Hugh Chatham Health is an independent, not-for-profit community health care network of physician clinics and an 81-bed acute care hospital that delivers high quality, convenient healthcare to residents of the Yadkin Valley region of North Carolina and southwestern Virginia.
Hugh Chatham Health’s experience with and journey towards value-based care has been a long one. They’ve worked with multiple different ACO organizations in the past but made the strategic decision to join a CHESS Health Solution ACO in 2018 to further their population health goals.
Learn more about this journey to value from Tabatha Loyd, RN, BSN, ACO Department Manager at Hugh Chatham Health.
What challenges have you experienced in implementing value-based care, and how have you overcome those challenges?
Some of the internal challenges we have here at Hugh Chatham Health for value-based care have to do with systems and how siloed care can become across the different practices. Our care system is across different counties and different locations. We have different systems at each spot that sometimes do not talk to each other. So, communication, electronic health record needs, those are all problems we have had to find a way to manage in our value-based care journey.
For us, one of the primary ways we’ve addressed communication needs is a secure messaging portal that all the providers and offices can use to communicate any type of patient information safely. This facilitates coordinating care in a timely manner. You do not have to wait on a fax to go through to find out if the provider wants them to stay on the statin or begin an insulin drip. Those types of things sometimes are urgent, high-quality needs that make a huge difference and impact on patient care. And getting that care to the patients in what we’re really focused on.
How have you found practicing value-based care to be beneficial to the patients?
Value-based care here at Hugh Chatham Health has been very beneficial to our population. Our patients tend to have higher acuity needs than a lot of the peers in our contract pools. Through our partnership with CHESS, we gain access to risk stratification scores and social determinants of health assessments that are performed throughout our care. So, when we see those needs, we know these patients are going to have greater issues for chronic health gaps.
When we see higher quality gap needs or chronic conditions, those are great areas for our Health Navigators to try to work towards improving. The biggest success we’ve seen here is through our controlling A1c initiatives. For a specific subset of the population, their average A1C used to be around 13% and it’s now down to less than 9%. So that’s a huge improvement. It did take us around five years to get there, but that is sort of the bet, or risk, that you take when you’re making the choice for value-based care. You don’t always see the benefits upfront, but they’re worth it in the long run.
How do you incorporate technology and data analytics into your value-based care approach?
Value-based care is heavily reliant on technology. You are taking a whole population’s worth of information and trying to make sense of what it all means to figure out what type of care you need to provide. That is really challenging. These tools help you target, strategically plan, and measure where you are, where you’ve been, and where you need to get to for all of your quality measures. Not just quality measures, but really important national patient safety goals. When you talk about your MIPs, infection rates, readmission rates, the cost of health care, there are so many ways that technology can make or break your system.
The conversation could be endless on this topic alone. It is my biggest barrier to be able to do more with less, which is the rural health atmosphere that I operate in here at Hugh Chatham Health. That’s what everyone in healthcare is working with. Doing more with less. Do it faster. See more patients. Give a better quality of care to your patients.
How do we get from over here to where they want us to be? We’re going to have to lean heavily into technology. I very much look forward to our technology transition coming up in 2024 here at Hugh Chatham Health. I am very eager to start using new tools. I always volunteer for Hugh Chatham Health to be a test subject for any new tools that CHESS can provide. Because yes, it’s a change. Yes, it’s something difficult to learn. But it is so worth it if it can help us do better, see better, manage our data better. And that is one of the biggest benefits we get out of working with large partners, like CHESS, is data management.
What advice do you have for health care organizations that want to participate in value-based care?
The biggest piece of advice I can give to anyone considering value-based care as an option is I know it does not look good on paper but do it. You are going to have the benefits. It is going to take time to see or reap those benefits but do it. The benefits for your staff, for the continuity of care for your patients, the community, the access to care, the level of support that your providers and patients receive through ensuring that the quality of care is there.
It really makes the difference. I feel like it has helped so many of our providers make it through all the increased levels of burnout that are surrounding us. There is something at least once every day that helps me see the reason why. It helps me get up and continue to work in healthcare.
Technology wise, absolutely invest in a system that is going to have analytics, dashboard capabilities, and interoperability. You are going to need that for anything you do, but particularly for value-based care. You are not going to be able to see where you are now or where you need to get to without that type of capability with whatever electronic health record you end up going with.