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Virginia Chamber 3rd Annual Health Care Conference June 6, 2013 Sheldon M. Retchin , MD, MSPH

Virginia Chamber 3rd Annual Health Care Conference June 6, 2013 Sheldon M. Retchin , MD, MSPH CEO, VCU Health System. Innovation is a vital competency for successful health care organizations. Value is the evolving currency in health care today

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Virginia Chamber 3rd Annual Health Care Conference June 6, 2013 Sheldon M. Retchin , MD, MSPH

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  1. Virginia Chamber 3rd Annual Health Care Conference June 6, 2013 Sheldon M. Retchin, MD, MSPH CEO, VCU Health System

  2. Innovation is a vital competency for successful health care organizations • Value is the evolving currency in health care today • Value rests at the nexus of quality and cost, and is fleeting given a dynamic and competitive market • Two VCU programs represent innovations creating value • Electronic Early Warning System (quality & safety) • Management of complex care patients (quality & cost)

  3. Early Warning System –EWS • Quickly identify changes in critically ill patients • Pulls data from the patient’s electronic record to alert providers to potential changes in the patient’s condition • Empowers the medical center’s rapid response team (RRT) to effectively triage and visit the most critically ill patients before their conditions deteriorate

  4. Early Warning System What is their resuscitation status? How are they trending? What is their EWS Score? Where is the patient? Who is the patient? Who is caring for this patient?

  5. Population Health Management …Programs targeted to a defined population that use a variety of individual, organizational, and societal interventions to improve health outcomes… Felt-Lisk, S. and Higgins, T., Exploring the Promise of Population Health Management Programs to Improve Health, Mathematica Policy Research, August 2011

  6. VCUHS “80/20” Scenario • $960 million Total Costs • 164,000 Unique Patients * *Understanding High-Cost Patients, IMS Institute for Healthcare Informatics, www.theimsinstitute.org/healthspending. Accessed April 2013.

  7. VCUHS Population Health Management Patient Stratification Process 5% of Patient Population

  8. Virginia Coordinated Care (VCC) ProgramComplex Care Program • VCC program established in 2000 to coordinate care for uninsured patients • Provides “medical homes” through partnerships with 50 community-based physicians • Care coordinators and outreach workers assist patients with case management and navigation support • Approximately 27,000 patients enrolled in FY12 • Published studies demonstrated the merits of managing care for uninsured patients • Launched the VCUHS Complex Care Clinic program in November 2011 • Medical home for patients with multiple chronic conditions

  9. Patient Experience With the Complex Care Clinic Engagement with Care Team Coordination of Care Interdisciplinary Care Improved Health Pharmacist Physician Clinical Nurse Patient Social Worker Behavioral Health Provider Nurse Care Manager

  10. Complex Care Clinic Pre- and Post-Utilization Study • Evaluated patients with at least one clinic visit between Nov. 2011 and Oct. 2012 • Cost of care for the population was reduced by approximately 49% • Inpatient utilization dropped 44% • Emergency Department use fell 38% *Includes Hospital inpatient, outpatient and ED costs

  11. Find out more: www.vcuhealth.org/annualreport

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