Wisconsin Health Plan Leverages MCG’s Cite to Transform Care
SEATTLE, May 10, 2016 – MCG, part of the Hearst Health network and a leading provider of informed care strategies, has named WEA Trust a recipient of the 2015 Doyle Award. The award recognizes WEA Trust’s innovative implementation of MCG’s informed care solution. WEA Trust implemented Cite, the industry’s most interactive evidence-based solution, to create a member-centric, coordinated care program. WEA Trust now assigns a single nurse “quarterback” to a member, reducing care delays and confusion. The result has been $12 million in reduced costs, but most importantly, reassurance for their members.
WEA Trust was able to accomplish this transformation by merging utilization review, complex care management, and disease management into the Care Management program. “A piecemeal approach to member care can mean settling for member confusion and fear,” said Mary Hughes, director of Member Health Services at WEA Trust. “Why settle? Using MCG’s Cite to help drive transformative change in care coordination, we’ve lowered costs by helping members know the care that is not appropriate and can even be harmful. Quality can cost less.”
With Care Management in place, WEA Trust is seeing results. Patient length of stay has reduced by 7.4%, inpatient admissions per 1,000 members have trended down, and readmissions have remained low. Hughes attributes the strong metrics to early, systematic use of Cite’s admissions guidance and discharge planning tools. “Unnecessary care exposes patients to needless inconvenience, but worse, to unnecessary risk. The patients understand this as we purposefully include them in the care discussion,” said Hughes. “MCG supports our conversations with patients and providers by offering objective, transparent evidence about admissions and procedures, along with care alternatives. A patient suffering from back pain sees theCare Manager not as an obstacle, but as an ally in exploring care options...and we have received thank you notes for this.”
WEA Trust has avoided significant unnecessary care in three key areas: Advanced imaging, spinal procedures, and inpatient sleep studies. According to Hughes, Cite’s extensive discussion of these high-cost procedures, with the underlying science referenced completely, has consistently helped care teams reach decisions based on patient outcomes, resulting in reduced costs.
The Care Management program has used Cite to improve administrative efficiency in a number of ways. Cite CareWebQI allows staff to access MCG’s evidence within the existing medical management system. With simplified workflow through integration, Care Management nurses spend more time with patients and less time documenting care decisions. By using MCG tools to cross-train nurses, the Care Management program has reduced internal hand-offs, improving both efficiency and patient experience. Care Managers use Cite’s flexible reporting to identify variations in care decisions across staff, focusing further training and more effective clinical decision making.
“In creating a new model for care coordination, the WEA Trust has demonstrated vision and a commitment to care focused on patient outcomes,” said MCG President Jon Shreve. “It is rewarding to partner with such a high-performing healthcare organization.”
About WEA Trust
The WEA Trust provides group health insurance and administrative services to public employers throughout Wisconsin. The not-for-profit WEA Trust was created in 1970 to serve Wisconsin school district employees. Today, the WEA Trust offers its top-rated service and quality benefits to all state, county, and municipal groups. To learn more, visit www.weatrust.com.
MCG, part of the Hearst Health Network, helps healthcare organizations implement informed care strategies that proactively and efficiently move patients toward health. MCG’s transparent assessment of the latest research and scholarly articles, along with our own data analysis, gives patients, providers and payors the vetted information they need to feel confident in every care decision, in every moment. www.mcg.com.
About Hearst Health
MCG is part of the Hearst Health network, which also includes FDB (First Databank), Zynx Health and Homecare Homebase, Hearst Health International, Hearst Health Ventures and the Hearst Health Innovation Lab. The mission of the Hearst Health network is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person’s health journey. Each year in the U.S., care guidance from the Hearst Health network reaches 84 percent of discharged patients, 174 million insured individuals, 41 million home health visits, and 4 billion prescriptions. www.hearsthealth.com
About The Richard L. Doyle Award for Innovation and Leadership in Healthcare
The Doyle Award was developed to recognize organizations that make innovative use of the care guidelines to help deliver effective healthcare. Dr. Doyle, the care guidelines founding editor, was a hospital chief-of-staff when he began creating clinical guidelines in the 1980s to help improve healthcare efficiency and quality at Mercy Hospital in San Diego. He later joined Milliman & Robertson and in 1990 published the first set of what was to become the care guidelines. Judges for this award are independent healthcare quality experts, not currently associated with MCG. Applicants were judged on how well their projects supported the MCG mission to help drive effective care. Judges looked for evidence of improvements in healthcare quality and patient safety; patient/member satisfaction; staff efficiency, productivity and satisfaction; internal/external communication; and effective use of resources.