Key Lessons From an Early Care Management Success Story

Tamara Cull Tamara Cull
Vice President, Advisory Services

Payers and providers should take note: Christiana Care Health System, its CareLink CareNow subsidiary, and its data-driven care management successes with Medecision’s Aerial platform are the feature of a recent case study published by IDC.

This insightful analysis offers key care management recommendations and takeaways from Christiana Care’s early innovations. The Delaware-based organization embraced risk-based contracting as it dove into, and then expanded, its population health programs beginning in 2012. They have since documented a wide range of positive clinical and financial outcomes.

Those of you who attended HIMSS may have learned about those improvements in the presentation “Sustainable Population Health: One Health System’s Journey,” with Dr. Terri Steinberg, Christiana Care’s chief health information officer and VP of population health analytics. Dr. Steinberg covered key steps in the journey as Christina Care evolved population health for a single patient population into a mature business model.

Partnering with Christiana Care during this journey was a rewarding, insightful learning process for us here at Medecision as well. Recently, as we reflected on the effort, we discovered three main “lessons learned” that might also help you navigate your own care management approach.

1. Partner to break down barriers.

Building a care management program requires organizations to think about care delivery in new ways and craft new relationships designed to benefit populations. That starts with bringing physicians, health systems, and payers to the same table to collaborate more deeply than they ever have before; determine how to break down historic friction between providers and payers; and build new clinical care pathways and end-to-end care processes to deliver better, more population-specific and person-centric care.

2. Enable gradual evolution.

It’s important to take a long-term, strategic view to new care management programs. Building flexibility into a program as it’s being set up will help organizations ensure the basic components of the plan can be replicated and scaled effectively. It’s also the way to help ensure efforts will be cost-effective, especially if they include taking on bundled payment initiatives and other risk-based contracts. Recognizing that care management programs are never static gives organizations and their partners necessary wiggle room to adapt to changing requirements and priorities.

The reality is that the care management evolution is an ongoing — and complex — journey that takes time. Christiana Care started with one small program for ischemic heart disease in 2012 and expanded out slowly before picking up the pace to manage its current volume of 200,000 patients in risk-based contracts. Acknowledging these realities upfront paves the way for more intentional partnerships overall. For us, this lesson has taught us to spend more effort in the strategic planning phase of project, ultimately leading to better implementations.

3. Define benchmarks upfront.

Benchmarks and “metrics for success” that define top performance should be established from day one. That means taking more time upfront to set the initial strategic plan, define the organization’s initial journey path, and figure out how you’ll measure success. But the upfront time is worth it: it’s the only way to replicate success later on, as you broaden your programs across populations and contracts. Those steps help ensure there is a strong blueprint to follow over time.

 

Every organization’s journey to successful care management will be unique. But the lessons learned through the Christiana Care experience can help providers and payers drive down some of the risk within the new adventure.

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