Avoidable Hospitalizations in Cuyahoga County Fall by Nearly 3,000 for Patients with Common Cardiovascular Conditions, Saving More than $20 million

Improvements Follow Better Health Greater Cleveland Initiatives

    • January 30, 2013

CLEVELAND, OH—Hospitalizations in Northeast Ohio for common cardiovascular conditions addressed by Better Health Greater Cleveland initiatives fell 10.7 percent in 2011 after marking steady declines in the two previous years, new analyses show.

The analyses, which examined cardiovascular hospitalizations for patients who are residents of Cuyahoga County, estimated that 2,854 fewer patients were hospitalized in the three-year period, saving $20.1 million for families, health plans and employers, compared to the next five largest Ohio counties.

The findings are reported today in Better Health’s 10th Community Health Checkup, a twice yearly report to inform the community on primary care providers’ progress to improve care for common and costly chronic conditions. This Checkup also reports the achievements of  55 primary care practices on almost 140,000 patients with one or more of the targeted cardiovascular conditions.

The cardiovascular conditions included in the findings – diabetes, high blood pressure, heart failure and angina – are among the health disorders that researchers classify as “ambulatory care sensitive conditions,” ones for which the likelihood of hospital admission for complications can be dramatically reduced by access to appropriate primary care. Community-wide declines in hospitalizations for patients with these chronic conditions are therefore an indicator of better primary care in a region.

“These new data show that our partner health systems’ efforts to transform primary care are paying off for Northeast Ohio patients, health plans and employers,” said Randall D. Cebul, M.D., Better Health Director and President. “Investments in electronic health records, care coordination and quality improvement have positioned primary care to play a strong and central role in the changing health care landscape.” 

In the 2009-2011 period covered in the findings of reduced hospital stays, 450 primary care provider members served more than 60 percent of patients in Cuyahoga County with cardiovascular conditions, and the number of patients included in  Better Health’s public reports grew.  In the three-year span, data reported for heart failure increased 6.5 percent (5,331 to 5,679), 12.7 percent for diabetes (25,498 to 28,741), and 16.4 percent for hypertension (95,715 to 111,377). The analyses shows year-to-year declines in ambulatory care sensitive hospitalizations as compared to the five comparator counties.

“We are delighted to see tangible evidence that the efforts of Better Health and its member practices is delivering better value for the dollars that business, government and consumers spend on health care,” said Tim Kowalski, M.D., President of Health Action Council Quality Forum and Chief Medical Officer of Progressive Corp. “We are optimistic that more investment in payment systems that emphasize quality and outcomes will further accelerate gains that are needed for the economic health of our region.”

Better Health marks several additional milestones in its 10th Community Health Checkup:

  • The Checkup reports on the care and outcomes of 137,600 patients, five times more than the 26,075 patients in 2007.
  • For the first time, 100 percent of the data are provided by organizations that use electronic health records (EHRs), due to recent conversions to EHRs by Better Health’s safety net partners, which are using them to improve care.   A 2011 paper published by Better Health’s leaders in the New England Journal of Medicine reported higher rates of achievement and faster improvement on quality standards for diabetes patients among practices with EHRs as compared with clinical practices using traditional paper records. 
  • Member practices’ rates of achievement and improvement continue to increase, despite large increases in patient volumes, among all patient groups, including poorer patients and those with no health insurance.
  • For the first time, the top 10 percent performing or improving primary care practices will receive awards to recognize their accomplishments.  Organizations ranging from Cleveland Clinic to Care Alliance Health Center, which primarily serves homeless patients and those in public housing, will receive certificates before a crowd of 170 at a January 30th event at the City Club of Cleveland, where Better Health’s will present results of its 10th Community Health Checkup.

    The event also features a talk by Anne F. Weiss, Team Director and Senior Program Officer of the Quality/Equality Health Care team at the Robert Wood Johnson Foundation and a panel discussion on state and community efforts. Panelists include Karen Butler, Director, Cleveland Department of Public  Health; Jennifer Scofield, Office of County Executive Ed Fitzgerald and Ted Wymyslo, M.D., Director of the Ohio Department of Health.

Better Health is a regional health improvement collaborative that was established in 2007 when it was selected by the Robert Wood Johnson Foundation for its national Aligning Forces for Quality initiative. The program, which now includes 16 communities or states, was developed to foster regional efforts to improve the quality and affordability of health care, a goal that requires collaboration among health care purchasers, payers and patients. Across the nation, regional health improvement collaboratives such as Better Health are responsible for the care of nearly 120 million Americans. Better Health’s new report marks the first time a decline in avoidable hospitalizations has been associated with efforts of a regional health improvement collaborative.

The core activities of Better Health in Northeast Ohio include measurement and public reporting of primary care practices’ achievement on nationally endorsed standards of quality care; identifying best practices and sharing them across health care systems in various forums and providing customized on-site coaching to help practices reach their goals to deliver patient-centered care that improves their patients’ health.

Better Health also works with health plans and employers that are eager for higher value health care --  quality health care that is more affordable -- an objective that is met in large part by reducing hospitalizations  that can be avoided with prevention or better management of chronic conditions in primary care settings.  The new analyses, which rely on Ohio Hospital Association data, confirm the power that primary care improvement can have on employers’ investments in their employees’ health.

 

Media Contacts

Melissa Blair

Robert Wood Johnson Foundation (609) 627-5937

Additional Media Contact: Diane Solov

Better Health Greater Cleveland (216) 778-8414