Legislation

Value-Based Care: Paving the Way to Health Transformation

Hospital administrator, physician and nurse collaborating

Intermountain Healthcare is a not-for-profit health system serving 24 hospitals and 215 clinics across Idaho, Utah and Nevada. When facing the transition from volume-based to value-based care, the organization knew it was time to reimagine their primary care so they could deliver high-quality outcomes and sustain costs in accordance with the new model of care. They also needed to address the displacement of patients from one provider to another—a common occurrence in shifting to new care models—and support them with appropriate clinical and financial resources.

The health system needed to implement and lead all of these changes for thousands of providers across hundreds of clinics as quickly and efficiently as possible. As eager as they were to get started, Intermountain Healthcare knew it was paramount to synchronize the transition across all levels of staff. Every facet needed to be carefully planned and deployed to avoid potential risk.

To meet these challenges, the organization conceived and designed a novel practice model, Reimagined Primary Care (RPC), to drive the transition. This model would ultimately help pave the way for their transformation and define their success once the transition was complete.

Stage 7 Success Story: Reimagining Primary Care

Intermountain Healthcare convened a team consisting of executive leadership, the enterprise initiative office and internal medicine leaders to design the RPC. Important features included creating meaningful alignment around value, building teams to drive the transition and implementing supportive workflows and technological innovations.

The team focused on the following primary development areas:

  • Panel and incentive alignment: To allow caregiver teams to focus on value, provider and patient panels—lists of patients assigned to each care team—were narrowed to only patients associated with at-risk payers. Providers were shifted from a productivity compensation plan to one with financial incentives for behaviors and outcomes.
  • Collaborating for better care: Each RPC team consisted of a provider, care guide, medical assistant, care manager, clinical documentation nurse, psychologist, psychiatrist and pharmacist support. All team members worked in order to deliver value-based care in a collaborative effort.
  • Supporting value-based care: Efforts were made to enhance workflows, technology, data and effective clinical partnerships. Workflows were optimized though daily huddles to identify, prepare and follow up on patient-centered, value-based activities; electronic huddle boards provided information on patients and actionable data for further support; and treatment pathways were facilitated with multiple clinical specialties.

Following the implementation, Intermountain Healthcare:

  • Exceeded clinical quality metrics (in comparison to control group) by 120%
  • Reduced utilization by up to 39%
  • Improved provider experience of care by 20%
  • Cut patient medical expenses by an average of 31%
  • Improved patient experience of care metrics by 3%

The program was initiated in mid-2018 with eight providers and 5,000 patients in four clinics. By the end of 2019, RPC included 45 physicians and advance practice providers in 25 clinics across the region, including both urban and rural settings, caring for approximately 50,000 patients in a fully value-aligned practice model.

The biggest takeaway for the organization was that thoughtfully and rapidly shifting to value-based care is possible in a legacy health system if there is dedication within the system and alignment with payer partners—and most importantly, when everyone involved is committed to full transformation.

Adoption Model for Analytics Maturity Stage 7 Validation

HIMSS is pleased to recognize Intermountain Healthcare for their HIMSS Adoption Model for Analytics Maturity (AMAM) Stage 7 validation.

“Intermountain Healthcare started their analytics journey in the 1950s, long before most organizations, and has been a leader in analyzing data to implement strategies to improve patient outcomes,” said James E. Gaston, FHIMSS, MBA, senior director, Healthcare Advisory Services Group, Analytics, HIMSS. “A prime example is the Intermountain Operating Model that aligns enterprise strategy with tactical daily action, which is driven by multiple tiers of KPIs and passionate desire for data-enabled insight."

“Intermountain Healthcare’s mission is to help people live the healthiest lives possible,” said Marc Harrison, MD, president and CEO, Intermountain Healthcare. “This commitment is the same no matter where, when or with whom people get care.”

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