Implementation Of High Value Health Care Practices In Community Health Centers

From the 2023 HVPA National Conference

Aiswarya Bulusu, Master of Public Health (Metro Health)

As the cost of health care in the United States continues to rise, the most common concern reported is the cost of healthcare in both insured and uninsured patients. This leads to avoiding necessary care such as prescription refills and missing doctor’s appointments causing gaps in care, decline of quality of life, and increase in health risk, especially in the medically underserved populations. In response to these challenges, community health care centers such as Metro Health are reflecting on their healthcare practices to identify opportunities and implement initiatives that improve patient care quality and safety while reducing costs.

High-value care means providing the best care possible, efficiently using available resources, and achieving optimal results for every patient. Metro Health monitors each patient by a risk stratification strategy that has been designed in accordance with the AAFP model, which assigns every patient a risk score. Patient care coordination and navigation services are allocated based on the risk scoring. By measuring the outcomes of our current practices, we improve our decision-making and achieve greater value for our patients.

The purpose of this analysis was to examine the current quality driven care methodologies that help improve the design of value-based care to provide better care for patients with a special focus on patient care safety and reduction in healthcare costs. The specific ideologies that are discussed are (i) advancing initiatives that improve health care quality and safety while reducing cost of care for patients, (ii) investigating outcomes to ensure that practice refinement maintains or improves diagnostic or therapeutic efficacy, and (iii) determination of the best methodologies to improve the value of care delivery.

Design and Improvement of Value Based Care by provision of better care to patients, improving population health, reducing the costs and clinical burnout. Practice Refinement Over the time, MH implemented efficient data management strategies which led to improvement in diagnostic and therapeutic efficiency, and improved quality of clinical measures. We track the clinical measures via a color-coded QI dashboard. Advanced Healthcare Initiatives – The percentage of population with underlying mental health concerns has spiked during the COVID-19 pandemic. Metro Health has been proactive in implementing advanced initiatives such as tele-behavioral health to provide the necessary care to patients while staying at home. Other advanced initiatives like onsite pharmacy services, prescription home delivery, and specialty services have been implemented in 2022.

Patient satisfaction scores have spiked from 4.3 to 4.8 since the implementation of home delivery of prescriptions. Tele behavioral health services have helped patients stay at home and avail themselves of the services they needed without the need to commute. Collaborative partnerships with managed care organizations on a weekly basis to prioritize the patients with chronic health conditions helped monitor and reduce the gaps in care.

Quality improvement of clinical care via data management platforms has helped log and track data in a timely and efficient manner. Metro Health implements Health Information Technology to improve patient and provider experience, advancing interoperability by protecting data and exchanging patient data safely, along with using this data to enhance value-based care. Further extension of services to pediatric care is anticipated in 2023 with the launch of a new site in the southeast quadrant of the District to better equip Metro Health for health equity services in underserved areas.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

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