Jason Dinger

Saint Thomas Health & Partners Launch MissionPoint

On Aug. 10, the leadership of Saint Thomas Health, Cisco Systems Inc., Crimson Services, Applied Health Analytics and the YMCA of Middle Tennessee announced the formation of MissionPoint Health Partners to a crowd gathered at the Frist Center for the Visual Arts. The new entity, which will launch in January 2012, provides a platform for the delivery of integrated healthcare services in Middle Tennessee.

In introducing the concept, Saint Thomas Health Chief Executive Officer Mike Schatzlein, MD, said MissionPoint allows STH to better fulfill its mission of ministering to the wellness and health of Middle Tennesseans and beyond. He pointed out that by partnering STH hospitals and the 2,000 physicians on staff with allied healthcare entities, the combined group had the scope and critical mass to address some of the key issues facing the industry today. “Healthcare is 30 percent too expensive, and it’s horrendously fragmented. It’s a cottage industry that grew up and got very technological and didn’t grow in integration as it did so,” he said, adding the American healthcare system in its current incarnation does a poor job in keeping people well and in controlling healthcare costs for employers.

“It’s appropriate that these healthcare leaders would come together in Nashville — the capital of the U.S. healthcare industry — to develop an innovative response to the nation’s need for a new way to experience, deliver and receive healthcare,” Schatzlein stated.

“So we’ve been working hard at Saint Thomas Health for the past several months on nothing less than a whole new delivery platform … it’s a care delivery platform that deals with people both when they are well and when they’re sick,” he continued.

The program is to be piloted in January with STH associates and their families. The expectation is to cover approximately 15,000 lives at launch with enrollment throughout 2012 so that by full rollout in January 2013, the program will have 35,000 members.

To explain the nuts and bolts of the delivery platform, Schatzlein turned the program over to Jason Dinger, CEO of MissionPoint Health Partners. “In an environment in which consumers — including patients, employers and payers — shoulder an increasing burden of the cost of healthcare, it is important for each of us to think of new and better ways to solve the issues that exist in today’s healthcare environment,” stated Dinger. “MissionPoint’s goal is to uniquely link together primary care physicians, specialists, pharmacy services, hospitals, rehabilitation services and wellness programs to offer patients and employers a seamless continuum of care.”

Dinger noted that much of the impetus behind creating the new platform was driven by projections that Medicare would be bankrupted by 2024. As a faith-based entity, he said it was STH’s core mission to serve anyone in need. “We want to continue to be able to take all comers, and in many ways the only way we can do that sustainably is to deliver care in a fundamentally different way. MissionPoint will enable physicians, healthcare facilities and other providers to work together under aligned incentives to achieve better health outcomes for our community.”

He explained there are four aims of MissionPoint. The first is to improve the health status of the community. “If the quality of care and of outcomes doesn’t improve, we have failed,” he stated simply. The second and third goals are for healthcare costs to come down and the patient experience to improve. Finally, MissionPoint hopes to enrich the lives of caregivers. “It’s clear that many of our physicians want a different type of care, as well,” he said. “The fee-for-service world has put them in a certain practice behavior that is difficult.”

An amalgamation of the Patient Centered Medical Home concept and an Accountable Care Organization on steroids, MissionPoint seeks to have patients form an ongoing relationship with their physician’s office, whose job it is to keep those patients well through routine visits, preventative services, education, and episodic care. When patients need services outside of the physician’s scope, the office staff and Care Partner Teams (a group of nurses, social workers and others) will help patients navigate the system to obtain the necessary services. He stressed that all of the collaborative efforts are underpinned by an extensive IT infrastructure.

Dinger said MissionPoint is targeting five distinct sectors to serve: the self-insured, commercial community, TennCare, Medicare ACOs, and the uninsured. Although national are underway to cover more people by 2014, Dinger said that’s simply too long to wait.

He went on to explain MissionPoint essentially is a platform for four different entities — physicians, facilities, care teams and new types of IT infrastructure, which are being brought together to interface and support each other to meet two goals … providing population management and coordinating care in episodic bundles.

“Episodic bundles,” Dinger explained, “are a way to integrate specialty care around discreet services.” He noted the focus is generally on a well patient who is undergoing a scheduled procedure such as a hip replacement and that costs are accrued from 30 days prior through 30 days post procedure. All the costs for services are bundled under one price and all the care providers and involved healthcare facilities share the risk for the outcome. “What this does is it naturally sort of encourages a level of teamwork and a level of data sharing from before they come to the hospital to after they leave to ensure that real quality outcomes are being obtained,” he said.

Population health, he continued, begins with getting hospitals, physicians and outpatient facilities working together to share information and build bridges between providers. Unfortunately, he noted, there are inherent risks in the gaps that currently exist between key players. MissionPoint will deploy care teams to fill those gaps.

“One of the things we’re most excited about is the advent of the home visit,” Dinger said. “We know that outcomes significantly improve if you do a home visit for that asthmatic child or the grandmother who just fell and has a hip fracture. By entering into the home and partnering with patients, which is an inherent part of our model, we think we can really improve those outcomes.”

Each of the partners brings something specific to the table.

• Cisco Systems Inc.: An advanced telemedicine platform, STH had already launched a partnership with the company in 2010 to bring Cisco’s HealthPresence Solution to rural, underserved communities. As part of MissionPoint, Cisco is expected to help extend the reach of specialty care, simplify communications and connect patients with medical providers and specialists in a convenient and affordable manner.
• Crimson Services: The Advisory Board Company’s Crimson Initiative has been tapped to provide aggregate quality, performance and cost metrics through intuitive dashboards. A simple green/yellow/red color system lets physicians know if all systems are go when it comes to performing consistently or better than the mean or if the brakes need to be applied and steps re-evaluated when there is significant variation from best practices.
• Applied Health Analytics: This partner’s job is to promote early detection and prevention in the fight against disease and illness. Applied Health will provide MissionPoint members with health risk assessments and personalized health plans to promote lifestyle change.
• YMCA of Middle Tennessee: With initiatives such as their popular ABC Program (After Breast Cancer) coupled with fitness options and educational outreach, the Y is expected to play a key role in member wellness.

For brokers and employers, Dinger stressed MissionPoint isn’t a gatekeeper model. “When you engage MissionPoint as a partner, we actually begin servicing your entire population regardless of what track they choose,” he explained, adding MissionPoint assumes risk for managing the total cost of your population regardless of where they seek care. There are, however, lower copays or premiums for using MissionPoint providers. “We believe that patients should retain choice,” he continued. “At the same time, we want them rewarded when they pursue providers that are working together.”

In addition to retaining choice, Dinger said the other two takeaways are that everyone gets a medical home and dollars shrink. “Dollars shrink to the employee … they shrink to the employer … and, in so doing, we begin to build a more sustainable marketplace that will get us past that 2024 timeframe.”

Dinger concluded MissionPoint helps ensure access by addressing many of the practicalities of engaging the healthcare system while simultaneously improving the outcomes of healthcare within the community.

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