A New Vision for Healthcare
By Mary Minor Davis
Carondelet Health Network, a pioneer in Southern Arizona healthcare, is building an innovative system of well-being designed to create a healthier community while reducing skyrocketing medical costs.
At the heart of this evolution is a new health management philosophy – launched with the “Be Well” brand last year – that sets aside the traditional way of doing things and integrates a holistic approach to community care.
Defined as “population health management,” the new approach provides the ability to keep healthy people well, identify and “course correct” those who may be at risk, better manage those who are chronically ill and work to eliminate gaps in care.
As Jim Beckmann, president and CEO of Carondelet Health Network put it, even as the Affordable Care Act has been driving dialogue about the need to address healthcare reform, Carondelet leadership believes that real change needs to begin within the industry.
“We’re excited to be participating in one of the greatest opportunities of our time,” Beckmann said of the new philosophy. The history of Carondelet in Tucson dates back to the 19th century, when the Catholic Sisters of St. Joseph of Carondelet opened St. Mary’s Hospital in 1880.
Today, with nearly 30 facilities and medical offices throughout Southern Arizona, Carondelet is the leading provider of healthcare services, serving a community of more than 1 million residents and employing more than 4,000.
From Tucson to Nogales, the region’s 12th largest employer is investing millions of dollars in resources, technology and innovative medical procedures – all designed to provide for the health and well-being of Southern Arizonans while raising the standard of care.
Carondelet St. Mary’s Hospital has been revitalized as part of the investment, and is now home to the Carondelet Heart & Vascular Institute. Carondelet St. Joseph’s Hospital has been the focus of growth and expansion, and ground has been broken on the new Carondelet Health & Wellness Pavilion in Sahuarita.
To develop its population health management approach, Carondelet is currently partnering with Healthways, a global leader in providing well-being improvement solutions that focus on this comprehensive model of care.
It begins with an assessment of what’s needed to meet Carondelet’s goals and ends with primary care physicians working in tandem with their patients, other physicians, specialists and the patients’ extended community to ensure comprehensive care and well-being that will transition care from “volume” to “value.”
Traditionally, healthcare has been delivered in a kind of silo system, with the primary care physician identifying medical conditions and then referring the patient to specialists.
Carondelet is removing those silos with this holistic approach, which takes into consideration all aspects of a person’s well-being – including financial, mental and physical – combined with the biometrics of the individual.
“With this information, we can then stratify individuals within the population into three main groups,” explained Dr. Donald Denmark, Carondelet’s senior VP and chief medical officer.
“The ‘at-risk’ group will, over time, drive costs, but studies have proven that intervention can help,” he added. “For individuals with chronic disease you employ intervention tactics focused on aggressive care management.”
Chris Castellano, executive VP and chief strategy officer for Carondelet, added, “For example, patients most often come to the St. Mary’s emergency room with stomach pain or dental pain. These issues can often be prevented or managed if people build trusting, valued relationships with a primary care provider or specialist. Without that opportunity for intervention and management, those with chronic disease turn to ERs once their condition has worsened to a point where a higher level of care feels like their only option.”
A trip to the ER is far more costly than preventive care. Under the new Carondelet/Healthways model, the value of care will be improved, reducing the number of treatable conditions entering the ER by boosting care before conditions become emergencies.
Healthcare costs today are $2.5 trillion – making up 18 percent of the gross domestic product, Beckmann said.
“As professionals, we have to take up the charge of the health and well-being of our community if we are to have an impact on the national cost of care,” he said.
A key element of community health management is that it is built around a team concept. Physicians, specialists, clinicians, social service organizations, family members, employers and patients themselves all play a role in making the model successful.
The Healthways model promotes engagement at all levels, providing individuals with simple, fun tools that encourage active participation in and personal accountability for the management of one’s health and well-being.
“Engagement is the result of motivation, inspiration,” Castellano said. “Changing the paradigm happens one person at a time – with the right social networks around them – with a strong base of primary care physicians to lead the effort.”
Beckmann and his team recognize that it will take time to implement this change, both from the patient and the physician standpoint.
Many Carondelet stakeholders and community members across Southern Arizona have already participated in the assessment, and Carondelet is implementing the program first within its own internal community of more than 4,000 employees.
The organization has set a goal of a 5 percent improvement in the overall health condition within its own organization in 12 months – primarily among employees with chronic illnesses – as well as a decrease in employee absenteeism due to sick leave.
Healthways claims increasing the well-being of a population – like a company’s employee base – can increase productivity, reduce absenteeism and improve job performance.
“In the end it will require each individual and family to take action for their health,” Beckmann added. “That’s why this is going to take time, and the investment is significant – but the results will be also.”
The energy that the program has generated is palpable when talking to physicians about the new approach.
“I’ve been a physician on staff at Carondelet for over 20 years,” said Dr. Amy Beiter, president and CEO of St. Mary’s Hospital. “We’re all very proud of this new direction we’re taking.”
Beckmann said the new philosophy is in line with the mission of the Sisters of St. Joseph of Carondelet to serve “every dear neighbor with dignity and respect.”
“We are fortunate in that we are grounded in the history of the Sisters,” he said. “This gives us a sense of purpose, greater than just being part of the medical community. We are able to maintain the legacy and mission of the Sisters, not only for today, but well into our community’s future.”