Leaders at Providence Health & Services, one of the nation’s largest not-for-profit integrated health systems, have been moving forward intensively in areas including population health management, patient and community engagement, and clinical transformation. Founded back in 1856, Providence Health & Systems is an enterprise with $22 billion in annual revenues, 50 hospitals, 829 clinics, and 111,000 employees across seven states, serving patients and communities across seven states: Washington, Oregon, Montana, California, New Mexico, Texas, and Alaska, with 40 percent of its presence in Washington state.
Preston Simmons, CEO of the western Washington region of Providence, delivered the luncheon keynote presentation on Thursday at the Health IT Summit in Chicago, being held May 11 and 12 at the W Hotel-City Center in downtown Chicago. Under the title, “Tackling Population Health—Key Elements of a Comprehensive and Sustainable Strategy,” Simmons shared in some detail his organization’s broad population health management strategy and implementation story to date.
After noting Providence Health’s absolute commitment to community benefit—noting that Providence organizations provided $1.6 billion in community benefit last year, including $209.8 million in free and low-cost care, $1 billion in Medicaid shortfalls, $110.5 million in community health services, and $180.9 million in education research—Simmons told his audience that he and his colleagues are committed to population health and patient and community engagement out of a sense of mission and vision—and out of practicality. “Healthcare payment will change rapidly. The way we deliver care to our customers will change—through accountable care organizations, technology,” and other means, he noted.
Change has taken place in phases, Simmons said. “Starting in 2015, we focused on taking healthcare online, similar to other industries.” In 2016, he said, he and his colleagues moved towards facilitating more personalized, “on-demand health,” through online scheduling and telehealth-based services; and this year, convenience is becoming a great focus. In terms of the organization’s digital strategy, he said, “The question is, how do you entice consumers to choose your organization, and then stick with your organization, for care?” Among the innovations been Providence’s “Express Care Clinics,” which are of two types—those wholly owned and operated by Providence; and others, which are co-located in Walgreens drugstores, and operated by Providence clinicians in concert with Walgreens staff.
The connection between convenience and population health management? Simmons gave an example of how those two concepts intersect. In that example, he cited a theoretical young teenaged mother-to-be. Connecting that individual through electronic means, he said, Providence can provide that pregnant teen “a personalized experience, clinically approved answers to her FAQs, timely and local to-dos,” and “convenient access to relevant resources.” As Simmons put it, one should consider the investment in these tools and capabilities, and imagine the fact using technology-based services to engage a young pregnant mom could benefit both her child, in terms of averting, for example, a neonatal intensive care unit stay, while also ultimately save the healthcare system the tremendous costs of having to resort to such care because of a lack of adequate engagement by that young woman in prenatal and postnatal care.
In terms of the organizational structures around Providence’s population health work, Simmons told his audience that, “Four years ago, we created a population health division, and Dr. Rhonda Meadows, who had a background at CMS [the federal Centers for Medicare and Medicaid Services], came in” as the system director for population health. The broad population health work involved spans numerous care delivery and care management settings, including several health system-owned health plans that cover 2 million lives across three states—Washington, Oregon, and Texas. What’s more, he noted, “In 2015, we created the Providence Institute for Healthy Communities. There are four domains we’re looking at” within that arena.
Shortly after he had concluded his presentation, Simmons sat down with Healthcare Informatics Editor-in-Chief Mark Hagland, to converse in detail about some of the topics he had covered in his presentation. Below are excerpts from that interview.
What are the biggest learnings so far on the journey that you and your colleagues have been leading, into population health?
The most important learning involves starting with the right vision and the “why” of where you’re going. Often you fail because you have a scattered vision and things are scattered. You have to be thoughtful about that. We have a centralized governance model and management for population health, and we’re starting to roll out population health at that regional level. It’s hard, because healthcare on one level happens locally, but you want to learn from each other and standardize, where it makes sense. So only by having those clear governance structures and communication patterns, can you work at scale; and working at scale is tough. We’ve just put together a governance model for population health, led by Rhonda Meadows, M.D., a model that involves six different population health domains.
You had mentioned the fact that you are a health system that runs some health plans. I’m sure that fact has been helpful in this, correct?
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