By BETSY TAYLOR
Centura Health, like many health systems nationwide, is working to shift its focus from reactive care for the sick, to taking a more proactive stance to encourage patient wellness, emphasizing healthy behaviors and illness prevention.
The Englewood, Colo.-based system, which operates in Colorado and western Kansas, wants to move beyond its hospitals' walls into "health neighborhoods." System leaders describe a health neighborhood as a physician-led effort to create a clinically integrated network where health teams converge to provide primary care, specialty services, urgent care, diagnostic services and occupational health.
Centura Health is organizing the effort under its wholly owned subsidiarity, Colorado Health Neighborhoods.
Centura Health, a faith-based nonprofit, is run through a joint operating agreement between Englewood-based Catholic Health Initiatives and Altamonte Springs, Fla.-based Adventist Health System.
The health neighborhoods will total about 30 geographic areas across Colorado.
In each health neighborhood, there are primary care practices serving as patient-centered medical homes. The goal is to have each one of the Colorado Health Neighborhoods primary care practices become a National Committee for Quality Assurance-accredited patient-centered medical home. In these physician practices, physicians and employees have been improving communication with patients and with other outside health care providers in an effort to make the care continuum seamless for patients. Health coaches and navigators are being hired as part of the Colorado Health Neighborhoods network to promote healthy lifestyles and help patients better manage chronic conditions.
Value focus
Dr. Kit Brekhus, a family medicine doctor and the physician director for Colorado Health Neighborhoods, explained, "When patients require specialty services, referrals are carefully orchestrated between the primary care patient-centered medical homes and the participating specialists. We keep all of the care in the neighborhoods whenever we can." If services are not available in a neighborhood, a patient may be referred elsewhere in the network. Colorado Health Neighborhoods specialists also will be taking part in the patient-centered specialty practice NCQA accreditation program in the future.
John Suits, executive director of Colorado Health Neighborhoods, said, "We're coordinating care across the continuum. We really want to have a relentless focus on increasing value through improved outcomes, service excellence, convenience and, most importantly, do all this at an affordable cost. That's what's going to differentiate our population health management from others."
Colorado Health Neighborhoods has more than 2,200 employed or independently affiliated providers in the network, and it is working to provide convenient access points to care for those in the health neighborhoods. On March 11, Centura Health announced plans for three ambulatory health centers in north metro Denver. Two of the new centers, one in Dacono, Colo., and one in Thornton, Colo., will be funded by CHI at a cost of $7 million each. Adventist Health System will pick up the $15.6 million tab for renovations to convert an existing building in Westminster, Colo., into the third center, system leadership said. At the centers, physicians, nurse practi-
tioners and physician assistants will provide care. The centers will offer primary care, obstetrics and gynecology and diagnostic imaging. Specialists will be available, based on the needs of the community. Scheduled for fall openings, the centers will also offer patients wellness strategies and nutrition counseling.
Centura Health is engaging with patients and consumers with online tools that provide health education and can help users modify behavior to improve their health.
Community connections
Colorado Health Neighborhoods has been working with other community organizations to provide additional care access points. It will be opening a care site on a YMCA campus in Colorado Springs, and is working with a federally qualified health center, a facility which receives federal public health moneys to provide care to a medically underserved population, in the Denver market. Suits said, "We're in discussions with other FQHCs. We think especially when you get into smaller rural areas they will be a very vital participant in the neighborhoods as we manage the health of populations." He said system employees also talk with school and government officials, as well as leaders of public health departments, who often have a strong sense of needs in each patient population.
While many of the health neighborhoods are being established in areas where Centura Health already has facilities and provides services, health neighborhoods have also been created in neighborhoods in areas where the system didn't previously have a presence, such as the San Luis Valley in southern Colorado. Three hospitals, Conejos County Hospital in La Jara, San Luis Valley Regional Medical Center in Alamosa and Rio Grande Hospital in Del Norte, and their associated physicians established a health neighborhood to manage the population in the valley, according to Suits.
Physician engagement
Brekhus said physician leadership has been instrumental in growing the network of health neighborhoods. He explained about 70 doctors serve in leadership roles, whether on Colorado Health Neighborhoods state-level board committees or in regional councils. Brekhus said about
76 percent of the network is made up of independent physicians and 24 percent of it is physicians employed by Centura Health. Suits said physicians are still reimbursed their fees for services as they've negotiated them with their payers. However, Colorado Health Neighborhoods has entered into contracts that include monthly payments per member in each population group as well as shared savings opportunities. Health care providers receive funding for tracking health metrics "above and beyond" what they would normally track, so that physician practices can better determine the health of the population they're working with and track where health improvements are being achieved over time.
Centura Health currently has more than 80,000 people who are part of the populations served by Colorado Health Neighborhoods. It began its health neighborhoods work with its own employees and their families on its self-funded health plan. The system is tracking measures like body mass index in adults and adolescents, hypertension, smoking cessation counseling and diabetes. It has not released data related to this population, saying it's still early in the process. In time, Suits said the Colorado Health Neighborhoods plan to create reports using data from providers and payers, showing the costs of care, where quality is improving and where health improvements need to be made. "That process is just now beginning," Suits said.
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