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PA Rural Hospital Leaders Speak at National Conference: “The Triple Aim is the right thing to do”

February 19, 2018

Rural hospital leaders from western Pennsylvania recently shared their insights and best practices for transformation and care coordination with several hundred colleagues from across the nation at the American Hospital Association’s 31st Annual Rural Healthcare Leadership Conference in Phoenix.

All four Pennsylvania speakers agreed:  Despite the lack of a clear and sustainable funding stream to cover the short-term costs, investing in population health, illness prevention, and the Triple Aim remains the right thing to do for their communities.

Leaders from Meadville Medical Center and Cole Memorial shared their efforts to focus on “value not volume” through improved care coordination and a focus on primary care.

How Meadville improves patients’ quality of life while reducing utilization

Meadville Medical Center President and CEO Philip Pandolph and Tracey Muere, Director of Community Care Network & Social Services, described their vision to engage a broader community of stakeholders in a strategy designed to reduce preventable admissions and readmissions, while improving the quality of life for hundreds of patients. The resulting program—Meadville’s Community Care Network (CCN)—is posting impressive results for participating patients, including:

  • A 38 percent reduction in hospital stays
  • A 26 percent reduction in emergency department (ED) visits

The program consists of:

  • Screening protocols to identify and recruit the “high utilizers” most likely to benefit from CNN’s intensive care coordination and health coaching
  • A patient-centered approach that starts with asking patients about their goals rather than trying to impose them on patients
  • Care coordination teams including nurses, social workers, dieticians, and other clinical professionals
  • The use of health coaches, typically undergraduate students from nearby Allegheny College, who join CCN team members on home visits and then follow up frequently to support the patient’s movement toward key goals

Supported by grants, the program is mostly funded through Meadville’s patient operations budget. Given the program’s proven results, Pandolph conveyed the program lays the foundation to explore possible shared savings contracting arrangements.

How Cole Memorial is moving from volume to value

Cole Memorial President and CEO Ed Pitchford and Immediate Past Board Chair David Crandall offered their unique perspective on the critical access hospital’s transition from “volume to value.”

This transformation actually began in the 1990s, with a decision to invest more heavily in primary care and evolve into an “ambulatory care organization.” The evolution led to a new mission statement: “Together, we optimize the health of individuals and communities.”

Cole’s community health needs assessment provided crucial information to support the identification of service priorities. The assessment also made clear that population health improvement would require extensive collaborative efforts with other stakeholders. Efforts to improve access to dental care, for example, not only improved dental health in the community but also helped reduce ED visits.

Crandall’s experience as an engineer in the aerospace industry informed his guidance around generating value. He encouraged the management team to use Toyota LEAN principles and processes to optimize operations.

As a result of these efforts, Cole Memorial improved efficiencies, took the plunge into value-based contracting with select payers, and hit performance targets.

Outcomes at Meadville and Cole Memorial show they are headed in the right direction for their patients and communities. But both CEOs commented on the up-front investments needed to launch these programs and affirmed the crucial role of capital financing to underwrite this work.

This access to capital is the stumbling block that many hospitals, especially smaller rural facilities, must navigate as they pursue the Triple Aim. Many thanks to these CEOs for their persistence on behalf of their patients and communities, and for sharing their journeys.