Risks and Rewards

AVH is “All In” the Hospital Transformation Program

Aspen Valley Hospital is participating in a program that will continue to build on positive changes it is making to support patients with better care and lower costs in the Roaring Fork Valley.

The Hospital signed onto the Colorado Hospital Transformation Program, a state-led effort that requires participating hospitals to create plans that improve patient outcomes and reduce the overall cost of care. By participating, AVH has agreed to hold itself accountable. If successful in hitting its program targets, it is eligible for more than $1 million in additional compensation, but if it fails to meet the targets it will be penalized financially.

“We chose to participate because we believe in advancing patient care through models that focus on our quadruple aim — increasing access, reducing costs, improving quality and enhancing provider engagement,” says Aspen Valley Hospital Director of Quality, Patient Safety and Risk Management Elaine Gerson.

The Colorado Department of Healthcare Financing and Policy designed the Hospital Transformation Program so that key activities and quality measures apply to hospitals across the state, but allowed flexibility so each hospital can develop approaches that best serve the local population.

It specifically tracks outcomes for patients enrolled in Health First Colorado, which serves people on Medicaid, but it will positively impact care for all of the Hospital’s patients.

“The measures we selected at Aspen Valley Hospital are geared specifically toward our broad patient population in the Roaring Fork Valley, including people enrolled in Health First Colorado as well those on Medicare or who have health insurance,” Gerson says.

So, what does this mean for the Hospital and its patients?

The Hospital will work closely with insurer Rocky Mountain Health Plans (RMPH), which is the state-designated “Regional Accountable Entity” that is in charge of administering Health First Colorado’s programs and payments in western Colorado.

Patients will receive more support from both organizations, but likely won’t notice many changes because several program goals are already being implemented here.

Aspen Valley Hospital’s focus areas include:

• Follow Up After Discharge: When patients are discharged, the Hospital has one day to notify RMHP, allowing them to ensure patients receive care coordination to connect with primary care and behavioral health care providers.
• Behavioral Health Support: Support for patients who present with mental health challenges, including substance use disorder, by connecting them to programs and providers who can treat their issues and develop follow-up plans.
• Postpartum Support: New mothers who screen positive for postpartum depression and anxiety are given support and care as soon as possible.
• Social Determinants of Health: The Hospital and its network of caregivers screen patients to identify those dealing with food and housing insecurity or have trouble with transportation. While not directly related to medical care, these issues can impact people’s ability to receive care in a timely fashion. The Hospital will connect them with organizations that can help with these basic needs.
• Opioid Reduction: This measure is designed to reduce opioid use and increase use of alternative medications for treating pain.
• Telemedicine: In rural communities such as the Roaring Fork Valley, telemedicine is an adjunct to improving access to many subspecialty providers who don’t have offices here.

Going forward, Aspen Valley Hospital and Rocky Mountain Health Plans will continue their work with local and regional agencies. The Hospital is also engaging Pitkin County’s public health and human services departments to keep them apprised of its work in the Hospital Transformation Program. And finally, it will look for opportunities to engage the broader community in the coming months.

“All of these measures relate back to our ‘quadruple aim’ in one way or another,” Gerson says.  “And because these measures are good for the overall population, most of these screening tools are already being used with all of our patients.”