The native owned Southcentral foundation in Anchorage Alaska is responsible for the care for 55,000 enrollees. The foundation has an annual budget of $200M. It owns and manages a small hospital and has built a modern campus of outpatient clinics.
The foundation won a Malcolm Baldrige award for excellent quality of care. The foundation has also achieved startling efficiencies: ER use was reduced by 50%, hospital admissions reduced by 53% and specialty visits by 65% and visits to primary care doctors by 36%. Between 2004 and 2009, health care expenditures grew by only 7% over 5 years. Health care inflation across the US and Canada is about 10% per year.
Costs are down while quality is up. Patients can see their GP on the same day that they call. The percentage of children getting high quality care of asthma soared from 35% to 85%. Customer and employee satisfaction exceeded 90%.
Here are some of the important techniques that they used. Any healthcare system can adopt them:
1) assigning small teams of nurses and doctors, various medical, behavioural and admin assistants are responsible for groups of about 1,400 patients. Team members communicate constantly. When a patient calls, the nurse decides if a face to face meeting with the doctor is necessary. Doctors deal with only the most complicated cases.
2) integrating a wide range of data to measure outcomes and costs. Graphics on the dashboard show how well doctors and the teams are doing to improve health outcomes and cut costs compared to their colleagues, their past performance and national benchmarks.
3) Focusing on needs and convenience of the patients and not the institutions.
4) Building trust and long term relationships between patients and providers.
5) Changing from a reactive to proactive orientation to meet patient needs.
Forward thinking health systems are already cloning this success formula with similar improvements in efficiency and quality with marked reductions in cost. Fife, Scotland for example.
Hoping that this case study goes viral in Canada.