2020 Acclaim Award Honoree
Intermountain Medical Group
Intermountain Medical Group has incorporated AMGA’s High-Performing Health System™ attributes into their multispecialty practice in the following ways:
- Under the guidance of its Chief Patient Experience Officer, Intermountain has implemented a culture of high reliability in all facets of patient and caregiver experience. Intermountain’s dedication to the safety of its patients and providers has empowered caregivers to create experiences that are personalized and caring, supportive of health, and delivering value that is free from harm.
Access to Care
- Intermountain has placed priority on telemedicine and virtual care. Its diverse digital offerings provide access to quality, affordable healthcare services to all populations and communities.
Quality Measurement and Improved Outcomes
- In 2018 and early 2019, Intermountain Medical Group developed a new primary care compensation model with the intent of promoting and rewarding high-quality, value-based clinical care. The Primary Care Standard Compensation Plan (“Compensation Plan”) was created iteratively in dialogue with frontline providers, senior leaders, and external benchmarking and review partners. The new plan was unveiled to providers in April 2019 and measured five months later in September. These results illustrated double-digit increases in the outcomes of Quality of Care Performance metrics. A planned change in associated provider payment will launch early 2020.
Efficient Provision of Services
- Intermountain’s Fundamentals of Extraordinary Care include: Safety, Quality, Patient Experience, Access, Stewardship, Engaged Caregivers, and Growth. All goals and initiatives are designed to support these fundamentals. Every year across the organization, specific goals are set around managing the per capita cost of healthcare services and improving the overall patient care experience. For example, in 2018, Intermountain’ s Accountable Care and Track 1+ ACO beat the benchmark set by the Centers for Medicare and Medicaid Services (CMS) and generated $2.4 million in savings.
Organized System of Care
- Intermountain places patients at the center of every decision it makes. The Office of Patient Experience (OPE) is chiefly responsible for patient for safety and quality, but also oversees the many elements comprising patient experience. This includes clinical risk management, outcomes quality, peer review, infection prevention, patient advocacy, experience of care, provider well-being, clinical regulatory affairs, data management, registries, and clinical documentation integrity.
- Intermountain’s internal alignment was restructured to better ensure its ability to deliver consistent, world-class patient experiences. Geographically defined administrative regions were replaced with an integrated, system-wide structure that enables comprehensive adoption of best practices and greater clinical consistency. These upgrades permit greater stewardship over quality and safety, as well as facilitate consistent patient experiences regardless of where, when, or how someone interacts with Intermountain.
- Intermountain has transformed the way its care is organized to deliver results that are meaningful and human-centered. Caregiver efforts have been redesigned to coincide with patient journeys, designing for people rather than process. Key successes include implementation of rapid event investigations for potential serious safety events, lessons-learned system-wide communications, an early communication and resolution program, physician error prevention training, application of learning collaboratives for improvement, learning from diagnostic errors, and daily continuous-improvement huddles to connect all to the “why.”
- Intermountain introduced its Experience Promises, three pillars of commitment to both caregivers and patients. Developed in conjunction with caregiver leaders and direct patient feedback, these promises of Always Safe, Always Present, and Always Together are driving the organization’s programmatic and cultural development of safe, quality, consistent patient experiences.
Broadening Lens to Focus on Continuum of Care
- During a 2018 event hosted by the Centers for Disease Control and Prevention (CDC) to launch the Antimicrobial Resistance Challenge, Intermountain publicly committed to improve antimicrobial prescribing in the outpatient setting. Intermountain’s urgent care clinics account for over 50% of its outpatient antimicrobial prescriptions. Prior to the creation of a centralized antimicrobial stewardship structure, no antimicrobial stewardship oversight existed in urgent care. To address this gap, Intermountain’s stewardship team was awarded a contract from the Centers for Disease Control and Prevention (CDC) to investigate how antimicrobial prescribing could be improved in the urgent care setting. This contract resulted in a 14% reduction in the rate of unnecessary antibiotics prescribed for respiratory conditions, equivalent to 3,755 prescriptions or 26 thousand days of antibiotic exposure.
Use of Technology
- Intermountain expanded its capabilities in the areas of Digital Urgent Care, Scheduled Video Visits, and Provider-to-Provider Professional Care, thus enabling patients to receive elite, affordable medical care regardless of their location.
- Intermountain’ s direct-to-consumer urgent care app connects patients at home, work, or on the go with the low acuity, urgent care service they need. Commonly treated conditions include stuffy and runny nose, allergies, sore throat, eye infections, cough, painful urination, lower back pain, and more.
- Reimagined Primary Care (RPC) is a novel practice model designed and implemented at Intermountain to deliver high-value care for patients with financially aligned, “at-risk” payers. RPC is designed around multi-payer risk, incorporating all of the Intermountain’s insurance/payer group products (including commercial, Medicaid, and Medicare Advantage), its Accountable Care Organization (MSSP 1+ ACO), and multiple other aligned commercial and Medicare Advantage plans. Reimagined Primary Care represents the leading edge of the rapid shift from volume- to value-based care.
- RPC started in mid-2018 with eight providers and 5,000 patients at four of Intermountain’s clinics. By the end of 2019, RPC included 45 physicians and advance practice providers in 25 clinics across the region, including both urban and rural settings, caring for approximately 50,000 patients in a totally value-aligned practice model. RPC providers include internal medicine, family medicine, and geriatric specialist providers practicing in the organization’s medical group.