A value-based strategy to address COVID-19: the Cambridge Health Alliance approach

Location:
Venue: Webinar
Date: 02 September 2020 9:00am to 02 September 2020 10:00am

Presented by Kirsten Meisinger, former Medical Staff President, current Regional Medical Director and Director of Provider Engagement, Cambridge Health Alliance

Janice John, PA-C, Medical Director of the Acute Care and Respiratory Clinic, Cambridge Health Alliance

Health systems in the United States have largely responded to the COVID-19 crisis according to their core competencies and for fee-for-service funded systems. This means ‘bigger is better’ and for most, ‘heads in beds’ has been the key strategy. Few have looked past the hospital walls to draw on resources in the surrounding communities.

The avoidance of excess costs and inpatient resource use show how a community-based strategy can help augment the capacity the health care system needs – avoiding inpatient settings from being overrun and collapsing during outbreaks as seen with COVID-19.

Cambridge Health Alliance (CHA), a Boston area-based safety net hospital system with a large ambulatory primary care and psychiatry network, has long pursued a value-based funding strategy and consequently implemented a value-based strategy in response to the COVID-19 crisis.

While CHA expanded hospital bed capacity in anticipation of the surge of acutely ill patients, they also remained focused on how to redistribute care in a system under stress. Using principles of risk stratification, they moved the evaluation, management and treatment of COVID-19 to the community setting, blunting surges in hospital demand, and limiting the impact on their system’s two hospitals.

CHA’s innovative community-based COVID management has treated 4,000 patients to date with only a 4.5% hospital admission rate, contributing to the Cambridge Hospital staying below its regional peers for ventilator access in spite of caring for a patient population with a community case rate that was more than three times the state average.