More than five million Americans have heart failure—costing the U.S. health system an estimated $32 billion a year.
But John Bulger, CMO of Geisinger Health System Population Health; Janet Tomcavage, Geisinger's Chief Population Health Officer; and Sanjay Doddamani, CMO of Geisinger's Keystone ACO, argue in NEJM Catalyst that health systems can do better.
They write that that Geisinger's heart failure program—ProvenCare, which launched in 2013—shows how hospitals can improve quality and reduce costs.
Geisinger, a 12-hospital system based in Pennsylvania, focused its ProvenCare program on patients with unplanned acute heart failure who require only diuretic therapy, deeming any such admission a "sentinel event" that could pose a risk to patient safety.
The health system revamped its cardiovascular network, "fully coordinat[ing]" care for such patients by referring them to multidisciplinary care teams organized specifically to manage heart failure patients.
Geisinger also established an on-site, urgent heart failure clinic in 2014 at its main campus in central Pennsylvania, from which:
The urgent care facility also includes beds for patients who need overnight observation. Care teams use a special algorithm to evaluate patients who may need more long-term case management and care. And some patients are sent home for "virtual" observation, for which Geisinger staff coordinate with home-care agencies.
According to Geisinger preliminary data, the program has helped contribute to several positive outcomes. For instance:
Explore the opportunity for coordinated heart failure services and learn how three institutions have developed successful heart failure centers.
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