Page 9 - Focus March 2018

It’s a challenge. We’ve got to get the payment model that’s also tipped, but
by demonstrating our commitment, by partnering with payers and with the state, showing them our results, we’re starting to see that payment can also change.
LEE: Maybe it’s too soon to tell, but the last question I want to ask is, how’s it going? I guess that boils down to three sub-questions: Are there any data yet to show that quality is improving? Are there any data yet to show that the cost curve is being bent? And then there’s the morale of the troops. You’re a very forward-looking, big-picture person, and it’s great that your board is, but not everyone is out there, so are our clinician colleagues coming along?
NEVIN: The answer to the first two questions is yes and yes. We are seeing some remarkable impact in terms of our focus on clinical pathways driving quality. For example, we have reduced admissions to our neonatal intensive care unit — and
I don’t have to tell you, one baby that’s low birth weight or has serious issues — that’s a huge cost to the system. That’s one example, as well as reducing readmissions, reducing utilization of the emergency department. And we know because we’re managing our own employee population that we’re seeing the impact on cost.
Again, we’re connecting more people to care management for their chronic illness. I just saw some outcomes for the work we’re doing with our employees. Not only are we under what we had budgeted, but I believe that we will end the year spending less on our employees this year than we did last, even though we’re covering more lives — certainly some early metrics that give me optimism about what we can accomplish in the future.
This is certainly a new world for caregivers, and the good news is that the work that
we have done inside our organization around engaging our caregivers in coming back to our values and behaviors has
had impact. We embarked, last year, on a systemwide initiative to engage everyone in the organization around redefining values and behaviors. It comes from a place of me believing that organizations that not only survive, but thrive, in times of change are organizations that understand their values and consistently live those values through behavior.
“Organizations that not only survive, but thrive, in times of change are organizations that understand their values and consistently live those values through behavior.”
So we did that work, and our new statement is “we serve together, guided by our values of excellence and love,” and it’s already having an impact. It gives us an opportu- nity to have a conversation about why we came to health care, the importance of the work that we’re doing, so helping connect people back to the purpose of being a care- giver. The work that we’ve done in our ACO, again, we’re able to show physicians in the community that we want to partner with you, we want to learn from you. How can we support you caring for your patients?
I do think there’s a lot more work to be done. We are, in many ways, just getting started. Engaging physicians, partnering with physicians, is a major focus for us. Many people are feeling overwhelmed and overburdened, and the issue of burnout has now gotten national recognition, and so we are addressing that through our Center for Provider Wellbeing, which is becoming
Thomas H. Lee, M.D, MSc Press Ganey Associates
| Interview a national leader in addressing issues of
burnout.
Back to engagement, my view is that it’s the people who do the work who can help us identify the real problems and then be the problem-solvers, the innovators, who will allow us to create an environment in which they can deliver all the care that needs to be delivered, and create an experience both for them and for those we serve that is truly exceptional.
LEE: I’m rooting for your success, and I’m glad you’re moving your system toward redesign when you’re in a position of strength, rather than facing a crisis. I hope we can continue to tune in from time to time and see how it’s going.
NEVIN: That would be great. I’m very privileged to lead this organization, to have the opportunity to serve the state of Delaware, and I think this is a great time to be a leader in health care. The opportunity to make a difference, from my experience, has never been as great as it is right now. Thank you for your leadership, and your inspiration for all that you do.
LEE: Thanks so much. 
Dr. Lee is the Chief Medical Officer for Press Ganey Associates, Inc., a member of the Editorial Board of The New England Journal of Medicine, and the NEJM Catalyst Leadership Board Founder.
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