Rural Health TransformationFrom Surviving to Thriving

Toby Freier, PresidentNew Ulm Medical Center

2.5 million people

Rural Advantage

Strengths Challenges

- Medical Homes before the buzz

- Comm. Relationships &

support

- Employee & Physician

Engagement

-Cost Efficiency

- Patient Experience

- Quality Measures

- Specialization of healthcare

- Scale and low volume

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Defining Success - Triple Aim

Care Experience

AffordabilityHealth Outcomes

• Readmits• Core Measures• Diabetes• Cancer Screening

• Smoking• Obesity• BP• Cholesterol• Physical

Activity• Nutrition• Stress

• Pricing• Utilization• Coverage• Employers

New Ulm Medical Center Fact Sheet

• CAH w/ 25 Acute + 20 beds for Mental Health & Substance Abuse

• 50+ Physicians & Providers• Allina Health has hospital, clinic, home

medical equip, homecare, hospice, ambulance, pharmacy, eye care

• 590 employees/physicians

• $80 million revenue• 2300 admissions• 10,500 ER visits• 1900 surgeries• 100,000 clinic visits

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Recognized Performance and Value

Top 20 Rural Hospital Last 3 Years Minnesota Hospital

Association Innovation of the Year and Top Community Health

Initiative

Joint Commission Top Performer on

Key Quality MeasuresAHA NOVA Award

5 Time iVantage Top 100 Hospital

CMS 5 Star Hospital

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Value of Rural Health System

Physicians (Clinics)

Long-term care

Pharmacy

Hospice / Home care

DME

Hospital

Tertiary Care

Hospital

Rural Provider

Clinical Service Lines

Clinical Service Lines

- EHR-Telehealth- Coordinators

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Clinical Access Model

Relationships

Number of people

entrusting us with their

health

Scope of services provided to patients

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Patient Access Model

Primary Care

Urgent care

Team Model

Regional clinic

On-line care

Employer-based

Senior Care

ER / Hospitalist

Specialty Care

Local specialists

Outreach (visiting)

Telehealth

Tertiary based

Community & Hospital

based Health

Services

Clinical Access Model*Integration and Coordination Key to Achieve Triple Aim

Allina HealthPartners of AllinaNon-Allina

Health Services Breakdown

• $360 million of healthcare

• $270 million attributed to New Ulm Medical Center

• $100 Million Actual System Revenue

Primary Care Opportunity – GIS Map

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New Senior Care Model(Partnership with 10 Nursing Homes and Assisted Living)

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• Dedicated Provider Team• Partner EHR Access• Family Conferences• Urgent Care Response• Payer Partnership

Allina Health Clinical Service Lines

Aim: Allina Health’s clinical service lines (CSL) provide consistently exceptional and coordinated care across the continuum of

care and across sites of care.

Oncology - VPCI

Rehab - CKRI Neurology Mother

BabyMental Health

Cardio-Vascular

Integrative Medicine -

PGIHH

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Specialty Access - TeleHealth: Share Expertise to Neutralize

Geography• Cardiology• Stroke Neurology• Mental Health – Pediatrics• Genetic Counseling – Cancer • Pulmonology/Sleep Medicine• Palliative• Perinatology

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TeleHealth Utilization - Wow

400 patient visits in 2015

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TeleHealth Growth vs. Opportunity

20,000+ face to face specialty patient visits in 2015

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Moving Upstream in Medical Staff Recruitment

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Volume to Value for Affordability

5,000+ lives (35%+ of revenue)

Data Analytics to Drive Improvement(ER Dashboard Below)

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Data Analytics to Drive Improvement

(Diabetes D5 Dashboard Below)

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Medicare ACO Claims Cost by Patient

3084 Attributed Patients• Top 1% accounts for 19% of

spending (30% of spend within Allina)

• Top 5% accounts for 48% of spending (46% of spend within Allina)

• Top 20% accounts for 80% of spending (55% of spend within Allina)

Allina services account for 62% of overall ACO Part A expenses

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Top 10 Most Expensive Patients

Allina Non-Allina Grand Total

$3,352 $389,360 $392,712 $11,649 $316,922 $328,571

$96,081 $56,977 $153,058

$631 $146,436 $147,067

$4,374 $136,107 $140,481

$15,707 $119,850 $135,557

$11,661 $119,845 $131,506

$30,149 $95,347 $125,496

$7,702 $107,496 $115,198

$73,456 $34,295 $107,751

Allina Health Pioneer ACORural vs. Metro Variances

• 21% lower total annual cost ($1800) for Medicare PMPY in New Ulm (rural) versus Twin Cities (Metro)

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ER Admits Imaging0

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40

60

80

100

120

140

160

180

New UlmTwin Cities Metro

Network-based Health Plan

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Redefining our “H” (Critical Access Organizations for Health)

HEALTH CARE

• Prevention & Wellness

• Chronic Illness Care

• Acute Care• End of Life care

Health EquityStratification by Payer as Socioeconomic

Indicator

Registry Total Patients

# MA/Uninsured

Optimal Care Rate All Other

Payers

Optimal Care Rate MA / Uninsured

Asthma 340 93 73% 69%

Major Depression 187 58 30% 36%

Diabetes (Glycemic Control) 1202 127 67% 59%

Colorectal Cancer Screening 5529 366 76% 57%

Breast Cancer Screening 3317 232 86% 77%

New Ulm Chronic Illness Hot Spots

The Heart of New Ulm Project: A Population-

Based Approach To Preventing Heart

Disease

Positive Improvement in Outcomes Sustained!

Improvement in LDL Screening and Outcome(Zip code 56073)

2006 2007 2008 2009 2010 2011 2012 2013 20140

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

0%

10%

20%

30%

40%

50%

60%

70%

80%

Tota

l Pati

ents

% LD

L < 1

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Join us in Aggressively Pursuing the Triple Aim

Care Experience

AffordabilityHealth Outcomes

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Thank you!

Toby.Freier@allina.com507-217-5108