Quality collaborations

CLINICAL & NETWORK SERVICES EMERGES AS CATALYST FOR ASCENSION’S MISSION-INSPIRED TRANSFORMATION

Clinical & Network Services (CNS) was formed last year to bring together Ascension’s clinical and physician enterprises, clinical quality function, managed care services, and Ascension Insurance to further Ascension’s Mission-inspired Transformation.

Aligning these four vital areas, with a focus on quality, has provided the unique opportunity for Ascension to operate in a manner that transforms healthcare and proactively addresses the holistic needs of those Ascension serves.

“We are excited about the new opportunities this integration has brought, as we seek to be the healthcare provider of choice for our patients and for those clinicians and associates who are called to serve our Mission,” said Joseph Cacchione, MD, FACC, Executive Vice President, Clinical & Network Services, Ascension.

Since the integration, the CNS team has been collaborating with many areas across Ascension and leading a variety of critical initiatives. Among them is the Mission-inspired Transformation initiative Redesigning the Front Door to the Health System. This effort centers on care that is provided where it is needed — in the home, while on the go, or in our sites of care — and when consumers want it — in person, or on demand through digital access to information and services.

As part of this work, more than 5,000 consumers have registered for Ascension Online Care, a new access point for patients in need of virtual, on-demand care for minor illnesses and ailments in all Ascension markets and now all 50 states. More than 2,500 virtual visits were conducted last year.

CNS is also driving the development of innovative care delivery models, including the opening of two chronic care clinics in Jacksonville, Florida, and Indianapolis. These clinics utilize appropriate services and a unique staffing model to focus on better, more convenient coordination of care for persons with extra needs and multiple chronic conditions. This model gives clinicians and care teams additional time to spend with patients who need more focused attention in order to produce the best outcomes and patient experience. This clinic model will be expanded across Ascension in the future.

CNS INTRODUCES TOTAL QUALITY CARE

Across Ascension, quality remains a top priority and a focus that continues to celebrate tremendous success. Exceptional quality is core to our Mission and our promise to provide compassionate, personalized care to all whom we serve.

To make quality a key differentiator for Ascension, work is underway to expand our definition of quality to encompass the whole person.

“As Ascension has adopted a holistic, person-centered approach for the future, quality is more than a single metric,” said Richard Fogel, MD, Senior Vice President and Chief Clinical Officer, Clinical & Network Services, Ascension. “While excellent performance on the various quality measures identified by CMS and many national health plans is important, these measures are insufficient to create optimal health for individuals.”

Growing new lives under care through strategic purchaser contracting is another important goal in fiscal year 2020. One way CNS is achieving this is through a value-based strategy in which eight Ascension Ministry Markets are participating in the Centers for Medicare & Medicaid Services’ (CMS) Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model program. This strategy includes developing 16 clinical bundles focused on pre- and post-acute care. This work fosters the redesign of person-centered care to better coordinate care across the continuum, improve quality of care and reduce costs.

Ascension Complete, a Medicare Advantage plan, also was launched last year. The plan is being piloted in three markets — Illinois, Florida and Kansas — and seeks to improve the health of 2,000 members in its first year.

Other key priorities for CNS include strengthening Ascension’s clinical community by recruiting top talent and enhancing clinician well-being and engagement.

CNS INTRODUCES TOTAL QUALITY CARE

Using the experience of Ascension’s engaged clinicians, CNS is redefining holistic care for each disease and prevention category to provide Total Quality Care. Ascension’s Total Quality Care model entails refined processes to deliver each element of person-centered, complete care across the continuum. This transformative process involves not only clinicians, but every staff member, as well as the patient and family. It is supported by advanced analytics and electronic accelerators intended to improve performance.

An example of Total Quality Care can be found in the treatment of chronic diseases, such as diabetes. Traditionally, diabetic care quality is assessed via a singular arbitrary target of HgbA1c. In Ascension’s move to Total Quality Care, diabetes will be assessed with a comprehensive panel of eight evidence-based measures selected by Ascension physicians including not only HgbA1c but also blood pressure control, cholesterol control, smoking status, pneumococcal and influenza immunizations, eye exams, and diabetic foot exams.

Reporting is based on all measures being satisfied, resulting in a more holistic view that helps to manage not only the disease but a person’s total wellness.

“With a more complete understanding of the persons we serve, we are also better equipped to prevent disease and manage populations by improving the health of our communities,” said Thomas Graf, MD, FAAFP, Senior Vice President, Ascension, President, Ascension Medical Group.

This approach fosters the development of critical collaborations and measures that we can impact beyond traditional areas of healthcare.

“CNS is excited to work together toward this common goal, that we know will ultimately help us fulfill our promise to provide compassionate, personalized care,” said Dr. Cacchione.

Diabetes is traditionally assessed via the most recent HgbA1c alone, a singular, arbitrary target. Total Quality Care assesses diabetic patients using a comprehensive panel of eight measures: HgbA1c, blood pressure control, cholesterol control, smoking status, pneumococcal and influenza immunizations, eye exams, and diabetic foot exams. Reporting is based on all measures being satisfied, resulting in a holistic view of health.

HgbA1c controlled

Blood pressure controlled

Cholesterol controlled

Smoking controlled

Pneumococcal immunization

Influenza immunization

Eye exam

Foot exam