The U.S. healthcare industry faces a time of unprecedented uncertainty as dramatic changes and fundamental reforms are debated that will have major impact on the health system. Atlantic General Hospital has formulated a new five-year strategic plan to guide our organization in these uncertain times … so that we will emerge as the strong, respected and preferred healthcare services provider in our region.
Although the healthcare delivery environment is rapidly changing, the AGH vision and mission remain the same: We are committed to be the leader in promoting access to healthcare services, and we will continue to provide quality care, personalized service, and education to improve individual and community health.
Access to quality healthcare services remains key to having a favorable quality of life in our region. Providing safe and effective healthcare … timely and efficient delivery of care … access and equity for all in the community … continuous technological innovation and improvement: All of these patient centered quality principles remain at the core of our purpose and the center of our activities.
Where We’ve Been
Over the previous five-year planning period for AGH, a major strategic emphasis has been on developing a service line focus based on the healthcare needs of our community. These service lines include:
- Women’s Health
- Cancer Care
- Pulmonary Medicine
- Wound Care
In addition to successfully building service line capabilities, we achieved notable success in other areas:
- Our medical staff membership has grown more than 25%.
- Our community perception has significantly improved.
- The performance and participation in our Foundation has increased.
- Worcester County will grow more than six percent between 2010 and 2015.
- Nearly 25 percent of Worcester County residents are 65 or older.
- The Regional Community Health Assessment data reports that 70 percent of residents are “overweight” or of an “unhealthy weight.” Nearly a third of individuals are “obese.”
- Medicare continues to be the predominant payer for healthcare services at AGH (more than 55 percent).
Where We Are Headed
Looking to the future, in addition to continuing to build on our service line foundation, our direction will be affected by regulatory and market mandates. The new AGH strategic plan focuses on principles for developing efficient and effective care delivery models, including the adoption of information technology capabilities at a rapid pace to achieve the quality and integration goals set by the federal government and private payers.
Regulatory and payment reforms are driving inpatient care in ways that will achieve predetermined clinical outcomes while eliminating medical errors. For example, Medicare and other payers are experimenting with new reimbursement systems. These, in turn, are forcing healthcare providers to redesign delivery structures to manage chronic illnesses in a proactive fashion, prevent acute admissions, and reduce the costly progression of disease.
The healthcare market is also undergoing a rapid transition to an electronic transaction environment, including electronic medical record-keeping. A significant portion of capital investment will be dedicated to keeping AGH ahead of the curve in this emerging healthcare delivery environment.
Our “E” Strategy
Our 2011-2015 “E” Strategy employs principles to support patients, families and caregivers, guiding investments in our clinical service areas that will utilize information technology to improve coordination of healthcare, the quality of care, and efficiency.
E Strategy Principles:
- Electronic medical records integration. An EMR is already in place within the AGH Health System physician offices and will be linked throughout the hospital environment and with participating independent providers in our community. This will be extended further into the community through a patient-centered medical home concept.
- Error-free service delivery
- Ethical conduct
- Economic stability
We will create a collaborative care model within AGH and with pre- and post-hospital care providers in an electronic environment. Patient outcomes will be measured throughout the system, while “unnecessary steps” will be reduced to optimize the patient experience, minimize the opportunity for errors, and enhance economic stability.
Our “E” Strategy will be carried out with a clear and unwavering focus on providing transparency in
healthcare delivery and ensuring the privacy of all patients and their families.
The Patient-Centered Medical Home Structure
The “patient centered medical home” (PCMH) structure has become a central tenet of healthcare reform legislation and experimental payer projects for future reimbursement systems. PCMH structures hold much promise for value-based purchasing desired by payers, including improved means of managing quality healthcare to thousands of patients in primary care practices, the integration of care and technology use at home for improved quality of life, and significant reduction in healthcare costs associated with chronic illness management.
We have already begun creating a PCMH structure through the initiation of a fully electronic medical record system at AGHS primary care practices. PCMH combines patient-focused principles with the integration of clinical professionals and IT under the supervision of primary care physicians. It will focus particularly on patients with chronic illnesses. Our strategic investment in this model will:
- Reduce acute crises associated with chronic illnesses.
- Reduce the stress of family caregivers in our community.
This will be of particular importance to our community because, according to the tri-county Community Health Assessment data, our population reports higher rates of diabetes, chronic lung disease, chronic heart disease and high cholesterol compared to national averages.
Healthcare Reform Initiatives
It is clear that significant healthcare reform will be occurring during 2011-2015 plan period, and this will impact AGH in numerous ways through increased quality reporting requirements, payment reforms, and information technology usage mandates. While the precise nature of these reforms is not yet known, areas that will be affected include:
Reporting requirements impacting operational or financial performance – such as pay-for-performance initiatives and expansion of quality reporting mandates for reimbursement.
Payment reforms – such as price reductions, bundling of payments driving vertical integration with pre and post-acute healthcare providers, and expansion of “potentially preventable error” designations for payment penalties.
Insurance reforms – such as private co-op programs, new public option plans, insurance exchanges, and the expansion of Medicaid qualifications.
Other developments driven by reform measures – such as tiered systems of care, expansion of retail medicine, and the use of telemedicine in specialty care.
Several important facilities initiatives are also planned for the 2011-2015 period. Among them:
- Establishing an AGH Cancer Center with expanded cancer care services, including chemotherapy and complementary holistic therapy services.
- Relocation of the Intensive Care Unit in anticipation of increased patient bed requirements.
- Establishing an observation unit to reduce medical/surgical short-stay admissions.
- Relocation of administrative offices to facilitate expansion of clinical service areas as well as provide enhanced parking and patient drop-off/pick-up convenience.
- Expansion of cafeteria facilities to serve a growing AGH staff as well as families of patients.
Measuring Our Success
Successful implementation of our 2011-2015 Strategic Plan will be reflected in achieving important improvements, including:
- Establishing an integrated electronic health record throughout the entire AGH system.
- Delivering quality care throughout our health system while maintaining economic stability in uncertain times.
- Achieving continued improvement of scores in the community’s rating of AGH care.
- Improving relationships between our physicians, hospital governance, and leadership.
- Maintaining employee satisfaction and pride in working at AGH