leading transformation
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Leading Transformation. The Commonwealth Fund March 14, 2013 Steven Blumberg Senior Vice President and Executive Director AltantiCare Health Solutions. Who We Are. Southeastern New Jersey’s largest health system and largest non-casino employer Dedicated to building healthy communities - PowerPoint PPT PresentationTRANSCRIPT
Leading TransformationThe Commonwealth Fund
March 14, 2013
Steven Blumberg
Senior Vice President and Executive Director
AltantiCare Health Solutions
Who We Are• Southeastern New Jersey’s largest health system and largest non-
casino employer• Dedicated to building healthy communities• 5,000+ team members in over 70 locations
Vision:AtlantiCare builds healthy communities
Mission:We deliver health and healing to all peopleThough trusting relationships
Values:Safety, teamwork, integrity, respect and service are our values
Atlantic City
Primary Service area: 252,000 pop.Regional Service area: 440,000 pop.60 miles from Philadelphia market
75% local market share 16% outmigration in PSA
AtlantiCare Service Area
Building Partnerships & Establishing Relationships
• Current Partners– AtlantiCare Engaged Benefit – Medicare Advantage– MSSP effective Jan 1st 2013
• Prospects– Local large employers – Casinos– Commercial payors – Unions– Municipalities
Special Care CenterChronic care management focused on high-cost, high-utilization patients. Our objective is to improve quality of life, return patients to productivity, and reduce overall cost of care.
Operational for six years with 2,700 patients enrolled during that period. Most local large employers participate on a PMPM basis for primary care services.
The SCC Model
Patient-Centered Medical Home for high-risk populations with multiple chronic conditions
The Special Care Center (SCC) model includes multiple features to help reduce outcome disparities: •Culturally and linguistically matched physicians and health coaches •In-depth and culturally appropriate educational materials •Improved access •Team training on cultural competency
SCC Downstream Costs
• Medications: switching to lower cost alternatives • Testing: reducing unnecessary tests and using lower
cost settings when needed • Specialists: finding and steering patients to high-quality,
efficient alternatives (or creating them if they don’t exist) • Emergency Room: getting patients to call and getting
notified if they do get to ER • Hospital: better management to keep people out,
aggressively managing LOS, consults, and testing
SCC Barrier Reduction
• Personal health coach for each patient• Waive visit co-pays and prescription co-pays• Open Access scheduling• Same day/next day hospital discharge
appointments • Access to the care team 24 hours a day, 7 days
a week• EMR utilization with visit planning
Utilization Measures
Office ED Admissions Length Average Visits Visits of Stay Cost/Day
+43%
-15%-8%-23%-22%
Source: Milstein Fund Report, 2010 and Internal analysis
Exporting Success
• Hardwiring lessons learned from the Special Care Center
• Primary Care Network Development – Primary Care Plus (employed & affiliated)
• Development of high-value specialist network• Incentive value-based contracting with providers
and suppliers• Physician leadership development
Current Priorities
• Continuum-wide models of care • Integrated care and case management• Transitions of care programs• Integrated enterprise-wide technology platform• Medical home deployment• Analytics development
Thank You!