Healthcare Matters

Edward Hospital & Health Services of Illinois is supporting care delivery for its 4,300 employees and the surrounding Naperville community using a new solution from Premier and Verisk Health that integrates payor and provider data.

With Premier’s solution, called PopulationAdvisor™, Edward Hospital can monitor clinical and financial performance across the continuum of care – an essential capability needed under the new accountable care (ACO) delivery model. The solution combines Premier’s massive comparative provider database with Verisk Health’s risk-based payor analytics enabling an unprecedented predictive picture of patient care –and total cost—throughout the entirety of the care delivery network (not just inside the hospital). And with most health systems responsible for the cost and quality of healthcare for their own employees, the solution is a double edged sword.

“Focusing on better coordinating care within our employee population will allow us to replicate what is working to improve our community’s health,” said Brent Smith, DO, MMM, vice president of clinical integration and chief medical officer at Edward Hospital, a Premier owner. “This solution bridges the gap between claims and provider data, which supports a range of clinical decisions. More informed predictions and customized decision-making means that patients will receive the most effective treatments possible for their unique needs. It also means we can keep the people in our community healthier, so they don’t become patients.”

“Edward Hospital is taking the needed steps to support their data-driven, risk-management initiatives in improving their community’s well-being. Treating sicknesses is an expensive way to do things. Enabling health and preventing illness is not only what’s best for the individual, it saves money as well,” said Keith J. Figlioli, senior vice president of healthcare informatics for Premier, which ranked 30th overall and third for healthcare companies on this year’s InformationWeek 500 list.

PopulationAdvisor has been refined to:

• Identify and manage high-risk populations – both to intervene with current high-risk, high-cost patients and model potential risk in the future;
• Discover gaps in care to improve clinical outcomes;
• Profile physician practice variation and establish best practices; and
• Maximize performance incentives and differentiate quality using HEDIS, PQRS and ACO-33 measures.

“It is essential that hospitals and health systems monitor clinical and financial performance across the continuum of care if they want to be an effective accountable care organization,” said Nathan Gunn, chief operating officer of Verisk Health. “This initiative will equip Edward Hospital with the tools necessary to understand both quality and efficiency, enabling Edward Hospital providers to more effectively support emerging care-delivery models.”

Demand management has always been a tricky bit –even for standalone acute care facilities. When you can leapfrog “old” generation demand analytics and land in a solution space that can effectively manage demand across entirely new care delivery networks, there is plenty of reason to be impressed. What we’re seeing here (and will continue to see) is all part of the promise of big data analytics. When you have a true platform in place like Premier, new solutions like these will continue to proliferate and drive all kinds of heretofore hidden values. The partnership with Verisk makes lots of sense. And there will be several others.

Source: Premier

—Tom Finn