Western Maryland Health System Successfully Shifts To Value-Based Care Model
By Christine Kern, contributing writer
Successful navigation of value-based care with healthcare analytics has $1.3 million ROI
Western Maryland Health System has successfully completed the shift from a fee-for-service to a value-based care model, facilitated by implementation of a new business intelligence solution to reduce costs and improve overall healthcare quality. The Diver Platform from Dimensional Insight helped the health provider identify ways to reduce costs while concurrently improving the health of its patients.
In a post for Hospital Impact last fall, Barry Ronan, president and CEO of Western Maryland Health System, wrote a recent survey on value-based care delivery found “approximately 80 percent of U.S. hospitals are, at best, evolving toward value-based care delivery with only 3 percent fully engaged in such care delivery.”
Maryland instituted a value-based care delivery demonstration project in 2010, encompassing 10 hospitals across the state, including Ronan’s institution. By January of 2014, the new care delivery model was expanded to include all Maryland hospitals, and Ronan explained “for the last five years, WMHS has been caring for patients in the most appropriate setting whether it’s acute, pre-acute or post-acute.”
Part of the success of this transition is due to the adoption of Dimensional Insight’s new platform. Western Maryland Health System, a 205-bed hospital in Cumberland, MD which services a rural population across Maryland, West Virginia, and Pennsylvania, achieved an increase of $1.3 million in quality-based reimbursements from the Maryland Health Services Cost Review Commission (HSCRC).
Maryland was the first state to win a waiver from Medicare rules, providing flexibility to implement its own quality-based program under the HSCRC. WMHS’s health system then experienced a turnaround, moving last place out of 46 Maryland hospitals in terms of in quality-based reimbursement measures to first place in the state.
“With Maryland being the first state in the U.S. to reimburse healthcare providers according to a value-based care model, Western Maryland saw the immediate need to implement a business intelligence solution to better leverage our data and improve revenue and the overall health of our population,” said Tracey Davidson, quality manager at Western Maryland Health System.
Diver enabled the health system to create a discharge discrepancy report that compares data from multiple systems in order to highlight and resolve patient inconsistencies. Implementation of the report reduced patient mismatches from 150 to zero per month, resulting in a significant reduction of the care gap. In addition, because Western Maryland was able to reduce unnecessary patient readmissions, it was able to avoid HSCRC penalties.
“As we continue to see more healthcare organizations shift from a fee-for-service model to a value-based model, the need for an effective business intelligence solution is greater than ever,” said Fred Powers, co-founder and CEO at Dimensional Insight. “By allowing Western Maryland to showcase the value and ROI that they have experienced through our Diver solution during HIMSS16, it is our goal that similar organizations will start to realize the value of an actionable data analytics platform and the benefits it can bring to one’s healthcare facility.”