The Innovation & Transformation Methodology

The Innovation and Transformation Approach/Methodology is an integrated process by which participating health systems accelerate the pace of change by replicating, scaling and adapting the Value-Based Care Model to other systems. We focus on deriving value for employees through process excellence with better results, including service for employees that will reduce the burden of chronic disease and consequently increase savings and satisfaction.

This approach creates a collaborative environment for honest dialogue and critical thinking to co-create innovative best practices in improving health and wellbeing for employees.

PLAN & DESIGN

PLAN & DESIGN

PLAN: Project potential savings from claims and HRA and identify how savings will be realized.

DESIGN: Assign and structure the team to establish performance, satisfaction, and savings targets for health plan, workers’ compensation, and mental health and addiction along with objectives, approach, and timeframe to deliver the projected savings.

IMPLEMENTATION

IMPLEMENTATION

IMPLEMENT: Deliver savings by accomplishing the work plan and delivering approaches to new systems and new populations.

OPERATIONALIZE: Replicate and scale the Principles that were improved.

SUSTAINABLE OUTCOMES

SUSTAINABLE OUTCOMES

SUSTAINABLE OUTCOMES: Continue to replicate, improve, and scale Principles with comparative metrics. Specific replication and scaling of the Principles lead to sustainable outcomes such as continued improvement for savings and satisfaction.

Developed and replicated through a 4-part Value Based Care Model

  1. Culture of Health / Economic Imperative

    The culture of health defines the leadership’s organizational and economic imperative based on these key assumptions: A focus on health and well-being modeled by leadership; an understanding that employees are the most valuable resource within an organization; and prioritization of employee health being economically beneficial for not only employees, but also patient populations and health systems.

  2. Population Health Management System

    A Population Health Management System (Person Journey) for Health Plan, Workers’ Compensation, and Mental Health and Addiction is tailored to the employee’s individual health analytics to ensure enrollee involvement and outline specific projection of savings can be accomplished. This Person Journey explains the components of the delivery system and highlights opportunities for improving the person’s health, as well as the efficacy of the delivery system.

  3. Evolution of the Delivery System

    A restructured delivery system ensures that the proper level of care is available and efficiently delivered to the enrollee, and that the members of the care team are serving “at the top of their license.” The evolution applies to team-based care for pre-primary and primary care, secondary care, tertiary/quaternary care, affiliates and partnerships, and accountable care with the integration of community providers to address social determinants of health for enrollees.

  4. Replication and Scaling Through the HEE Systems

    Implementation of the HEE Model will engage system senior leaders in an accountability model for executing each initiative. The HEE Innovation and Transformation methodology was designed to deploy through Leadership, Design and Implementation teams following a rigorous process for team deliverables. The final component of the HEE Model is where participating health systems implement and share sets of best practices to achieve common set of goals. Moving forward, initiatives are focused on continuous learning pilots and scaled for replication by self-insured employers.

“[This program] creates a reputation in the community that we are serious about health through our living examples of healthy employees.”