Dale Maxwell, who was recently named president and CEO of Presbyterian Healthcare Services, based in Albuquerque, N.M. discussed with Hospitals & Health Networks his system’s innovative initiatives, including its patient-navigation model and its increasing use of telemedicine to treat its far-flung rural population.

He said that the system must grow to be sustainable over the coming years, saying:

“We have two really important initiatives from the growth standpoint right now. One in Santa Fe, where we’re building a medical center to serve the northern part of New Mexico which will open in 2018. Growing outside of New Mexico is also an important strategic option for us. Over the past 30 years, we’ve built expertise and knowledge in integrating the financing of care into the delivery of care; we’re in a great position to export that knowledge and expertise outside of New Mexico and partner with other provider systems to ensure the move toward value-based care and population health. And in North Carolina, we’re partnering with 11 systems to bid on Medicaid as they roll out managed care and move away from a fee-for-service model.”

On the patient-navigation model:

“We started this model in 2010. It came out of the early work of looking at the data and analytics, where patients received care and the overall cost of that care. As we looked at the emergency department, it was a great opportunity to change how care is delivered and be more specific about delivering care in the right place at the right time.

“As patients enter our ED, each one has a medical screening. If the screening determines that the patient is not in an emergency status, the or she is navigated to a more appropriate care setting. That could be a referral to urgent care or a primary care facility.

“The goal is to establish that patient with a primary care physician; then they can begin to manage the patient for future services. It’s taking a very expensive ED visit and translating it into a less costly clinic visit. More importantly, the management of the patient in the long term is going to provide better care to the patient and, overall, decrease the cost of care.”

On the system’s home health care, including palliative services:

” The unique piece of this is that it’s embedded into our patient-centered medical home, similar to other services like behavioral health or pharmacy management services. This aligns the care across the continuum with all of the care teams, so it’s not isolated in any respect.”

On telehealth:

“We have a couple of, I would say, established and successful programs. One is our Telecritical care program. Intensivists here in Albuquerque take care of patients at two of our regional facilities through video. By using the care teams at the point of care and a physician in Albuquerque, we’re able to deliver the necessary care for the patient. He or she receives the highest-quality physicians, is able to stay in the community and doesn’t need to be transferred to a different facility, so that really benefits members.”

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