Health Plan Helps Hospitals Achieve Better Grades
In the fall of 2008, Adventist was picked to join the pilot, and the hospital system agreed. JoAline Olson, vice president for clinical innovation for the Roseville, CA-based Adventist, says the coalition came at a good time for Adventist because it was in the midst of a single-minded purpose: trying to improve quality for its patients.
Adventist Health was selected as a partner "due to its strong presence in the Central Valley Market and strong commitment to quality," according to Blue Shield officials.
Specifically, the health system showed a significant investment in raising quality across the system by, among other things, implementing IT infrastructure improvements, developing sustainable "culture changes," and creating physician/RN councils at the hospital and system levels to improve communication.
The pilot involves four Adventist Hospitals: Central Valley General Hospital and Hanford Community Medical Center, both in Hanford; San Joaquin Community Hospital in Bakersfield, and the Sonora Regional Medical Center in Sonora.
The three-way partnership aims to create an environment in which hospitals are supported and motivated to dramatically improve on different levels in measurable improvements: Clinical quality, patient safety, health outcomes, and patient satisfaction.
"We've been on a quality journey for several years," says Olson. "Our goal is to have 90% in three years and get rid of the variability. It would be fair to say there is room for improvement. We aim to increase quality, decrease cost, and provide the highest valued care for purchasers, payers, and ultimately for the patients."
We'll be waiting for the final grades, but this could serve as a model for other regions as all stakeholders struggle with improving quality and reducing costs.
Note: You can sign up to receive Health Plan Insider, a free weekly e-newsletter designed to bring breaking news and analysis of important developments at health plans and other managed care organizations to your inbox.
Joe Cantlupe is a senior editor with HealthLeaders Media Online.
- MU Compliance Announcement Sparks Concern, Confusion
- New G-Codes to Pay Doctors for Broad Array of Non-Face-to-Face Care
- Scary Financial Challenges for 2014
- Telehealth Improves Patient Care in ICUs
- CMS Sets 2014 Pay Rates for Hospital Outpatient and Physician Services
- LifePoint Bolsters Presence in Michigan's Upper Peninsula
- 1 in 5 CT Screenings for Lung Cancer Results in Overdiagnosis
- States Rejecting Medicaid Expansion Forgo Billions in Federal Funds
- Douglas Hawthorne—A Chance to Do Something Big
- MGMA Urges 'End-to-End' ICD-10 Testing