Presentation on theme: "Leading Transformation The Commonwealth Fund March 14, 2013 Steven Blumberg Senior Vice President and Executive Director AltantiCare Health Solutions."— Presentation transcript:
Leading Transformation The Commonwealth Fund March 14, 2013 Steven Blumberg Senior Vice President and Executive Director AltantiCare Health Solutions
Who We Are Southeastern New Jersey’s largest health system and largest non- casino employer Dedicated to building healthy communities 5,000+ team members in over 70 locations Vision: AtlantiCare builds healthy communities Mission: We deliver health and healing to all people Though trusting relationships Values: Safety, teamwork, integrity, respect and service are our values
Atlantic City Primary Service area: 252,000 pop. Regional Service area: 440,000 pop. 60 miles from Philadelphia market 75% local market share 16% outmigration in PSA AtlantiCare Service Area
Building Partnerships & Establishing Relationships Current Partners –AtlantiCare Engaged Benefit –Medicare Advantage –MSSP effective Jan 1 st 2013 Prospects –Local large employers – Casinos –Commercial payors –Unions –Municipalities
Special Care Center Chronic care management focused on high-cost, high-utilization patients. Our objective is to improve quality of life, return patients to productivity, and reduce overall cost of care. Operational for six years with 2,700 patients enrolled during that period. Most local large employers participate on a PMPM basis for primary care services.
The SCC Model Patient-Centered Medical Home for high-risk populations with multiple chronic conditions The Special Care Center (SCC) model includes multiple features to help reduce outcome disparities: Culturally and linguistically matched physicians and health coaches In-depth and culturally appropriate educational materials Improved access Team training on cultural competency
SCC Downstream Costs Medications: switching to lower cost alternatives Testing: reducing unnecessary tests and using lower cost settings when needed Specialists: finding and steering patients to high-quality, efficient alternatives (or creating them if they don’t exist) Emergency Room: getting patients to call and getting notified if they do get to ER Hospital: better management to keep people out, aggressively managing LOS, consults, and testing
SCC Barrier Reduction Personal health coach for each patient Waive visit co-pays and prescription co-pays Open Access scheduling Same day/next day hospital discharge appointments Access to the care team 24 hours a day, 7 days a week EMR utilization with visit planning
Utilization Measures Office ED Admissions Length Average Visits Visits of Stay Cost/Day +43% -15%-8% -23%-22% Source: Milstein Fund Report, 2010 and Internal analysis
Exporting Success Hardwiring lessons learned from the Special Care Center Primary Care Network Development – Primary Care Plus (employed & affiliated) Development of high-value specialist network Incentive value-based contracting with providers and suppliers Physician leadership development
Current Priorities Continuum-wide models of care Integrated care and case management Transitions of care programs Integrated enterprise-wide technology platform Medical home deployment Analytics development
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