In this issue:

The Value in Collaborating Across Departments to Transform Care
Thank You to California’s Healthcare Workers!

The Value in Collaborating Across Departments to Transform Care

In these current times, I’m reminded about the importance of bridging silos and engaging in collaborative problem-solving. It’s going to take us working across aisles, departments, organizations, and industries to tackle the challenges that lie ahead.  The recently concluded “Making the Value Connection” (MVC) Pilot Program is a promising example of how beneficial multidisciplinary collaboration can be.

MVC was developed by IHQC in partnership with Capital Link (www.caplink.org) to help safety net healthcare organizations further their understanding of the value of services they provide – looking holistically at Value (V) across quality measures (Q), service levels (S), access to care considerations (A), and costs (C).

Thanks to the generous support of the Cedars-Sinai Community Benefit Giving Office, we spent 9 months working with 5 health centers to build skills, share resources, and engage finance, quality, and operation leads in a collaborative forum.

One participating team brought multiple departments together to apply this value framework to one of their priority quality measures – Annual Wellness Visits for their Medicare patients. Their patient navigator observed that many Medicare patients were newly assigned to the health center, and most had complex medical needs. The billing representative also noted their PMPM reimbursement rates for this patient population were tied to their health center’s Risk Adjustment Factor (RAF). If the care team didn’t see these newly assigned patients and document their underlying health conditions, their risk adjustment score wouldn’t accurately reflect their assigned patient population. With this broader understanding of the problem, and by tracking metrics that demonstrate value, the team could better articulate how their efforts improved value for the organization.

• Cost/Revenues: Accurate documentation increased the RAF score, leading to 1) increased annual revenues by over $160,000; and 2) more opportunities for additional P4P dollars in 2020.
• Quality: Annual visit rates increased by >15% from the previous year;
• Service: Patients shared their appreciation of the health center’s concerted efforts to get them the healthcare they need; and
• Access: Through case management and transportation interventions, they connected patients to necessary services.

If you’re interested in hearing more about this work, join the “Prioritizing Value” virtual panel at the Annual Healthcare Symposium on Friday, April 3^rd and hear from 2 MVC pilot teams about their experiences. Registration is still open!