MaineHealth Responsible Care Group is a community of 10 hospitals, 378 teach locations and 1,600 healthcare services devoted to measurably increasing the everyday and reducing the fee of be pleased 380,000 patients in Maine and northern Original Hampshire.
MaineHealth’s coverage space has one in every of the highest emergency department utilization rates within the nation. So the ACO launched the REDUCE initiative: Cutting again ED Utilization: A Collaborative Endeavor). MaineHealth’s academic tools support patients with valid-time decision-making, guiding them to the ideal care at the ideal location. Predictive analytics and an venture clinical recordsdata warehouse proactively title at-menace patients, and support understand the root causes of their utilization.
Kicking issues off
Jennifer Moore, president of MHACO, and her colleague Ashley Soule, senior program supervisor, ACO performance, discussed these efforts in a HIMSS20 Digital academic session, Tackling ED Utilization with Predictive Analytics.
“Most of the utter is terribly rural, which ends in elevated emergency department utilization,” Moore explained. “As we checked out our recordsdata, that’s what with out a doubt became apparent. For our Medicare Shared Savings Program, our ED price per thousand relative to other ACOs was as soon as greatly elevated. And we inventory out reasonably wisely on utilization normally. So this was as soon as a valid standout for us. We had been round 775 visits per thousand, when compared to other ACOs wisely below 700. So we knew we had loads to tackle in ED.”
“We had been round 775 visits per thousand, when compared to other ACOs wisely below 700. So we knew we had loads to tackle in ED.”
Jennifer Moore, MaineHealth Responsible Care Group
MaineHealth also saw in its recordsdata that major care visits had been virtually 10% below other ACOs.
“So we would have correct stopped there and acknowledged, ‘Smartly, that’s an remark and we are able to also very wisely be in a draw to take care of out something about it,’ nevertheless we knew there was as soon as potentially extra to the story,” Moore eminent. “But these two recordsdata facets had been with out a doubt what helped us title ED as an space to pay attention to for the ACO.”
Going to the committee
When it came to wrapping their fingers around the distress of ED utilization, namely avoidable ED, MaineHealth workers knew they wanted very focused recommendations and tactics.
“We had to have very specific and wisely-outlined tactics, and colorful that, we leveraged our price oversight committee,” Soule explained.
“The committee is a team of physician and administrative leaders who come collectively on a monthly basis to: prioritize our targets and initiatives; personal and visual show unit our performance; leverage collective enter to title and spread recommendations and tactics; and, lastly and in actual fact no longer least, affect native accountability, and that with out a doubt plan working with native management to adapt and cascade recommendations within the neighborhood.”
Staff knew after they had the full correct recordsdata in hand, and introduced that recordsdata to the cost oversight committee. They made certain they had buy-in and engagement from physician and administrative leaders across the community upfront.
Lovely care, correct time, correct location
“It was as soon as clear this with out a doubt wanted to be a heart of attention space, and we wanted to put collectively a technique and tactics,” Soule acknowledged. “And finally, the cost oversight committee in actual fact agreed, and stumbled on it worthwhile to scrutinize at the solutions. And at the tip of the day, they knew it was as soon as the ideal thing to take care of out. Getting the ideal care at the ideal time at the ideal location for our patients, and this was as soon as correct the ideal thing to pay attention to.”
Moore and Soule dig deep into predictive analytics and their avoidable ED utilization mission within the HIMSS20 Digital academic session. To relieve the session, click on right here.
Twitter: @SiwickiHealthIT
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