February 2020

Health Care Systems Will Face New Challenges as Disruptors Move In

There was a clear take away from the WCHQ February 12 Assembly: Health care organizations must reinvent themselves or others will do it for them. To illustrate just two of dynamics, WCHQ invited a health insurer to describe what they see as dynamics that are driving change in the health care marketplace, and a representative of Walmart’s new health and wellness efforts.

A former health plan executive and physician in Wisconsin, Craig Samitt, MD, MBA, now President/CEO of Blue Cross Blue Shield Minnesota, shared four predictions based on his experience:

  • # 1 - Health care as we know it is unsustainable. It is not working, and health care systems are not making progress fast enough, according to Dr. Samitt, that leaves room for the disrupters to, well, “disrupt.”
  • # 2 - If we don’t deliver value, someone will. Health care is not different, the incumbents make it different.
  • # 3 - Reinvention of health care is transformational not incremental. We cannot be in the lower half of affordability and upper quartile of cost. We are creating the opportunities for others to come in and make change happen. The incumbents can be realigned to make the changes that are needed, including teaming up to combat rising health care costs.
  • # 4 - The incumbents will rise. No single incumbent will prevent disruption. Silo’ism doesn’t deliver results. To reinvent health, incumbents will need to rise. Together.

Dr. Samitt encouraged health care systems to “get into new spaces where we can make a difference.” Examples of these areas included prescription drugs costs, disease prevention and addressing the opioid crisis.

Walmart is, without a doubt, seen as a disruptor, but the health care business and promoting healthy living is not new to Walmart. Soujanya (Chinni) Pulluru, MD is the senior director with Walmart Health and Wellness working in clinical strategy, quality and operations. She leads Walmart Health on scope of services, quality, clinical education and proficiency as well as operations. The statistics Dr. Pulluru give weight to her statement, starting with the fact that Walmart has been in the pharmacy business for 40 years. In 2019, Walmart:

  • Filled 425 million prescriptions;
  • Dispensed 6.5 million glasses;
  • Saw 100,000 patients last year in 19 care centers located in 3 states;
  • Conducted 4 million Walmart Health Screenings; and,
  • Saw 160 million people walk through one of the 4,769 stores in the US every week.

Dr. Pulluru noted that 90% of the population in the US lives within 10 miles of a Walmart. When Walmart surveyed customers to identify why they were not getting health care, 43% cited cost, 27% said it was not convenient and 22% identified access to providers and services was an issue for them.

Walmart is committed to having their stores be the “center of well-being in the community.” In September 2019, Walmart opened their first Walmart Health Center delivering primary care, labs, x-rays and EKGs, behavioral health, optical, hearing and community health in one location.

“Our presence in thousands of communities, rural areas, and hard-to-access areas give us a unique opportunity to provide access to affordable health care to many people,” according to Dr. Pulluru. “Walmart is committed to making health care more accessible and affordable to our communities. It is an important part of what we feel our role is in the communities that we serve.”

The February Assembly was the first of five education events WCHQ will hold in 2020. To align with WCHQ’s strategy to help our members improve both the quality and value of health care, members can expect to learn how Wisconsin health care providers are delivering better, more affordable care in their local communities. If you have a project, program or a process you would like to share at a WCHQ education event, contact Mary Kay Fahey. Our members are our greatest resource and collaboration is in our name. We are always proud to showcase our members clinical achievements.

The February 12 meeting materials and recording that featured Drs. Samitt and Pulluru are available to members only. If your organization is a member, you can log in or sign up for access to the WCHQ Online Community here.

Registration Open for WCHQ Assembly, “Innovations in Behavioral Health Access and Treatment”

The challenges providers face in identifying and treating behavioral health issues that are comorbid with medical illness are well documented. Confounded by workforce shortages, health care professionals in the primary care setting are using innovative approaches to support patients with depression, anxiety, chronic pain and other behavioral health and medical issues.

Registration is now open for WCHQ’s April 21 Assembly, “Innovations in Behavioral Health Access and Treatment” and feature presentations by both national experts and WCHQ members.

The keynote speaker is a nationally known expert on integrated behavioral health services in the primary care setting, Neftali Serrano, PsyD. Dr. Serrano is CEO of the Collaborative Family Healthcare Association, a national not-for-profit organization dedicated to promoting integrated care as the standard of care. He has devoted much of his career to working with federally qualified health centers (FQHC), starting integrated care programs and consulting with clinics in underserved settings to assist with implementation of primary care behavioral health (PCBH) programs.

Presentations by several members of the WCHQ Behavioral Health Steering Team in the afternoon will offer the audience an opportunity to learn about innovative treatment approaches in Wisconsin clinics. They include:

Behavioral Health Treatment: Adolescents

  • Monica Case, MBA, director, Behavioral Health and Physical Rehab Services, UnityPoint Health – Meriter Hospital
  • Howard Wiese, BSN, MSN, Nurse Manager, Meriter’s Child and Adolescent Psychiatry Inpatient Unit
  • Sarah Schlough, LCSW SAC, Program Supervisor of Unity Point – Meriter’s Child and Adolescent Psychiatry Intensive Outpatient Services

Treating Chronic Pain and Health Issues in the Context of Behavioral Health

  • Michael Larsen, PhD, Marshfield Clinic Health System

Telehealth: A Resource in Improving Access to Behavioral Health

  • Jessica Small, PharmD, Vice President, Operations, Advocate Aurora Behavioral Health Services

Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) in the Clinical Setting

  • Laura Sanders, MSSW, Great Lakes Addiction Technology and Transfer Center

Direct questions about the Assembly to Mary Kay Fahey. For information related to WCHQ’s Behavioral Health Steering Team, including how to join, contact Sarah Wright.

The ABIMF Recognizes WCHQ for Building Trust in Health Care; Invites Applications

Recognizing the importance of rebuilding trust between physicians and patients, the ABIM Foundation has made a concerted effort to raise these issues on the national stage through the Trust Practice Challenge, a major initiative to identify innovative, effective approaches to building trust in health care.

Last summer, WCHQ was honored by being selected as one of eight “trust practice challenge” winners by the ABIMF. WCHQ was recognized for its pioneering and sustaining work in building trust among and between physicians/health systems, the business community, and the public at large through its mission of public reporting and collaborative learning. In making the award, ABIMF recognized WCHQ’s long history of innovative and leading-edge work toward improved health, better care and lower cost.

As part of WCHQ’s selection, WCHQ President/CEO Chris Queram was invited to make a three-minute presentation (think of it as a kind of “TED talk”) at the annual ABIMF Forum. The video summarizes how WCHQ has influenced and built trust by adhering to its basic mission of catalyzing collaboration, public reporting and transparency. at the annual ABIMF Forum. (This video will also be posted to WCHQ’s Online Community and WCHQ.org.)

The ABIMF is moving to the next phase of this initiative by recruiting health systems and provider organizations to engage in the trust-building effort. If your organization is interested in participating, contact Chris Queram.

Celebrate and Learn with WCHQ June 16 in Madison

Mark your calendar for June 16 for WCHQ’s Annual Statewide Quality Conference. A number of WCHQ’s members are presenting on topics related to integrating pharmacy into primary care, behavioral health and innovations in treatment that improve access to specialty care.

Join us as we celebrate the top performers in WCHQ’s priority areas and as we present the Quality Leadership Award. We have added several new award categories to recognize both large and small systems as they improve care and help Wisconsin reach its potential to be the healthiest state.

For information, contact Mary Kay Fahey.