100 Hospital
CMS 5 Star Hospital
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Value of Rural Health System
Physicians (Clinics)
Long-term care
Pharmacy
Hospice / Home care
DME
Hospital
Tertiary Care
Hospital
Rural Provider
Clinical Service Lines
Clinical Service Lines
- EHR-Telehealth- Coordinators
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Clinical Access Model
Relationships
Number of people
entrusting us with their
health
Scope of services provided to patients
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Patient Access Model
Primary Care
Urgent care
Team Model
Regional clinic
On-line care
Employer-based
Senior Care
ER / Hospitalist
Specialty Care
Local specialists
Outreach (visiting)
Telehealth
Tertiary based
Community & Hospital
based Health
Services
Clinical Access Model*Integration and Coordination Key to Achieve Triple Aim
Allina HealthPartners of AllinaNon-Allina
Health Services Breakdown
• $360 million of healthcare
• $270 million attributed to New Ulm Medical Center
• $100 Million Actual System Revenue
Primary Care Opportunity – GIS Map
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New Senior Care Model(Partnership with 10 Nursing Homes and Assisted Living)
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• Dedicated Provider Team• Partner EHR Access• Family Conferences• Urgent Care Response• Payer Partnership
Allina Health Clinical Service Lines
Aim: Allina Health’s clinical service lines (CSL) provide consistently exceptional and coordinated care across the continuum of
care and across sites of care.
Oncology - VPCI
Rehab - CKRI Neurology Mother
BabyMental Health
Cardio-Vascular
Integrative Medicine -
PGIHH
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Specialty Access - TeleHealth: Share Expertise to Neutralize
Geography• Cardiology• Stroke Neurology• Mental Health – Pediatrics• Genetic Counseling – Cancer • Pulmonology/Sleep Medicine• Palliative• Perinatology
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TeleHealth Utilization - Wow
400 patient visits in 2015
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TeleHealth Growth vs. Opportunity
20,000+ face to face specialty patient visits in 2015
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Moving Upstream in Medical Staff Recruitment
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Volume to Value for Affordability
5,000+ lives (35%+ of revenue)
Data Analytics to Drive Improvement(ER Dashboard Below)
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Data Analytics to Drive Improvement
(Diabetes D5 Dashboard Below)
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Medicare ACO Claims Cost by Patient
3084 Attributed Patients• Top 1% accounts for 19% of
spending (30% of spend within Allina)
• Top 5% accounts for 48% of spending (46% of spend within Allina)
• Top 20% accounts for 80% of spending (55% of spend within Allina)
Allina services account for 62% of overall ACO Part A expenses
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Top 10 Most Expensive Patients
Allina Non-Allina Grand Total
$3,352 $389,360 $392,712 $11,649 $316,922 $328,571
$96,081 $56,977 $153,058
$631 $146,436 $147,067
$4,374 $136,107 $140,481
$15,707 $119,850 $135,557
$11,661 $119,845 $131,506
$30,149 $95,347 $125,496
$7,702 $107,496 $115,198
$73,456 $34,295 $107,751
Allina Health Pioneer ACORural vs. Metro Variances
• 21% lower total annual cost ($1800) for Medicare PMPY in New Ulm (rural) versus Twin Cities (Metro)
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ER Admits Imaging0
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40
60
80
100
120
140
160
180
New UlmTwin Cities Metro
Network-based Health Plan
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Redefining our “H” (Critical Access Organizations for Health)
HEALTH CARE
• Prevention & Wellness
• Chronic Illness Care
• Acute Care• End of Life care
Health EquityStratification by Payer as Socioeconomic
Indicator
Registry Total Patients
# MA/Uninsured
Optimal Care Rate All Other
Payers
Optimal Care Rate MA / Uninsured
Asthma 340 93 73% 69%
Major Depression 187 58 30% 36%
Diabetes (Glycemic Control) 1202 127 67% 59%
Colorectal Cancer Screening 5529 366 76% 57%
Breast Cancer Screening 3317 232 86% 77%
New Ulm Chronic Illness Hot Spots
The Heart of New Ulm Project: A Population-
Based Approach To Preventing Heart
Disease
Positive Improvement in Outcomes Sustained!
Improvement in LDL Screening and Outcome(Zip code 56073)
2006 2007 2008 2009 2010 2011 2012 2013 20140
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
0%
10%
20%
30%
40%
50%
60%
70%
80%
Tota
l Pati
ents
% LD
L < 1
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Join us in Aggressively Pursuing the Triple Aim
Care Experience
AffordabilityHealth Outcomes
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