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Lahey Health Reexamines the Appropriate Care Model

John Commins, for HealthLeaders Media, March 12, 2014

We are introducing more specialists in Lahey community hospitals so patients don't have to migrate to Boston. They are getting procedures done in their community hospitals that they may not have been able to get before because we have sprinkled these hospitals with Lahey specialists. We really think our system is more than aspirational. In fact, it is working and we have the data to prove it.

HLM: How to you determine the appropriate care setting?

Nesto: Our community hospitals now are redirecting all of their transfers to us as opposed to Boston teaching hospitals. Because we are in constant dialogue with these hospitals, they have a better idea of what should be transferred and what should be held locally. And with the access to Lahey specialists and physicians on site they can retain more of these patients who formally where directed to tertiary care, which was a great inconvenience to the patients' families and a greater expense to the healthcare system.

There has been a 22% increase in the number of patients from Lahey primary care doctors who are admitted to Beverly Hospital who formerly would have gone to Burlington prior to the merger. That is a pretty robust increase in a community hospital census as a consequence of this merger.

The other evidence that this is working, the (Case Mix Index) of severity of illness is going up at our community hospitals, which means that sicker and sicker patients are being treated more and more locally and as long as the quality is good, which we measure through a variety of score cards, then that also means the system is working.

HLM: How do you determine what service lines you'll carry?

Nesto: The big ones we are concentrating on are neurosciences and neurosurgery, cardiovascular disease, cancer, and primary care. Now you can get a neurosurgical operation at Beverly Hospital where there was no neurosurgery before.

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