WASHINGTON, Sept. 6, 2011 /PRNewswire/ -- In today's economic
and health care environment, hospitals face increasing urgency to
strengthen relationships with physicians. Among the concerns
are an aging population driving increased demand for health care
(and a growing Medicare population), reimbursement reductions and
changes, and physician shortages in key specialties. In this
environment, it is more critical than ever that hospitals engage
physicians to enhance health care quality while also improving
efficiency and cutting costs across all care settings.
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To achieve these goals, physician organizations at leading
systems such as Covenant Health System, a member of St. Joseph
Health System based in Orange, CA,
and Memorial Hermann Healthcare System of Houston have developed Clinical Integration
(CI) programs. These programs can serve as a bridge for
hospitals to join the Medicare Shared Savings Program after first
developing accountable care capabilities through contracts with
private payers and local employers.
In Clinical Integration programs, a network of independent
physicians collectively commits to collaborate with a hospital or
health system to delivering improvements in quality and cost of
care. Once the CI program is established, physicians in the
CI network may negotiate collectively for commercial payer
contracts and present them for antitrust review by the Federal
Trade Commission (FTC). These contracts can include
pay-for-performance components that allow both physicians and
hospitals to receive incentive payments for improved quality and
efficiency achieved via enhanced collaboration, which must be
demonstrated through compliance with recognized clinical best
practices and improved outcomes.
Both Covenant and Memorial Hermann developed their CI programs
with CRIMSON (R) physician performance technology services from The
Advisory Board Company, a global research, consulting, and
technology services firm serving a membership of more than 2,900 of
the world's leading health care organizations.
CRIMSON is a division of The Advisory Board Company that helps
hospitals and health systems advance quality goals and secure cost
savings by providing data, business intelligence, and other
services to eliminate inefficiencies in care delivery.
CRIMSON's ability to provide detailed cost and quality data
across the continuum of care -- encompassing inpatient, outpatient,
and ambulatory settings -- is a key component in many best-practice
Clinical Integration programs.
Covenant Health Partners is the Physician Hospital Organization
arm of Covenant Health System, a five-hospital system in
Lubbock, Texas. Founded in
2007, Covenant Health Partners today includes over 300
community-based physicians, half of whom are employed by Covenant
Medical Group and half of whom are independent physicians in the
community. As a CI network, the organization has entered into
several contracts and has achieved exceptional gains in clinical
performance, including reducing average length of stay by 1.1 days
and eliminating incidence of ventilator-associated pneumonia cases
for 18 months.
"Physicians have responded well to our model for engaging them
in the Clinical Integration program, especially the 'self service'
component," said Michael Camacho,
COO, Covenant Health Partners. "To be eligible for shared
savings, both employed and independent physicians are required to
log in and review their own severity-adjusted cost and quality
performance data that is benchmarked against their peers.
Last year, 80% of physicians in the program logged in to
examine their data and are a driving force toward positively
impacting patient outcomes and quality metrics."
Covenant Health Partners is currently working with CRIMSON to
address population management. John Grigson, CFO of Covenant
Health System and CEO of Covenant Health Partners stated that,
"With health care reform requiring more quality, cost efficiency,
and transparency from physicians and health care providers,
Covenant Health Partners, together with CRIMSON, is transitioning
toward using Clinical Integration as a base for population
management to produce the highest quality of care with the lowest
cost."
Memorial Hermann Physician Network, the physician group
associated with the 11-hospital Memorial Hermann Healthcare System
in Houston, received FTC review
prior to launch with favorable feedback in 2008 for a CI program
that now includes 2,400 physicians. Benchmarked against
nonparticipating physicians, CI program physicians' average lengths
of stay were 29 percent lower and complications of care were 15
percent lower during the first year of the program.
Subsequent years of the program have shown similar
performance.
"We have put a lot of effort into educating our physicians on
CRIMSON and they have come to trust the data we collect and its
reflection of their performance," said Shawn Griffin, MD, Chief Quality and Informatics
Officer for Memorial Hermann Healthcare System and Memorial Hermann
Physician Network. "Today, we dynamically track clinical
activity across care settings and achieve an unprecedented level of
coordination. Our Clinical Integration program has been one
of the critical tools that have enabled us to continue to provide
quality care while reducing the cost of delivering care to our own
employees by 9 percent."
Participating physicians who met the bonus criteria with
Memorial Hermann received their first bonus payout in fall 2010,
which has increased interest in the program from physicians who had
not previously participated.
"Covenant Health System and Memorial Hermann Healthcare System
have emerged as leaders in building an environment of trust not
just with the physicians they employ, but also with physicians at
independent practices across the continuum of care," said
Paul Roscoe, CEO, CRIMSON.
"For many hospitals, extensive employment of physicians is
not an option. In these cases, Clinical Integration presents
the most effective means for hospitals and physicians to
participate in aligned incentive models measuring quality and cost
metrics."
For more information on clinical integration services from The
Advisory Board Company, please visit the CRIMSON homepage of the
Advisory.com website. Hospital and health system executives
may register for the free Webconference, "Six lessons for building
a clinical integration program that works," with Covenant Health
Partners' Michael Camacho on
Tuesday, Sept. 27 at 1 p.m. EDT.
About Covenant Health System
Covenant Health System is a member of St. Joseph Health System,
one of the most successful not-for-profit health systems in
the United States. It was
founded in 1998 through the merger of two of Lubbock's most venerable heath care
facilities, St. Mary of the Plains Hospital and Lubbock Methodist
Hospital System.
Covenant Health System is the largest health care institution in
the region with 1,326 licensed beds, more than 5,000 employees and
a medical staff of more than 600 physicians at its cornerstone
facilities. Covenant serves a 62-county area spanning
West Texas and eastern
New Mexico, with a population in
excess of 1.2 million. Cornerstone hospitals are Covenant
Medical Center, Covenant Women's and Children's, and Covenant
Specialty Hospital. Other system hospitals are Covenant
Hospital Levelland and Covenant Hospital Plainview, along with 12
other affiliated hospitals across the region. For more
information please visit www.covenanthealth.org.
About Memorial Hermann Health System
An integrated health system, Memorial Hermann is known for
world-class clinical expertise, patient-centered care, leading edge
technology, and innovation. The system, with its exceptional
medical staff and more than 20,000 employees, serves southeast
Texas and the greater Houston community. Memorial Hermann's 11
hospitals include three hospitals in the Texas Medical Center,
including a level 1 trauma center, a hospital for children and a
rehabilitation hospital, and eight suburban hospitals. The
system also operates three heart & vascular institute
locations, the Mischer Neuroscience Institute, the Ironman Sports
Medicine Institute, an air ambulance, cancer, imaging and surgery
centers, sports medicine and rehabilitation centers, outpatient
laboratories, a wellness center, a chemical dependency treatment
center, a home health agency, a retirement community and a nursing
home. To learn more, visit www.memorialhermann.org.
About CRIMSON
CRIMSON is a national collaborative of hospitals and health
systems dedicated to strengthening hospital-physician alignment and
clinical performance. Combining business intelligence
technology with best practice implementation, CRIMSON offerings are
developed with hospitals, health systems and physicians seeking
improved alignment on key clinical, operational and strategic
goals. CRIMSON currently supports more than 440
individual hospitals, representing over 300,000 physicians.
To learn more about CRIMSON offerings, please visit the CRIMSON
homepage on our website.
About The Advisory Board Company
The Advisory Board Company is a global research, consulting, and
technology firm partnering with 125,000 leaders in 3,200
organizations across health care and higher education.
Through its innovative membership model, the firm collaborates with
executives and their teams to elevate performance and solve their
most pressing challenges. The company provides strategic
guidance, actionable insights, web-based software solutions, and
comprehensive implementation and management services. For more
information, visit the firm's new website,
http://www.advisory.com.
SOURCE The Advisory Board Company