Allina Health’s Dedication to Quality Improvement Delivers On the Triple Aim
In any industry, improving performance and accountability requires having a shared goal that unites the interests and activities of all stakeholders. For Allina Health—a not-for profit healthcare system comprised of more than 26,000 employees, 5,000 affiliated and employed physicians, 13 hospitals, 90 clinics, and numerous specialty medical services—that goal is to deliver high value to its patients through all of its services.
To focus its efforts, Allina adopted the definition of value set forth in the Institute for Healthcare Improvement’s (IHI) Triple Aim—improving the health of its populations while also improving patient experience and lowering the per capita cost of care.
EMBRACING THE MANDATE OF VALUE-BASED HEALTHCARE
It is widely known that U.S. healthcare is too expensive, too inefficient, and that quality is too varied. Policymakers and industry insiders view value-based healthcare as the solution to this problem—and even as a mandate—for all providers. As Allina’s leaders took up this mandate, they recognized that they would need to realign their strategies, organizational structures, and management practices in order to deliver better value to patients and the community.
Specifically, they recognized that the improvements they sought would require a shift in mindset: They needed to look at healthcare more as a data-driven science rather than a proficiency-based art. They needed to be able to use data-driven insights to deliver such improvements as better outcomes, less variation, fewer readmissions, lower infection rates, and fewer medical errors.
A DATA-DRIVEN PERFORMANCE IMPROVEMENT STRATEGY
As a key component of its mission to achieve the Triple Aim, Allina devised a data-driven performance improvement strategy. The health system implemented an advanced analytics infrastructure based on Health Catalyst’s Late-Binding™ Enterprise Data Warehouse (EDW) and Analytics Platform.
Timely, accurate and reliable data helps ensure Allina can deliver the best possible care at a lower cost in pursuit of the Triple Aim while also maintaining a solid bottom line in a mixed-reimbursement-model environment. The analytics platform provides data to clinicians at the point of care, enabling them to focus on the right opportunities and realize outcome improvements.
Allina leaders also instituted a permanent project management structure to identify, oversee, and manage improvement projects. The health system requires each improvement project to have a business plan with clear improvement and cost reduction goals for a specified period, as well as metrics to ensure visibility into performance.
To systematize improvement further, Allina developed a ten-step quality improvement process model. The data-driven model examines the current state, identifies opportunities for improvement, implements action steps, and measures the results.
Using this ten-step process, Allina teams identified and undertook several important clinical, operational, and financial quality improvement efforts focused on improving productivity, improving the documentation and coding process for more efficient billing, eliminating inappropriate clinical variation, lowering length of stay, and improving care integration.
FINANCIAL IMPROVEMENT OF $125 MILLION IN ONE YEAR
Allina’s systematic efforts to achieve the Triple Aim have yielded the following consistent, impressive results:
Advanced the Triple Aim through dozens of improvement projects
The combination of Allina’s analytics platform and project management structure drove improvement projects that achieved a better experience for individuals, better health for populations, and lower per capita costs.
Realized a total financial improvement of $125 million over a one-year period
The combination of clinical, operational and financial improvement projects yielded significant financial improvements and a strong bottom line in a mixed reimbursement model environment. The components of this financial improvement include:
- Productivity improvements – $43 million
- Clinical documentation – $14 million
- Reducing clinical variation – $30 million
- Site specific initiatives – $25 million
- Care integration – $10 million
- Length of stay (LOS) – $3 million
The $30 million financial improvement achieved from reducing clinical variation resulted from a range of improvement projects, including:
- Lowering heart failure readmissions,
- Lowering all preventable readmissions,
- Improving stroke care,
- Improving the prevention and treatment of VTE,
- Improving outcomes for spinal conditions,
- Improving cancer outcomes.
Allina’s impressive financial improvements were not just a one-year wonder. The health system has achieved approximately $100 million a year in financial improvements since the second year of the program—and maintained this for four years.
WHAT IS NEXT?
While Allina and Health Catalyst have now worked together for several years, the two organizations signed a further long-term collaborative agreement in 2015 to improve the quality and lower the cost of care for Allina’s patients. Allina will expand the number of clinical and operational improvement projects to continue to improve care and to sustain or grow annual financial improvements of $100 million per year. The health system will also sustain and reinforce its culture of working on improvements from both a clinical and cost perspective—a dual approach that leads to richer outcomes.
ABOUT HEALTH CATALYST
Health Catalyst is a mission-driven data warehousing and analytics company that helps healthcare organizations of all sizes perform the clinical, financial, and operational reporting and analysis needed for population health and accountable care. Our proven enterprise data warehouse (EDW) and analytics platform helps improve quality, add efficiency and lower costs in support of more than 50 million patients for organizations ranging from the largest US health system to forward-thinking physician practices.