"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Friday, July 20, 2018

One of the Greatest Transformations for Hospitals: Value-Based Care

BR:  Since 1980, the healthcare environment has been reshaping itself. Today, there are 1400 less hospitals and yet a 40 percent increase in population. In 2010, Western Maryland Health System (WMHS) could see this change and implemented a value-based care model within our system. We transitioned our workforce to shift the delivery of care away from volume-based care to value-based by moving care across the care continuum and to provide care in the most appropriate location. Value-based care is considered to be the future of healthcare with a focus on helping patients improve their health and well-being through a shift on health emphasis and resources. This care model engages healthcare providers to reduce admissions and readmissions; strengthen patient engagement; reduce variation in quality; work collaboratively with community partners; reduce utilization of the emergency department (ED) as well as observation and ancillary services while saving millions of dollars. This approach measures health outcomes against the cost of delivering those outcomes.

BR:  While implementing the value-based model at WMHS, we found that a critical component of keeping patients healthy and out of the hospital that still needed to be addressed were the social determinants of health. After a careful analysis, issues affecting the patient’s health outcome were the result of poverty, food insecurity, heart disease, chronic obstructive pulmonary disease, diabetes, access to care and substance abuse. We started to look at the whole person more carefully and the needs surrounding them.  From job opportunities to primary care “hot spot” clinics to community gardens, patients now have resources to address not only their physical health but the social triggers that may affect their health outcomes.

By building a culture of health and collaborating to address the social determinants of health, we have dramatically reduced the cost of care over the last eight years by tens of millions of dollars, improved the health status of our community in a number of areas, improved our regional health rankings in key focus areas, and truly made a difference in the lives of many of our patients and residents throughout the region.

BR: WMHS has established many safety net partnerships throughout the region with pharmacies, the local health department, social service agencies, the business community, the food bank, the Boards of Education, Chambers of Commerce, City and County governments, and our colleges and universities. By collaborating with community partners, we are working to build a culture of health and provide comprehensive care to our community and the surrounding region. Through this culture of health, WMHS has seen a decline of 27 percent in admissions, 25 percent in readmissions and 15 percent in emergency room visits through these initiatives. One such initiative is Bridges to Opportunity, this is a program that provides community leadership to bring people out of poverty. We have also implemented a focus on food insecurity throughout the community that is delivered through education around healthy eating, school exercise programs and participating in several feeding programs for children and the community at large. Through our community partners, we have gone even further by establishing seven community gardens and an orchard to ensure fresh fruits and vegetables are available in the surrounding food desert locations. To deliver accessible comprehensive care to the community, WMHS is providing primary care clinics or “hot spot” clinics in homeless shelters, churches, senior centers and even, municipal buildings. There are many health concerns facing our community, but by creating many community partnerships, we are very well positioned to address those concerns now and into the future. When delivering the value-based care model and the initiatives surrounding population health, it is necessary to respond to the needs of the community.