TriHealth was named a 2018 HIMSS Davies Enterprise Award recipient for leveraging the value of health information and technology to improve outcomes, as evidenced in three use case submissions below. Topics covered include strategic payment optimization that made metrics more achievable for care delivery goals, a perioperative surgical home partnership program that reduced readmissions, and an advanced quality outcome initiative that improved communications with SNFs.
TriHealth has over 200,000 covered lives in value-based contracts with over 50+ quality measures across multiple contracts. Recognizing that payer scorecards did not reflect the high level of care they believed they were providing and that the managed care team lacked data to use during negotiations to make the metrics achievable, they formed a multidisciplinary workgroup that developed a process to reconcile payer claims data and EMR data to confirm that payer data reflected improved care delivery.
TriHealth recognized that patient outcomes were being impacted due to clinical variation, lack of coordinated care and patients being disconnected from their primary care providers. To address this, they developed a perioperative surgical home program in partnership with National Perioperative Learning Collaborative. The goal was to reduce readmissions, improve patient satisfaction, reduce same-day surgical case cancellations and reduce surgical site infections.
Observing the large number of skilled nursing facilities (SNFs) and growing needs around population health management, TriHealth recognized that forming a joint effort with external, non-affiliated facilities was critical to achieving the Triple Aim. The intended outcomes of the initiative were to create a preferred provider SNF network, increase communication with SNF partners, decrease readmissions from SNFs and improve utilization of their preferred providers – demonstrating better quality outcomes and increasing their shared savings.