Every Memphian deserves great health care.
It starts with ONE Health.
At Regional One Health, we understand that Memphis is a city with complex health issues. It’s our job to face them head on. But what if the health care industry focused more on the word health in an effort to decrease the need for the word care?
Within health care, there exists a patient population who utilizes high-cost services, like emergency department care, more than others. Often referred to as “high utilizers,” many of these patients lack social resources or find themselves with economic, education, addiction or housing issues that exacerbate their health. For example, a diabetic patient is told he needs to lose 100 pounds, but sodium-rich foods in bulk cost much less than healthy vegetables. Many populations in Memphis face health crises, but decisions are based on environment, many of which don’t allow for healthy choices.
It’s time for ONE Health in Memphis. Using compassionate care and exceptional services to keep our most vulnerable residents of the Mid-South healthier, ONE Health is a new concept in care that will transform the community.
The purpose of ONE Health is to reduce the human and financial costs among Regional One Health’s highest of high-utilizers. This proven model of care will improve patient outcomes and experiences within the health care system and lower unnecessary hospital use, reducing the cost of care.
Regional One Health has formed a partnership with the Camden Coalition to launch ONE Health. The Camden Coalition is a nationally-recognized nonprofit organization that works in its community to improve health and reduce costs. It uses data-driven, human-centered practices to improve patient outcomes and reduce the cost of care.
Together, Regional One Health and Camden Coalition will devote the next several months focused on analyzing every piece of data to better understand our patients and possible trends related to their circumstances that have them in need of care. Funded in part by the Assisi Foundation of Memphis, this project will give Regional One Health the resources to dig much deeper than ever before into underlying reasons people in our community become patients, and what we can do to reduce or remove those reasons.
“It must be done,” said Susan Cooper, RN, MSN, FAAN, the Chief Integration Officer and Senior Vice president of Ambulatory Services at Regional One Health. “I think Regional One Health has the will. It certainly has the population that can benefit from these activities. This is a chance for us to take the learnings from others; the Camden Coalition nationally has set up a coordinating center for this complex care management. And across this nation they can choose to work with anybody, but they see something in us. They’re excited about coming here to Memphis.”
“The changes we need to make seem pretty massive and monumental. But if I think about the change as a big ocean liner that has a rudder on the back, you can make a little change in the rudder and the ship will make a large change in direction in the ocean. We’re trying to find what are those little changes in the rudder of this ship called health care that can create these large changes in the health of the people we serve.” —Susan Cooper, Chief Integration Officer, Senior Vice President, Ambulatory Services
Watch how Camden Coalition revolutionized care for their community.
How Do We Know What Really Works in Health Care? Listen to a Freakonomics Radio Podcast featuring Camden Coalition’s work.
In Camden, New Jersey:
of costs came from 1% of the patients.
of costs came from 13% of the patients.
of costs came from 20% of the patients.
Bringing Camden Coalition’s work to Memphis
Regional One Health has nearly 16,000 inpatient admissions and over 187,000 outpatient visits annually. Those patients come through our doors with a variety of concerns and every patient is unique with his or her own story. But some of those individual stories put together reveal recurring themes. And when these stories are those of outlier patients – those who have complex, hard-to-manage needs and chronic conditions – more expensive and risky treatment often becomes necessary.
Over a 12-month period, a patient – let’s call him Dan – visited the Regional One Health emergency room 64 times, but was never admitted. He doesn’t have insurance, and Regional One Health provided and wrote off $70,000 of care to Dan. During that same 12-month period, another patient – we’ll call her Sue – visited the emergency room six times and was an inpatient eight times. She also has no insurance and the care Regional One Health provided Sue and wrote off was more than $1 million.
What if we can address the needs of patients similar to Sue and Dan with a different approach, one that drastically reduces the number of E.R. visits? We want to identify those patients through health care hotspotting, a strategic use of data to reallocate resources to better understand the problem and design more effective interventions. This multi-disciplinary care treats the whole patient. It also addresses non-medical needs that affect the person’s health: mental health, housing, emotional support and substance abuse.
It all started in 2002 when Dr. Jeff Brenner faced a similar struggle of caring for super utilizers in Camden, New Jersey. Much like Memphis, Camden’s population is one of high poverty and poor access to medical facilities. Dr. Brenner analyzed hospital data and discovered that 20 percent of the patients at his hospital accounted for 90 percent of the cost. Dr. Brenner’s model is intended to improve care with a nice side effect of also reducing costs.
In fiscal year 2015, there were 1,023 self-pay, TennCare and unmanaged Medicare patients who visited Regional One Health’s emergency room. Those patients were responsible for $81 million in charges, $50 million of which was attributed to 500 patients. In Camden, Dr. Brenner’s first 36 patients averaged 62 hospital and emergency room visits per month before the intervention. It dropped to 37 visits per month afterwards. Their total hospital bill fell to just over $500,000 from a monthly average of $1.2 million.
So how will it work in Memphis? The Camden Coalition doesn’t have preconceived notions. Different models work in different cities. They don’t know what model will work in Memphis. But the Camden Coalition and Regional One Health leadership, together, are convinced a best model for Memphis exists. The goal of ONE Health is to tightly manage the care of super utilizers. It will provide high-touch, high-quality, patient-centered coordinated care to individual patients via a multidisciplinary health team and technology.