Value-Based Medicine and the Patient Experience

What is Value-Based Medicine?

Value-based care is the approach of improving healthcare quality for patients and preventing problems before they begin. Potential benefits of value-based care are lower costs, higher patient satisfaction, reduced medical errors and better-informed patients. When providers help patients improve their health and limit the problems created by chronic diseases, they are rewarded.

Through the South Texas Health System® Value-Based Medicine Program, we are laser focused on improving health outcomes and lowering the cost of care at every facility. The aims of our program are to:

• Provide better care for individuals
• Improve population health management strategies
• Reduce healthcare costs

Higher Quality at a Lower Cost

South Texas Health System is a leader in Value-Based Medicine initiatives. Our success in the Medicare Shared Savings Program for FY 2018, as reported in 2019, reflected the strong physician-hospital alliance that was created while generating savings in Medicare in excess of $11.4 million and while achieving a 100% Quality Score. These results place our affiliated Accountable Care Organization (ACO) among the top 10% in the country, and have continued through 2021.

We embrace working with all ACOs, payers and physicians in the community so we can collectively share best practices in the pursuit of more cost-effective services and better coordinated care.

Using Analytics to Improve Efficiencies and Optimize Care

• Our facilities offer the opportunity to add a “flag” to the electronic medical record (EMR) to alert our care team when a local ACO’s patient is in or has been admitted to our Emergency Department (ER)/Freestanding ER. This “flag” guides the care team’s decision making from care coordination to care transition.
• We also offer the “best partner” proposition through data sharing and analytics to help local physicians obtain better actionable information in order to assist care management and all other related transitions of care.
• We offer a software system that gives hospitalists — both independent and employed — critical insights into their documentation and care management to help ensure they have the resources needed to optimize patient outcomes.
• In our efforts to improve patient care, we use real-time analytics and engage partners to help uncover care and unnecessary cost opportunities. We help to identify better performing post-acute providers and partner to improve care transitions, lower the cost of care and optimize patient outcomes.

Providing Effective Solutions to Enhance Employee Health and Employer’s Bottom Line

• We provide innovative solutions for employers that help their employees achieve wellness and maintain healthier lifestyles. From concierge-level services for an employee injured on the job to preferred pricing for self-insured employers, our occupational health services focus on keeping employees safe and on the job.
• We also have a partnership with Vera Whole Health. Vera Clinics provide on-site and near-worksite care using an enhanced primary care model that is proven to reduce the employer’s cost of health benefits while offering employees a lower total cost of care for themselves and their covered dependents. By the start of 2023 we will have at least one Vera Clinic in our market.
• In addition, South Texas Health System offers a number of lower cost services in an outpatient setting such as physical therapy, occupational therapy, speech therapy, sleep studies, wound care, intensive cardiac rehabilitation, and physician office clinics.
• We are reducing unnecessary admissions to the ED and hospital, as well as the use of home health and skilled nursing care, with our payer partners and their pay-for-performance programs.

Offering Specialized Pediatric Care to Benefit Parents and Employers

South Texas Health System Children’s is a hospital solely dedicated to children. Here, children receive high-quality care and comprehensive services provided by a multidisciplinary, specially trained team, instilling peace of mind for parents and children alike.

We recognize that a child’s hospital admission affects not only the entire family, but also the parent’s employer who must accommodate parents’ need for time away from work. It is for this reason that South Texas Health System Children’s is committed to offering more pediatric subspecialty services locally. By doing so, we can continue to help parents and their children stay in the Valley when specialized hospital care is needed. In turn, we are in the process of creating a Clinically Integrated Network with local pediatric offices to achieve increased value and deploy Value-Based Medicine Program services across all populations.