Academic journal article Frontiers of Health Services Management

Population Health Management: The Intersection of Concept and Reality

Academic journal article Frontiers of Health Services Management

Population Health Management: The Intersection of Concept and Reality

Article excerpt

The FEATURE ARTICLES in this issue of Frontiers offer different philosophies and approaches to meeting the Triple Aim of the Institute for Healthcare Improvement. Zenty, Bieber, and Hammack document a local and granular means of creating targeted accountable care organizations (ACOs) to make Triple Aim inroads toward ensuring the health of the discrete populations. Their "build on success" approach offers practical insights on developing mission, governance, and analytics to guide the creation of clinically oriented population health programs, in contrast to the "total population health" ambitions of Kindig and Isham.

Over the past five years, Saint Francis Care has been working on many of the same issues and initiatives mentioned in both of the feature articles, from population health management to clinical integration to aligning clinical and social services to developing accountable care models for several payers, including our own hospital, Medicare, and private insurers. Along the way, we have encountered the intersection of concept and reality and forged a path forward.

Saint Francis Care

Saint Francis Care, an integrated healthcare delivery system in central Connecticut, is the largest independent Catholic healthcare provider in New England. Our services cover the spectrum of patient needs, including community-based preventive and primary care, specialty care, high-acuity tertiary care, and postacute care. Many of these services are provided through partnerships, affiliations, and relationships developed with other exceptional providers. Overall, Saint Francis Care provides access to almost 900 affiliated physicians, three hospital campuses, 12 satellite medical offices, and a variety of community clinics.

With 617 licensed beds and 65 bassinets, the flagship of Saint Francis Care is Saint Francis Hospital and Medical Center in Hartford. The hospital expanded in 2011 with the addition of the ten-story John T. O'Connell Tower, featuring a state-of-theart surgical pavilion, dedicated space for the Connecticut Joint Replacement Institute (CJRI), and an expanded emergency department (ED) with 70 treatment areas and a rooftop helipad for the LI F ESTAR helicopter. In addition to CJRI, Saint Francis offers centers of excellence in cancer care, heart and vascular disease services, rehabilitation medicine, and women and infants' services. Indeed, Saint Francis opened its 24,500-square-foot Comprehensive Women's Health Center in November 2013, a site that combines breast health, heart health, gynecologic care, and integrative medicine services for women.

Our integrated healthcare delivery system also includes the Mount Sinai Rehabilitation Hospital, Connecticut's only free-standing acute care rehabilitation hospital, which shares space on campus with our Mandell Center for Multiple Sclerosis. In addition, Johnson Memorial Medical Center signed an affiliation agreement with Saint Francis in 2012. The central structure for our ACO is Saint Francis Healthcare Partners, a 50:50 physicianhospital partnership that provides clinical integration and comprehensive administrative support to 700 physicians in more than 200 practices.

A Vision for Value

While we have outstanding facilities, we have long recognized that a well-articulated strategy and aligned providers-not bricks and mortar-are the foundation for advancing healthcare delivery. Back in 2009, Saint Francis Care embarked on a unique strategic planning process with an eye toward shaping an organization that would be well positioned to thrive in a changing and uncertain healthcare environment. The core working group was small but represented a diverse mix of administrators, physicians, and board members. The Innovator's Prescription: A Disruptive Solution for Healthcare, by Christensen, Grossman, and Hwang (2008), was assigned reading for this group.

From this work, we generated a compelling vision: BestCare for a Lifetime. The focus was on delivering value for patients across the continuum of care. …

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