Cooperating for better care.


Tag Archives

Geisinger develops a ‘nursing bundle’ to improve care



Geisinger Health System has developed a “nursing bundle” to improve and streamline care.

The big nonprofit Pennsylvania/New Jersey system said, in a NEJM Catalyst article:

“Our goal was to develop and adopt a consistent ‘nursing bundle’ across all of our sites. A bundle, as defined by the Institute for Healthcare Improvement, is a structured way of improving the processes of care and patient outcomes: a small, straightforward set of evidence-based practices — generally three to five — that, when performed collectively, consistently, and reliably, have been proven to improve patient outcomes. This definition allowed us to focus on the most critical elements of the bundle.”

“We created a team comprising chief nursing officers (CNOs) and key nursing leaders across the system. This team identified evidence-based practices that were proven to provide the best experiential and clinical care outcomes. Each CNO was charged with vetting the best practices and eventual nursing bundle plan with managers and frontline registered nurses. This process assured support, buy-in, and input from all levels within the organization.”

Its lessons so far:

  • “Executive leadership must make patient experience a strategic priority via goal-setting, day-to-day behaviors, and culture.
  • “It is just as important to train the top leadership as to train frontline employees.
  • “Monitoring performance is essential. Ongoing results and progress, monthly and quarterly, are shared with our board, our CEO, all levels of leadership, and fellow employees to track performance and celebrate successes.
  • “We are improving our performance by adding other tools, such as an inpatient welcome letter that helps set expectations by educating patients on the nursing bundle elements and providing photos and contact information for the nursing leaders in each department.”

To read the whole NEJM piece, please hit this link.


5 notable provider-payer collaborations


This FierceHealthcare article looks at five particularly interesting provider-payer collaborations in 2016.

In some cases, “a driving force behind these partnerships is the quest to expand access to data that holds the key to lower costs,” Fierce wrote.

The collaborations are:

  • Geisinger Health Systems and St. Luke’s University Health Network, both in Pennsylvania, announced a new partnershipto cut insurance premiums.  Six hospitals and 270 medical offices within the St. Luke’s system partnered with the Geisinger Health Plan.
  • partnershipbetween Moffitt Cancer Center, in Florida, and UnitedHealthcare established a new bundled payment program to cut the cost of cancer care. For a three-year pilot project, the two organizations developed surgery and radiation therapy bundles focusing on early-stage lung cancer. The goal is to reduce costs by incentivizing providers to reduce variation through evidence-based best practices.
  • Anthem joinedwith Aurora Health Care in Wisconsin to create the Wisconsin Collaborative Insurance Co. The partnership offers a commercial health plan called Well Priority to move patients to high-quality providers within the state. ‘’The new 50-50 venture was born out of a 2012 partnership in which Anthem offered incentives and penalties for Aurora physicians based on specific quality measures,’’ says Fierce.
  • Aetna and Inova Health System, in Northern Virginia, solidified their partnership back in 2012through creating Innovation Health Plans, a jointly owned plan that offered financial incentives for low-cost, high-quality care. Four years later, executives have cited such tangible benefits as a reduction in medical-waste costs.
  • After Humana and UnitedHealth exited Colorado’s Affordable Care Act exchange earlier this year, insurance startup Bright Health saw an opportunity to fill the gaps left behind. The company is set to offer plans on the state’s marketplace starting in 2017. Using its existing partnership with Centura Health System, Bright Health co-founder and President Kyle Rolfing told FierceHealthPayer that the insurer, in Fierce’s words, “plans to leveragethat partnership to maintain cost efficiency and high-quality care and invest in technology that allows the two organizations to share data.’’

To read the whole article, please hit this link



Geisinger to buy medical school


Geisinger Health System, based in Danville, Pa., plans to buy Scranton, Pa.-based The Commonwealth Medical College.

The new medical school will be named the Geisinger Commonwealth College of Medicine.

TCMC, which currently has 480 students, opened its doors in 2009. But by 2011, the Liaison Committee on Medical Education (LCME) put it on probation because of its fiscal problems. Then the school considered affiliating with the University of Scranton (Pa.); however those talks  ended in 2012. More happily, LCME lifted its probation a few months later.

Geisinger, which offers health insurance as well as hospital and other health services, has been a pacesetter in integrating health services. For it to buy a medical school is another extension of this.

To read a news article on this, please hit this link.

Geisinger dramatically expanding geographical reach of its insurance


Danville, Pa.-based Geisinger Health System and Bethlehem, Pa.-based St. Luke’s University Health Network have agreed to extend Geisinger health plans to almost 50 Pennsylvania counties.

“The systems will share population and value-based payment model data and create a sponsored Medicare Advantage product to provide recipients access to services not covered under traditional Medicare and Medigap plans. In addition, more than 10,000 St. Luke’s employees will be placed on Geisinger’s health plan, effective Jan. 1,” reported Becker’s Hospital Review.

The development is one of the more dramatic demonstrations of hospital systems expanding insurance offerings to achieve the  cost efficiencies and customer loyalty that some systems see  as needed in the developing value-based world of healthcare.

“When you get to the heart of it, we are two organizations focused on taking the best care of patients and we’re excited to partner with a healthcare system that aligns with our vision and values,” said David Feinberg, M.D., Geisinger president and CEO. “Geisinger is thrilled to expand the scope of our relationship with St. Luke’s to advance population health, improve quality and provide better access to care.”


To read the whole story, please hit this link.

Geisinger sees big gains for heart-failure-treatment integration


Signs of heart failure.

Geisinger Health System, based in Danville, Pa., has long received attention for its advances in integrated care. Now a piece in NEJM Catalyst says it has used better care integration  to improve medication management and reduce emergency-room visits.

FierceHealthcare reports that Geisinger started to consider every unplanned admission for acute heart failure that required only diuretic therapy for treatment as something to be avoided.  System leaders then developed a “central urgent heart failure clinic, offering onsite review of each patient’s care plan, coordination between nurse navigators and community nurse case managers, and medication management.”

The NEJM Catalyst piece summed up the findings thus:

  1. “High-quality, integrated, multidisciplinary teams can be organized around heart-failure care.

  2. “Heart-failure clinical experts can effectively disseminate, implement, and monitor care plans through community partnerships with nurse case managers.

  3. “A unified approach to assessing heart-failure cases through the electronic medical record, by phone, and during face-to-face encounters helps to integrate the work of multidisciplinary teams.”

Preliminary data indicates that  the new approach saved the system $240,000 in ED visits in 2015, with 28 percent of hospitalized heart-failure patients avoiding emergency care. Meanwhile, monitoring of renal function and potassium rose to 80 percent from 41 percent.

Rough road for provider-led insurance

A new McKinsey & Co. report looks at the dainting challenges  of provider-led health-insurance plans and asks whether they will just repeat the mistakes of the 1990’s.

Thirteen percent of all U.S. health systems now  offer insurance in one or more market.

The report says that special circumstances explain the success of the few health systems that have succeeded — such as Intermountain Healthcare, Geisinger and the University of Pittsburgh Medical Center.

Contact Info

(617) 230-4965

Wellesley, Mass