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Tenet Opens Population Health Campus

 |  By John Commins  
   June 25, 2014

Resolute Health Hospital is a test lab for population health that links all providers in Tenet Healthcare's network and the hospital on a single EMR to coordinate care.

Money talks.

 

Tess Coody-Anders
CEO at Resolute Health Hospital

With that in mind, Tenet Healthcare Corporation is shouting out its $200 million commitment to population health and value-based care with the opening this week of its 128-bed Resolute Health Hospital in New Braunfels, TX.

Resolute Health Hospital is Tenet's 79th hospital, and the 19th in Texas for the Dallas-based chain. Situated on the fast-growing I-35 corridor between San Antonio and Austin, the 365,000-square-foot Resolute Health Hospital has all the amenities that we've come to expect from newly built acute-care hospitals: all private rooms, state-of-the-art HIT, opulent decor, and a range of lucrative service lines including cardiovascular and orthopedics.

It is not so much the capital projects or the 56-acre "wellness campus" that make the Resolute Health Hospital campus so intriguing. It's the strategy behind the investment. Tenet is using Resolute Health Hospital as a test lab for population health that links all providers in the network and the hospital on a single EMR to coordinate care.

Many health systems build their population health models around anchor hospitals, a one-stop shopping strategy modeled somewhat like suburban shopping malls.

Tenet turned that model on its ear and built Resolute Health Hospital around its population health model.

Tess Coody-Anders, CEO at Resolute Health Hospital, says building the hospital was the next-to-last piece of a project on the wellness campus that was part of the design when Tenet launched the pilot nearly four years ago.

"We started with community health and population programs first. Based on what we saw with our health trends, we opened an endocrine and diabetes institute," Coody-Anders told me.

 


Resolute Health Hospital

Wellness Center to Come
"Then we opened two in different communities urgent care centers where we saw information just getting siloed off in the urgent care environment. Then we began adding primary care clinics and, of course, the 200-plus person clinical integration net. And then this week culminated in the opening of the hospital."

The 25,000-square-foot wellness center opens in September, capping the list of capital projects. I asked Coody-Anders why Tenet didn't just build the hospital first, and then build the provider networks around the hospital.

"It is absolutely the most important pole in the tent that we are building an integrated delivery system and we don't want that delivery system to be wholly dependent upon or focused on inpatient acute care revenue or services," she says.

"By beginning our relationship with the people we serve around health and wellness issues, we are able to more clearly communicate to physician partners, business partners, [and] payers, that that was our genuine focus, to move toward a population health environment where we are prepared to be paid for performance and not just what we do to you."

"So, the hospital," says Coody-Anders, "is an incredibly important part of what we are doing. But to be honest, for a while, we even looked at whether or not we needed to build a hospital."

The healthcare landscape has changed a lot in the past four years, and the incremental rollout at the Resolute Health campus gave Tenet the chance to make significant design changes in the hospital along the way.

"In the beginning there was a lot of discussion about lots of beds. We looked at the health trends and the outmigration statistics for the area and we saw that in some cases better than 60% of inpatient services out-migrated to Austin or San Antonio. We realized there was a need for additional acute care beds," she says.

Emphasis on Prevention
"Then we modeled out what we wanted to do in the way of prevention and ambulatory services [and] looked at some projections at where things could shift to the outpatient environment in the next 5-10 years. We felt that (128 beds) was a more appropriate level to open at, despite the fact that this area is growing at about 5% a year."

The hospital is designed for vertical expansion and could add as many as 200 beds.

The wellness campus is includes a fitness center, health-oriented restaurants, walking trails and an integrative medicine center, which provides complementary therapies such as nutrition counseling, fitness instruction, and lifestyle coaching. Retail shops and a women's health center will open in the fall.

Coody-Anders says Resolute Health benefits from "a fairly robust payer market."
"Our payer mix is more favorable from a traditional fee-for-service environment than our larger metropolitan neighbors, with better than 33% of our market being managed care, 33% being Medicare, [and] less than 9% Medicaid," she says.

Integrated Data
Resolute Health Hospital's first ER patient this week exemplifies how the hospital will provide care. The woman brought her medical records encrypted on a Resolute Health BeneFIT swipe card.

"As she was arriving by ambulance, because she was a patient of one of our primary care providers in the clinically integrated network and has visited our Resolute Health outpatient urgent care, we were able to pull up her medical record and see her health and medication history before she arrived," Coody-Anders says.

"We were able to swipe her smartcard upon arrival and she was instantly registered and all of the details from the ER were added to her health record. Since she was discharged, a navigator has already called her to set up an appointment to see an educator and members of our integrated care team to continue the process of getting her better and keeping her out of the ER again."

In the coming months, Resolute Health will look to build accountable care organizations with BlueCross BlueShield of Texas and some area employers that want to manage health and wellness for their employees.

How will the organization know if this experiment works?

"We are measuring at the unit level. If it's an enterprise, each of the business units has goals that are created to contribute to the enterprise-wide financial goal that we have," Coody-Anders says. "It will take some time. We are talking about five to seven years to see the kind of EBITDA diversification that comes from being engaged across the continuum."

"The early signs [indicating that] we are successful with this investment will be employer interest in working with us on this, followed by the large payers. We are also launching our own health plans for individuals and small businesses and that will definitely help us to align incentives between our members and the delivery system."

Coody-Anders sees Resolute Health's role as "the innovation lab" for one of the nation's largest for-profit hospital chains.

"We are not betting the company on what happens here," she says. "But we can treat it as a crucible for innovation and see what works and roll it out in other places."

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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