Rounds: Leaders Detail Care Coordination Strategies

A dual audience, some in attendance and others online, heard senior leaders from three exemplary health systems present detailed, diverse strategies for coordinating care and aligning reimbursement Thursday at Gundersen Lutheran Health System in LaCrosse, WI.

The live event, sponsored by HealthLeaders Media, featured these speakers:

• Jeff Thompson, MD, Gunderson
• Marilu Bints, MD; Gundersen
• Deb Rislow, RN, MBA Gundersen
• Dave Moen, MD, Fairview Health Services, Minneapolis
• Marsha Vollbrecht, RN, Aurora Health Care, Milwaukee

There is no "one-size-fits-all" solution, the speakers emphasized, but it's important to begin the process of transformation now or risk being left behind as reimbursement strategies shift from fee-for-service to reimbursement based on quality and value. They each identified different tools that put the focus on value rather than volume.

 Rounds Webcast:  Coordinating Systems of Care Order today.

Aim for High-Quality, Low-Cost Care

Thompson, CEO of Gundersen, spoke about innovative programs to bring high-value care to patients regardless of their reimbursement source as a strategy to prepare for greater accountability in healthcare in the future.

For instance, Gundersen, a fully integrated system, has nonetheless created a comprehensive heart attack program that links several providers that are not part of the Gundersen network. Thompson stressed modifying metrics, such as door-to-balloon time, from using Gundersen's "front door" to the front doors of all its partners.

He also demonstrated the health system's major lead in low cost-of-care statistics, despite the fact that Gundersen's patients have as many or more risk factors than those in high-cost areas. Health IT is a major component of the integration, but dedicated peer review among physicians about quality metrics is also key to building a high-quality, low-cost system, Thompson explained.

All of this is achieved, however, not with IT or financial reward in mind, but with a culture of coordination that depends on communication across specialties and across a variety of care providers, including nurses, care coordinators, physicians, and many others.

 Rounds Webcast:  Coordinating Systems of Care Order today.

Negotiate Shared Savings Contracts

Moen spoke about building a network of providers and employer partners who share Fairview's vision for changing the way care is delivered and how it is paid for. The system has negotiated shared savings contracts with its commercial payers as a way to move toward a more accountable model.

Reduce Complications, Readmissions
Finally, Marsha Vollbrecht shared key attributes of Aurora Health Care's Acute Care for the Elderly (ACE) program as a way to reduce complications, prevent readmissions, and provide better patient care. Given that seniors often have the highest cost profile in the system, focusing on their needs and coordination of care can yield impressive results, she said.