Transforming Healthcare Together: Northern Regional Hospital Pt.1

Emily Volk - Value based Care at Northern Regional Hospital

Northern Regional Hospital (NRH) is an independent nonprofit healthcare network and 133-bed hospital serving the citizens of Mount Airy and the surrounding region. After two years with a different ACO and a year of managing its own value-based contracts, NRH partnered with CHESS Health Solutions in 2019. Being a small organization, one of its early challenges was aggregating the necessary data to identify who needs care and what care they need. Through its partnership with CHESS, NRH gained access to a population health platform that seamlessly aggregates clinical and claims data, enabling NRH to focus time and energy on patient care.

Learn more about this journey to value from Emily Volk, Manager of Quality Management at Northern Regional Hospital.

What challenges have you experienced in implementing value-based care, and how have you overcome those challenges?

The first challenge in value-based care is knowing which patients are yours and being able to find out what their needs and care gaps are. Working with an organization, like CHESS, helps us identify those patients easily because they are interfacing with the payer. CHESS is sending us our rosters and we can investigate to find out where our patients are, who is seeing them, and what kind of care they need. Initially, that was a struggle.

The other struggle is helping people understand what value-based care is because it is such a shift from the fee-for-service world. So just helping providers, staff, and patients understand value-based care. Patients are very appreciative of the shift because they are getting more attention to their needs. We’re looking at the whole patient rather than just “I’ve got a cold,” or “I have precursors to cancer.” To overcome that, patient education, provider education, and staff education have been helpful. And that’s another area where CHESS has jumped right in and helped. Our previous experience with ACO providers was not that way. But with CHESS we have onsite education for our providers, virtual education, a lot of print materials and things that we can send to them. That’s been a huge help with those challenges.

How have you found practicing value-based care to be beneficial to the patients?

The biggest benefit of value-based care is looking at each individual patient’s situation to see what gaps exist in their care and helping them find what they need. Not only care gaps, like breast cancer or colon cancer screening, but also any social gaps.

A lot of our patients at NRH have financial issues. They have trouble paying for their medications, affording their doctor visits, or securing transportation. Being able to focus on those social drivers through value-based care has enhanced the patient experience and given us an opportunity to interface with patients as people, not just as the 9 o’clock who is coming in for their annual wellness visit.

Value-based care has changed the way patients perceive the care they are receiving from their providers. They are experiencing more comprehensive visits and getting to know the staff that help them with some of those daily issues they have with accessing care.

How does your organization address health disparities and social determinants of health in your population health programs?

Social determinants of health, as new as it seems, is something we have always addressed at Northern, but now we are focusing more on it with regulatory agencies bringing it to the forefront. We have begun more specific screenings for patients, both in the acute environment, like the hospital, and in our ambulatory practices. We make sure we’re capturing the same information on all our patients, helping us provide more targeted resources.

Transportation is an issue in our area and with our patient population. And then of course, like many places across the nation, financial difficulty is an issue. We have taken that information, gathered it in our EMR, and then utilized it in our care coordination department. Any patients who are higher-risk patients, maybe because of their diagnosis, who also report barriers to care because of social determinants, we reach out to them with education. We make sure they’re able to follow-up with their primary care doctor and can access their medications. It’s really helped us to focus our efforts on the highest-risk patients.