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Improving Quality of Care

November 6, 2015
It’s such a tall order it’s practically a paradox: How do you keep healthcare costs in check and find ways to improve quality of care at the same time? For GBMC HealthCare, it’s more like a mission and it starts with putting the patients first.

“Our approach is all about actively seeking out what needs to be done to serve and support the patient,” said Mary Ely, Executive Director of the Greater Baltimore Health Alliance (GBHA).

One minor example is the innovative way GBMC helps make sure patients are taking prescribed medications. Insurers are starting to send GBMC data about patients’ prescription fill rates and when a patient isn’t filling a prescription as directed, GBMC reaches out to the patient to discuss the barriers that are preventing the patient from getting his or her medications. This lets GBMC identify people who can’t afford their medications, allowing staff to help the patient with things like prescribing lower-cost alternatives and finding affordable prescription-coverage programs. As a result, more patients take their medicine and are less likely to end up returning to the hospital or in the ER.

Another way GBMC improves care is connecting routinely with its payer partners to review care, enhance services and share data to help make informed decisions about areas to focus. This is most evident with care management where we have been able to include payer partners in daily huddles or practice meetings to share treatment plan information and assess a patient's current and future needs,” Ely said. “We routinely meet with the various payers to review quality information to help reduce patient barriers to care.”

Another way GBMC improves care is through connecting routinely with its payer partners to share data to help make informed decisions about areas to target for improvement When you’re trying to reach new heights in quality cost-effective care, it helps to tap the resources of experts. That’s why GBMC works with some of the top names in healthcare to seek out every advantage for its patients.

Kaiser Permanente has many of its own personnel working on site to care for Kaiser patients at GBMC, a practice that has targeted efforts to reduce patient readmissions.

“Kaiser Permanente really has a true care partnership with GBMC that is designed to provide exemplary care while managing costs to the patient,” said Permanente cardiologist Dr. Catherine Campbell, who also sits on the medical board at GBMC. “It is a very strong relationship ranging from daily clinical collaborations to regular meetings on the executive level to discuss best practices and improving care.”

Healthcare Interactive, a health benefits technology firm, recently launched a new self-funded health plan called Habeo - in partnership with GBMC’s patient-centered medical homes, which are essentially one-stop shops for a person's medical care. Habeo’s integrated software platform offers GBMC’s care teams powerful tools for managing patient health and wellness programs. Patients who are members of the health plan, and participate in health screenings, wellness activities and health coaching, are eligible for lower health insurance premiums from their employers.

Cigna has established a Collaborative Accountable Care program that is working with GBMC to accelerate improvements in patient care. The program also recognizes and promotes patient-centered medical homes that secure National Committee for Quality Assurance recognition, which GBMC’s primary care practices have done.

CareFirst BlueCross BlueShield works with GBMC in connecting care teams to identify and work with high-risk patients. Physicians, nurses and other healthcare professionals review patient information and develop targeted care plans to improve and maintain a person’s health. The teams can then identify enhanced services that may be available through the patient’s insurer, such as telemedicine and complex care management.

Evergreen Health, the newest payer to the marketplace, developed a high performance network that fosters a collaborative relationship with GBMC, along with two other hospital systems and the company’s affiliated Evergreen Health Primary Care offices.

Working as partners, Evergreen Health and the providers developed core quality metrics used to monitor and target key areas for patient population improvements. "The high-performance network that Evergreen Health has developed in partnership with GBMC seems like a clear win-win,” said Evergreen Health CEO Dr. Peter Beilenson. “Improved health outcomes for many of our members and greater cost control for the hospital. We're very pleased to be involved with such an innovative approach to health care delivery.”

These efforts have helped GBMC’s patient-centered medical homes earn the highest possible rating from the National Committee for Quality Assurance — a nonprofit organization that accredits and certifies a wide range of healthcare centers.

–David Ogul, Tribune Content Solutions
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