December 03, 2014

A new nationwide analysis shows that TriHealth West Chester Medical Group has been identified as delivering significantly higher quality care at a substantially lower cost than nearly all of its peers across the U.S.

The findings were announced today by the newly established Peterson Center on Healthcare, which funded the research conducted by Stanford University's Clinical Excellence Research Center. Researchers looked for primary care practices that performed in the top 25 percent on nationally recognized measures of quality, and the lowest 25 percent on health care costs per patient. Of 15,000 primary care practices considered, just 5 percent met these criteria. Of these, researchers conducted in-depth site visits to a sample of the highest performing sites, including West Chester Medical Group.

"The U.S. health care system is the most expensive in the world, but patient outcomes are often worse than many other nations," said Jeffrey D. Selberg, executive director of the Peterson Center on Healthcare.

"Innovative primary care practices in communities across America illustrate that there are bright spots in the system. There are healthcare providers in communities large and small who are consistently delivering high-quality care at a lower-than-average total cost. If we replicated what these providers are doing on a national scale, America would have one of the world's highest-performing health care systems."

Researchers observed that these high-performing primary care practices are distinguished in three distinct ways from practices with average costs and quality scores: their relationships with patients are deeper, their interactions with others in the local health care system are more coordinated, and their practices are organized to foster teamwork.

"Ensuring continuity of care is essential to providing quality care. Our physicians take their own calls five days a week and make closing the gap on hospital visits a priority, said Kevin Bundy MD of West Chester Medical Group. "

When a patient goes to the hospital, our care coordinators contact the hospital to prevent any information gaps. Our coordinators can then facilitate discharge plans, including medications, diagnosis and follow-up. The more we can increase quality through effective communication, the more it will also reduce costs."

The following 10 features shared by West Chester Medical Group and others on the list can serve as a blueprint to achieve higher quality care at lower cost:

1. The practices are 'always on.' Patients have a sense that the practice is always on call, and they can reach the care team quickly, whether the practice is open or closed.
2. Physicians adhere to quality guidelines and choose tests and treatments wisely. Care teams have systems to ensure patients receive evidence-based care and physicians are mindful of benefits, risks and patient preferences when ordering tests and treatments.
3. They treat patient complaints as gold. Practices actively solicit patient feedback, good and bad, to improve the patient experience. 
4. They in-source, rather than out-source, some needed tests and procedures. Care teams do as many tests and procedures-as can be done safely-in-house, often with guidance from specialists.
5. They stay close to their patients, even when referring them to specialists. Physicians refer to a select group of specialists they trust to act in their patients' interests and stay in close communication as care decisions are made.
6. They close the loop with patients. Practices actively follow up to ensure that patients are seen rapidly after hospitalizations, adhere to medications, and see specialists when needed.
7. They maximize the abilities of staff members. Support is provided to physicians by a range of staff who are encouraged to perform at the 'top of their license.'
8. They work in 'hived' workstations. Open, 'bullpen-style' environments facilitate physician supervision and communication across clinical teams.
9. They balance compensation. Physicians are not paid solely on volume of services or revenue they individually produce.
10. They invest in people. Investment in staff is prioritized over space, equipment and technology.

The other exemplary primary care practices named include: Banner Health Clinic Internal Medicine (Phoenix, Ariz.); Baptist Medical Group, Memphis Primary Care (Memphis, Tenn.); Family Physicians Group (Kissimmee, Fla.); Florida Medical Clinic Internal Medicine (Zephyrhills, Fla.); Northwest Family Physicians (Crystal, Minn.); Ridgewood Med-Peds (Rochester, N.Y.); St. Jude Heritage Medical Group (Yorba Linda, Calif.); South Cove Community Health Center (Quincy, Mass.); SureCare Medical Center (Springboro, Ohio); and USAA Health Services (San Antonio, Texas).

"Our findings challenge the belief that excellent primary care can only be provided by large healthcare organizations that are household names," said Arnold Milstein MD, director of Stanford's Clinical Excellence Research Center. "We found un-sung physicians who are achieving something extraordinary-much better quality at a lower cost. What's most encouraging is that their distinguishing features are tangible, and transferable to other primary care practices nationwide."