One thing leads to another

By now, you, as a hospital board member, are familiar with three terms that are driving much of the transformation underway in our field: value-based care, population health management and the continuum of care. To achieve the goal of improving the quality of the services our organizations provide — and doing so efficiently — we must understand how those three concepts intersect and how strengthening one strengthens the others.

For example, a hospital might decide to identify the cohort of individuals who come to the emergency department much more frequently than the community as a whole. To manage that patient population, hospitals must better understand these so-called “high users,” who, no doubt, would benefit from receiving routine care at locations other than the ED and, in the process, reduce the cost of their care. That means not only understanding their medical issues but also the social issues that bring them back to the ED so frequently. Do they lack access to primary care? Do they lack transportation or proper nutrition or adequate housing? Do they have behavioral health issues, such as depression or substance abuse?

Obviously, addressing many of those factors is out of the wheelhouse of most hospitals and health systems. Therefore, hospitals are teaming up with others in the community, such as civic groups, social service agencies and faith-based organizations, to help meet these different needs. Hospitals also are working more closely with primary care, post-acute care and behavioral health providers to coordinate the patient experience all along the continuum. Does everybody understand a patient’s history? Is somebody in contact with the patient to make sure he or she is following treatment protocols and, when care is needed, receiving that care in the most appropriate setting?

Many of the articles in this issue of Trustee address the board’s role in seeing that its hospital is making effective connections when it comes to managing a population’s health, strengthening the care continuum and — ultimately — improving value. The cover story, for example, looks at how some hospitals are teaming up with other health systems to reap the benefits of scale while remaining independent. And Practical Matters provides a “partnership road map” for aligning with other organizations. I hope you find these, and every article in the issue, well worth the read.