Community Care Alliance, a Western Health Care Alliance Company

August 2019
Organization: 
Community Care Alliance

Network Name Community Care Alliance, a Western Health Care Alliance Company
Location Glenwood Springs, CO
Key Contact

Marguerite Tuthill, Network Development Manager

Tyler Downing, Data Innovation Manager

Website

https://communitycarealliance.com/

Mission Collaborating to Improve Community Health Care
Vision The Valley View Hospital (VVH) and the Community Care Alliance (CCA, Network) seek to expand access to, coordinate, and improve the quality of essential health care services in the rural communities in which the Network's participating providers operate or reside. 

Marguerite Tuthill, Network Development Manager, and Tyler Downing, Data Innovation Manager for Community Care Alliance, were interviewed by the Network TA team discussing their Data Analytics and Dashboards. 

In a nutshell, how would you describe your network?

We’re member owned and rural focused. Our members are Critical Access Hospitals (CAHs), Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and independent practices, all interested in building value-based capabilities and collaborating across the region. We are owned by a network of rural hospitals and healthcare organizations, the Western Healthcare Alliance.  The Western Healthcare Alliance provides the necessary administrative support for the Community Care Alliance to focus on the population health space.

Aside from those mentioned above, what types of organizations are you partnering with?

A regional behavioral health organization is represented on our Accountable Care Organization (ACO) board, and it has been good to have their perspective included at the board level. We also partner with other rural ACOs across the country and communicate on a regular basis with regional health alliances made up of organizations focused on social determinants of health. A Health Information Exchange (HIE) happens to be headquartered down the street from us, and we are always looking for ways to work with them.

What network accomplishments are you most proud of?

In theory, we’ve generated about $6 million in CMS shared savings for our members. Unfortunately, we haven’t actually seen these funds because we just barely missed our minimum savings ratio. Still, we know we’re on the right track with these numbers.

We’re also proud of having created a clinically integrated network. We’re days out from signing our first performance fee contract with a group of self-funded employers.

Lastly, we’re proud to have trained over 50 Care Coordinators. Our member hospitals hire these folks and the network is responsible for training. It’s great to be responsible for creating 50 new jobs in rural communities through this program.

What are your biggest challenges?

Our number one challenge is inadequate data analytics platforms. The first platform we had did not meet our needs, so we’re now on our second platform in two years. We’re still in the process of working through interoperability with this platform.

Provider engagement is getting better, but this is still a hurdle to overcome. We would like to see more providers attending our regularly scheduled clinical meeting and would like to see more of those who do attend participate more fully in discussions.

Another major challenge comes from having a complex network organization operating in a complex healthcare environment. It’s our job to educate our members on CMS rules, Merit-Based Incentive Payment Systems (MIPS), commercial insurance, healthcare regulations, and many other topics. We often have to explain things multiple times before people really understand, and then much of it changes the next year and we have to start all over again.

What advice would you give to other network leaders?

Make sure you have a well-developed three-year strategic plan before you implement your project. This can be difficult when there’s a short timeframe between grant award notices coming out and grant project start dates. It’s very difficult to be developing a strategic plan and carrying out the project at the same time, especially when things change during the process of implementation. There are so many things we want to do that it’s easy to get out of scope quickly. A strategic plan solidifies things and keeps you grounded when everything is moving so quickly.

Talk to other networks. Largely this grant program is how we’ve met other networks. It’s one of our favorite parts of participating in the grant. Other networks are working on similar challenges and really help us figure things out.

What role do you see networks playing in population health?

Networks are a natural approach for population health with their broad reach of partners. There are so many networks, alliances, and community groups out there, it’s important to pool resources and avoid duplicating services that other networks offer. We have to be careful to not oversaturate the community and give everyone “network fatigue”.  

Data Analytics and Dashboards

What best practices regarding data do you think all network leaders should follow?

Have well-defined Key Performance Indicators (KPIs) on both the quality and financial side, for the board and for members. These can change over time, but it’s important to have a set of KPIs right from the start. There are great resources for this. For ACOs, the National Association of ACO’s (NAACOS) provides really valuable information. We attend several of their boot camps. We also read a lot of white papers from health organization consulting firms such as Premier.  These resources allow us to keep up with changing regulations as well as facilitate internal calculations which work to model our current financial and quality positions.  We talk to other ACOs, some of which we find via a public use file that gets put out every year. We look up people who are similar to us in size and assigned benchmark and query them to investigate our alignment with other successful ACO programs.

Have a documented data model for standardized reporting, and we keep up with developing robust documentation.

When working on standardizing financial data reporting across network members, enlist billers, and coders in developing the process. It can also be helpful for network staff to have some coding knowledge.  

As far as standardizing quality data across network members, this can be challenging when members have different Electronic Medical Records (EMRs). CMS has good guidance on calculating numerators and denominators, but different EMRs store these in different fields. It can sometimes take substantial manual work to get a HIE to pull this data together correctly.

What’s the best way you’ve found to get data from your members and partners without placing too big a burden on them?

Commitment from members is key. We can’t do much without the support of our members.

For your members to support you, it’s important that they know you support them. When you pick an analytics platform, talk to as many of their customers as you can and make sure there aren’t a lot of hidden costs. We  chose our new platform, in part, because their fee structure didn’t pass any unforeseen fees onto our members.

What advice do you have for choosing measures that best tell the story of your progress and impact?

For our ACO, we started by pulling historical data for our population to get a solid baseline. Our KPIs generally relate to the population’s risk and prevalence of disease state because those are priorities for us. Choosing the right financial data is a little easier because benchmarks are already established for us as an ACO.

We also look at things that we know have a major impact on our goals. For example, we look closely at data related to things like directing people to the right skilled nursing facility because this can make or break shared savings in a Medicare program.

Any other advice for network leaders related to data?

Take the time you need to find the right people to fill data-related roles. It’s really hard to find the right person with the right skills. Do everything you can to offer compensation that will attract skilled data professionals. Don’t sell yourself short as far as data support.