Duluth-based Essentia Health earns top accreditationEssentia is one of two health systems in the country to be recognized as having reached the highest level of providing cost-effective, comprehensive care to patients, a key goal of the nation’s health care reform efforts.
By: John Lundy, Duluth News Tribune
Duluth-based Essentia Health is one of two health systems in the country to be recognized as having reached the highest level of providing cost-effective, comprehensive care to patients, a key goal of the nation’s health care reform efforts.
Essentia, which provides hospital and clinic services and operates in four states, was cited as attaining the highest level of accreditation as an accountable care organization — ACO — by the National Center for Quality Assurance.
It’s a wonkish-sounding designation from a wonkish-sounding organization. But it reflects Essentia’s efforts to help chronically ill patients manage their care rather than just treat people who come through the doors, said John Smylie, Essentia’s chief operating officer.
“This isn’t an academic exercise at all,” Smylie said. “It really gets down to … the care you would want for anyone in your family or anyone in your community.”
Congress created ACOs with the intention of slowing health-care spending while maintaining, or even improving, quality, said Cristina L. Boccuti, a Medicare specialist for the California-based Kaiser Family Foundation.
If those goals are achieved, it makes a huge difference to patients, Boccuti said.
Medicare will be more sustainable because its costs will be lower. Patients will be happier and healthier because they’ll spend less time being hospitalized and shuffled from procedure to procedure.
“If the care is better and keeps them out of the hospital, the patient is safer and the patient is experiencing a better quality of life,” she said.
Essentia has achieved that in such areas as the heart failure program at its heart center in Duluth. Each patient in the program is seen at least four times a year, starting with a two-hour appointment that normally takes place within five days after the patient leaves the hospital, Linda Wick, the program’s director, said in a 2011 interview.
The idea is that it helps the patient manage his or her disease, she said.
According to the most recent data, Essentia’s heart failure program has a rate of readmission to the hospital within 30 days after being released of 7-10 percent, said Essentia spokeswoman Kim Kaiser. That compares to a national rate of 20-25 percent.
Essentia heart patients in the Telescale program, which allows nurses to track blood pressure and weight readings that patients take in their homes, had a readmission rate of just 2 percent, Kaiser said.
Essentia was one of six health systems to achieve the accreditation earlier this year from the NCQA, a nonprofit dedicated to improving the quality of health care. In September, the agency elevated the two of them to the highest level: Essentia and Health Partners, a Twin Cities-based health system.
The fact that both are Minnesota-based isn’t a coincidence, an NCQA official said.
“Minnesota has a long history and special degree of commitment to quality, where organizations — health plans and providers — actively compete on quality,” said Sarah Thomas, the organization’s vice president of public policy, in an e-mail.
Smylie said a key to achieving the distinction was the ability to collaborate with other entities through the Institute for Clinical Systems Improvement, which is sponsored by five nonprofit health plans in Minnesota and Wisconsin.
It would have been much more difficult if Essentia were based in another state, Smylie said.
“I think it’s a tribute to what’s going on in this state, and oftentimes we take it for granted,” he said.
Minnesota has achieved high quality without costs that are as high as in many other states, said Terry Hill, executive director of the Duluth-based National Rural Health Resource Center.
Hill said states that spend the most money on Medicare patients, such as Florida, are among the lowest in terms of quality.
That gives Minnesota a head start toward the kinds of changes everyone will have to make to emerge from an unsustainable health care system, Hill said.
“It’s going to be up to the Essentias and the St. Luke’s to figure out how we’re going to improve the quality and bring the cost down,” he said. “The providers are going to figure it out or they’re not going to survive.”