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Population Health Opportunities for the Community Hospital

Mary Mitchell. Margaret Hillenbrand. Population Health Opportunities for the Community Hospital. Tim Putnam, DHA, FACHE CEO, Margaret Mary Health Batesville, Indiana. Batesville, Indiana. Why the Move to Population Health?. 18%. Grandparents of our Population. National ACO Initiative.

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Population Health Opportunities for the Community Hospital

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  1. Mary Mitchell Margaret Hillenbrand Population Health Opportunities for the Community Hospital Tim Putnam, DHA, FACHE CEO, Margaret Mary Health Batesville, Indiana

  2. Batesville, Indiana

  3. Why the Move to Population Health? 18%

  4. Grandparents of our Population

  5. National ACO Initiative • Shared cost $150,000 annually vs. $1.5M est. to start our own. • 2,400 covered lives

  6. NRACO Consortium Cohorts

  7. What Can You Learn From Data? • Hospital A • Hospital B • Hospital C • Hospital D • Hospital E • Hospital F • Hospital G • Hospital H • Hospital I • Inpatient Admissions • Where do you rank? • PBPY = per beneficiary per year.

  8. What Can You Learn From Data?

  9. Data, Data and more Data: • $8,000 • 36% vs. 87% chance of visiting the ER • $251 vs. $6 • Correlation with urinary catheter and frequency of ER visit. Really led us to start asking different questions

  10. Care Coordination $41.92 PMPM

  11. Changes the Conversation • Council on Aging • Hospital and Foundation Board of Directors • Hospital Staff • Civic Leaders • YMCA • Local Ministers

  12. Is a 911 Call a Sentinel Event? How many 911 calls could we prevent if we had engaged with the patient when they first noticed a problem?

  13. New Questions: • Paramedicine • Opportunity with Rising Risk Population • What social support resources should we be offering?

  14. Waivers for Stark, Anti Kickback and Civil Monetary Penalties ACO participants may provide items or services to Medicare beneficiaries for free, provided that: • They are reasonably related to the beneficiary’s medical care. • Items and services are in-kind. • Are either for preventive care or advance certain clinical goals.

  15. Perspectives from: • CFO – We are not going to make money on the ACO. So, what if we do a great job at population health? • Board of Directors – “This is R&D.” • Physicians – Cautiously optimistic. …. Just don’t rock my world too much. • Community – Finally!!!!

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