Case Studies

Southwest General Hospital Reduces 30-Day Readmissions by 50 Percent

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SUCCESS STORY PREMIER BUNDLED PAYMENT SOLUTIONS SOUTHWEST GENERAL HOSPITAL "Our decision making related to our bundle is impacting our readmission rate, which has been decreasing. This increases our confidence in our work and the information we get from Premier's analytics tool." Southwest General Health System joined the Bundled Payment Collaborative in November 2013 and began the Bundled Payment for Care Improvement (BPCI) program in January 2015. As a community based hospital with both employed and independent physicians, Southwest General knew they needed the appropriate people, processes and technology to tackle bundled payment. Their leadership elevated their commitment to population health both strategically and operationally — placing them in an advantageous position in the marketplace for value-based care. Solution Southwest General knew that aligning people, processes and technology would be the key to success in their bundled payment program. By choosing to pursue the Congestive Heart Failure (CHF) bundle, Southwest General knew they needed to engage primary care physicians to ensure that consults and care management concepts aligned to the hospital's bundled payment strategy. They set up a process whereby primary care physicians and specialists began receiving notifications when their patients fell in the bundle to encourage the attending physicians to seek guidance and support from the population health team. This helped the physicians with patients in the bundle understand implications and needs for care coordination. "Care coordination in a bundled payment program is now much more strategic than it is operational, because you are engaging physicians who are already focused not only on their current job but also on the patient's successful navigation through the entire continuum," says Jill Barber, executive director of population health at Southwest General. "Finding the attending physicians and walking them through the data and overall expectations is imperative." The Southwest General bundled payment team worked with physicians to help them understand the importance of discussing post-acute options with patients. Physicians now realize the importance of engaging the skilled nursing facilities (SNFs), payers and specialty pharmacists in the care of their patients when they were discharged from the hospital. Southwest General's pharmacists are focusing on the transition to post- acute care and are actively working with SNFs to verify that medication reconciliation is completed upon discharge and connections are made with clinical staff at the appropriate site of care. Pharmacists also provided additional help and counseling to patients, which builds upon initial primary care education. Success Highlight: Reduced Readmissions Within Heart Failure Bundle "As a result of achieving a positive NPRA (net payment reconciliation amount), we are able to reinvest in new ways to improve patient care. We feel it is so important to reinvest to help our patients." Jill Barber Executive director of population health Southwest General 15% reduction in 30-day readmissions CHF BUNDLED PATIENTS 1 17% reduction in 90-day readmissions CHF BUNDLED PATIENTS 1

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