Christiana Care is moving toward a health care model based on quality, rather than volume.
As the name indicates, the strategy means moving away from the traditional fee for service model that is typically used in health care.
That will mean the bundling health care services. For example, a surgical procedure can be bundled to include pre and post-surgery services as well as the procedure itself.
Christiana Care is the largest health care system in Delaware and ranks 22nd in the nation in patient admissions. Patient revenue totals $2.5 billion as of 2013.
Sharon Anderson said the state’s largest health care system is embarking on the approach as a way to improve outcomes and keep patients from returning to the hospital when complications arise. Anderson serves as Senior Vice President, Quality, Patient Safety and Population Health Management; and Director, Center for Quality and Safety, Christiana Care Value Institute.
Anderson spoke last week at a breakfast briefing of Delaware Bio, a trade association represent the state’s biotech industry. The briefing featured presentations on the work of the health system.
The value approach is also part of an ambitious plan by Christiana Care to improve the overall health of the population in a state known for its high incidence of cancer, as well as chronic illnesses
Christiana Care has invested heavily in reinventing its approach to care. In essence, it involves “getting paid for keeping you out of the hospital,” Anderson said.
Anderson said Christiana Care has made progress in improving quality and patient safety. It sees the value approach as way to coordinate care and keep patients from returning to the hospital.
One success story is Bridging the Divides. Bridging the Divides helps patients with ischemic heart disease move successfully from hospital to home. This program is supported by a Health Care Innovation Award from the federal Center for Medicare and Medicaid Innovation.
Another step is Christiana Quality Partners, “a clinically integrated network of physicians, hospitals and other health providers working to improve collaboration of care, clinical quality and value,” according to the health system.
Quality Partners focuses on the Triple Aim championed by the Institute for Healthcare Improvement with better care for individuals; better health for populations, and lower health care costs.
The model aims to provide greater coordination and a proactive approach to treating chronic conditions, such as hypertension, asthma and diabetes. Quality Partners will first cover about 18,000 Christiana Care employees and their families.
Christiana Care, which has 10,000 employees, is now believed to be the largest private employer in the state.
Christiana Care Quality Partners also teamed up with Geisinger Health Plan, a part of the health care system that operates in a large portion of Pennsylvania. Geisinger has been moving to bundling of health care services as a way to control costs and improve outcomes for chronic diseases such as diabetes.
Playing a key role in the process will be technology, including the smartphone, said Christiana Care Chief Information Officer Randy Gaboriault. Sensors that send information to the smartphone and the physician will be part of the effort to build healthy population, he noted.
Another technology now being explored is using the patient monitoring technology used in intensive care in nursing homes and similar facilities.
One challenge, according to Gaboriault. Is the sheer volume of information available to physicians and patients.
Gaboriault said Delaware is ahead of many areas with the formation of the Delaware Health Information Network, which allows hospitals and many physician practices to safely move patient information back and forth without the burden of transferring paper records.
