Health systems were honored for achieving better outcomes and higher patient satisfaction while keeping costs down, as rapid industry consolidation continues.
IBM Watson Health published its annual list Monday of the top 15 health systems in the country based on overall performance.
The organizations identified in the report achieved better risk-adjusted outcomes and higher patient satisfication while also keeping their average per-patient costs down, as the healthcare provider landscape adjusts to rapid merger and acquisition activity.
"The growing trend of hospital consolidation into larger, more complex health systems has yielded benefits, but it also has presented challenges to hospital administrators who must now integrate disparate data sets, acquire actionable insights and assure the health of larger communities," said Kyu Rhee, MD, MPP, vice president and chief health officer at IBM Watson Health, in a statement. "These winning health systems are demonstrating the power of aligning best practices, including utilizing data, across multiple hospitals to achieve greater efficiency while delivering a higher overall quality of care."
To conduct the study, researchers evaluated 337 health systems and 2,961 health system member hospitals, reviewing public data sets. These are the 15 systems that topped the list:
Large Health Systems
Avera Health – Sioux Falls, SD
Mayo Foundation – Rochester, MN
Mercy – Chesterfield, MO
St. Luke's Health System – Boise, ID
UCHealth – Aurora, CO
Medium Health Systems
Edward-Elmhurst Health – Naperville, IL
HealthPartners – Bloomington, MN
Mercy Health, Cincinnati – Cincinnati, OH
Parkview Health – Fort Wayne, IN
TriHealth – Cincinnati, OH
Small Health Systems
Asante – Medford, OR
Aspirus – Wausau, WI
PIH Health – Whittier, CA
ProHealth Care – Waukesha, WI
Spectrum Health Lakeland – St. Joseph, MI
If all Medicare inpatients were to receive the same level of care as those treated at these 15 health systems, more than 60,000 more lives could be saved and healthcare-associated infections would drop 10%, according to extrapolations by IBM Watson Health. The full report is available from IBM Watson Health.
By Valerie Rinkle, MPA, CHRI, Regulatory Specialist, HCPro
As the healthcare industry slowly transitions to value-based care and technology better enables that move, CMS has expanded Medicare coverage and payment for several technology-enabled services.
Expansion of these various technology benefits is important as they are key to cost reduction and the clinical management of patient cohorts using clinical teams versus traditional one-to-one clinician-patient encounters.
Terminology matters for this expansion of coverage: It is important not to make the mistake of calling these new benefits "telehealth" because telehealth has a specific statutory definition and limited benefits for Medicare that can only be expanded by Congress.
CMS has creatively and crucially recognized the importance of a variety of technologies by announcing coverage and separate payment for "technology-enabled" services that are not telehealth and, therefore, are not restricted by telehealth statutory limitations.
Until this year, Congress limited all Medicare telehealth to beneficiaries in rural areas. Now, Congress has removed both the rural and home restriction for telehealth services for home dialysis patients; beginning in July, the restrictions will also be lifted for substance use disorder (SUD) patients with or without co-existing mental health diagnoses. Congress also lifted the rural restriction completely for telehealth services for patients with acute stroke. So even classic telehealth is an expanded benefit that health systems should explore to better deliver expert stroke care as well as dialysis care to Medicare patients.
While the clinician service will be paid with these expanded benefits, it is important to note that Congress did not allow payment of the originating site fee in urban areas or for homes, so the facility originating site fee continues to be separately paid only for telehealth originating in rural locations. CMS has also finalized Medicare Advantage plans to cover telehealth without regard to the classic rural telehealth restrictions beginning in 2020.
What is exciting this year are some new technology-enabled services CMS has recognized for payment. These include:
Chronic care monitoring services such as remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), enabled by smartwatches and various applications. These are billed for the initial setup; every 30 days for the data collection and software-enabled monitoring that should be integrated with the electronic medical record; and for at least 20 minutes of clinician work per month for interactive communication with the patient and caregiver.
Clinician-to-clinician interprofessional internet consultation services, where a patient-specific case can be securely discussed for the treating clinician to obtain advice designed to inform the patient’s treatment plan. These are time-based codes and require specific documentation.
Note that patient consent to bill these services is specifically required due to patient copayments, but that should not be a barrier to consideration of these technology-enabled services, adopted specialty-by-specialty in a manner designed to expand the reach of the provider as well as reduce visits and costs associated with clinical management.
