The Nashville Health Care Council hosted Robert Allen, senior vice president and chief operating officer of Intermountain Healthcare, for an in-depth conversation about innovation and delivering value-based care. The discussion was moderated by former Utah Governor Mike Leavitt, founder and general partner of Leavitt Partners, at the Loews Vanderbilt Hotel in Nashville. More than 200 Council members were in attendance.
View event photos on Flickr.
Photo credit: (c) 2019, Donn Jones.
The conversation explored Intermountain Healthcare’s growth into an integrated delivery network, its continued commitment to proactive community-based care, and the impact of innovation on patient livelihood.
Salt Lake City-based Intermountain Healthcare was founded in 1975 and was a gift to the community from the Church of Jesus Christ of Latter-day Saints. The religious organization built and managed 15 hospitals in Utah, Idaho and Wyoming.
“In the mid-seventies, the church recognized health care was becoming much more complex, and their mission was to reach far and broad,” said Allen. “They gifted hospitals to the community with one charge: to be a model health system. That’s how we started.”
Since then, the not-for-profit health system has blossomed into a network of 24 hospitals, including a “virtual” hospital. It has 40,000 caregivers, a medical group with more than 2,400 clinicians and 215 clinics, a health plan division, and other services including affiliate networks, homecare and telehealth. Intermountain’s reach extends west through Utah and into the southern regions of Idaho and Nevada.
“Intermountain Healthcare has always existed to serve the community. As long as we’ve been financially sound, we have focused on community needs,” Allen said. “Fifty percent of Americans can’t afford an unexpected $400 bill. We have a mission to deliver care to those who can’t pay, and we’ll continue to do that.”
Through Intermountain’s growth came significant turning points in the organization’s approach and business model. As they grew, the organization realized they were operating two businesses and redesigned the organization to focus on acute care and community-based care. As chief operating officer, Allen was involved in the redesign.
“When patients needed episodic service, we wanted to continue to deliver the best care at the most affordable cost. But we also recognized that our mission demanded we focus on a patient’s lifelong journey by offering community-based care,” he said. “We had to ask, ‘How do we structure our organization to connect with patients throughout that journey?’ Changing the dynamic to better care for people before they entered the hospital and more efficiently after they left it was a big but important shift for our journey.”
Before opening the discussion to audience questions, Gov. Leavitt asked for examples of innovation currently occurring at Intermountain.
“Innovation happens every day at the front line at Intermountain,” said Allen. “When we launched our new operating model, we created a process for caregivers to submit and execute innovative ideas. Last year caregivers brought forth 48,000 ideas that were put in action. From minor to major ideas, Intermountain is implementing more than 130 ideas per day.”
An integral step in innovation, according to Allen, is recognizing areas for improvement. In support of their mission to help people live the healthiest lives possible, Intermountain employed a new approach at a handful of their clinics: a coordinated care model allowing primary care providers to organize when, where, why and at what cost patients receive care. This approach helps patients receive the right care at the right time, in the right place, for the right price. As a result, Intermountain saw a 60% reduction in hospital admissions, a 35% reduction in emergency room visits, a 20% decrease in per-member per-month spend and a dramatic increase in physician, caregiver and patient satisfaction. To further expand this care model and add strength to the Intermountain health system, they acquired Healthcare Partners Nevada, a physician group providing patient-centered primary, specialty and urgent care services to approximately 375,000 people.
Intermountain is also a founding member of an innovative project related to social determinants of health, the Utah Alliance for the Determinants of Health. This collaboration between community partners is designed to address the social and environmental forces that can affect people’s health, such as access to food, housing, employment and transportation. The alliance chose two zip codes in Ogden and St. George, Utah, with a high amount of need, to provide acute and preventive care. Intermountain has committed $2 million annually for three years to this project.
“These are multi-year or sometimes multi-decade journeys,” said Allen. “It’s important to understand that when you get into something you really believe in strategically and it’s getting rocky, instead of looking for the way out, look for a way through.”