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Transcript of PAC Link.final
Raising the bar in Home Health
EvergreenHealth’s journey to become a high acuity HH provider
Brent Korte, Director of Home HealthEvergreenHealthKirkland, WA
EvergreenHealth Home Health:Largest single location HH provider in the Pacific Northwest265 Clinicians129,000 visits in 2015Hospital based in Kirkland, WAHorizontal leadership structure
5 Managers each overseeing 50+ employees Model that mandates clinician inclusion and referent leadership
Our model to raise acuity and to innovate…Identify opportunity/issue
All ideas are considered from all staffClinicians and support staff solve the problem
Present problem=>Interest gauged=>SIG forms=>Innovation project begins
Why give it to the clinicians to solve? Utility: They will be doing the work Expertise: If we hire the right people, our clinicians are a pool of experts Engagement: The more they are able to lead, the higher engagement Think tank: 265 minds are better than 1
Culture of Innovation Innovation: Tech vs. Healthcare
Technology innovates to:• Change the world, to disrupt, to make $$$
Healthcare innovates to survive because..• we were told to…in 20,202 pages/11.5M words through the
regulations of the ACA Tech hears: “Do the unthinkable, break the mold and change the
world” Healthcare hears: “Do better, less $$, more ”, “oh and partner with
everyone”, and by the way “you need to compete with your new partners”.
Tech: Change is literally in the air…..Good food and flying packages Healthcare: EvergreenHealth’s plans
Shortlist of Current Innovation ProjectsPsychiatric Nursing/Occupational therapy program
Trying to get ahead of behavioral/mental health issues
COPD and CHF pathways involving telehealth and community partnerships
Value Based Purchasing Model Restructured all processes to achieve success with outcomes
HH for Same Day Joint Replacement….
Same Day Total Knee ReplacementsOutpatient TKA happening for years..but at very low rates.
As of March 2014, only 1.6% of all TKA surgeries** Few non-HMO Home Health providers have programs
Why did we decide to pursue this program? To innovate is to compete:
• Top Surgeons in Seattle metro area are performing outpatient TKA more often• Top Surgeons in Seattle metro area refer to EH…for now
How did we identify the opportunity for OTKR?Answer: The need identified us.
Surgeon #1-Top ortho MD in US, but “what is bundling?”
Visit to local 90 bed SNF, same question.
And then. Call on drive back from Surgeon #2-Help me design our OTJR Program Quotes
What is our model for OTKR?Expectations:
Prehab visit PT waiting at patient’s home daily or BID visits for next three days
Reality: Prehab visitPT waiting at patient’s home Daily or BID visits for next three days
What is our model for OTKRHow we reacted to these asks:
“We’ll figure it out” Orthopedic Special Interest Group engaged the next day
• Study best practices• Audits of Total Joints over past year• Deep dive into quality metrics affecting surgeons
Ortho “Strike Team” formed Ongoing planning with go live set for October for TKR, August for
partials and anterior hipsCultural shift to: The answer is yes, what’s the question?
Who are we competing with?Skilled Nursing Facilities
How can HH compete with Skilled Nursing? MDs care about LOS, pain/swelling/infection control, HCAHPS,
readmissions We think we can get most patients to 110-120 knee flexion within 2
weeks We are cheaper
Why does this matter to SNFs?
We are now competing for many of the same patients and Home Health’s value proposition is strong
Home Health nationwide is being asked to do provide care for highly acute patients-and the top HH providers are raising the bar
HH is provided at a lower cost
Why does this matter to Home Health?Long term care is already providing care to highly acute patients and
does it very well
Up to three hours of combine rehab daily and more equipment
MD referral trends are slow to change
Home Health may be less costly, but can’t provide the same level of care
What have we learned clinically?
Lasting change occurs at the clinician level
Hire Top Clinicians, keep them engaged and support them with education $1000 per clinician/$265K for optional CE
Communicate the ‘Why’
Leaders step back, clinicians drive the change
What have we learned financially?ROI on education investment is significant
VBP example
ROI by building upon our reputation as the top provider “We can take whatever you throw at us”
HH is seeking to become leader not just of Post Acute but within the entire continuum
Relationship between higher acuity and risk based models..Raise the bar with higher acuity, showcase quality outcomes and your organization can be…
Top referral source
Sought after partner with top end providers
Sought after partner in ACOs, CINs and other risk based contracts Quality mechanism is already in place, great outcomes follow
Questions…