Mercy Clinics
Reorganizing Care around the Wagner Chronic Care Model
Mercy Clinics, Inc., in partnership with Mercy Medical Center in Des Moines, IA, provides patients and families convenient and effective treatment for sudden illness, minor injuries, disease prevention, diagnosis, treatment and education.
Prior to 2008, Mercy Clinics faced a problem: their inconsistent health care delivery systems were resulting in inconsistent patient care. They found that only 55 percent of patients were receiving evidence-based care in primary care settings, blood sugar was being controlled in only 37 percent of diabetic patients, and blood pressure was being controlled in only 35 percent of patients with hypertension.
To combat these issues, Mercy created systems that supported proactive rather than reactive patient care. Mercy took the following actions:
- Implemented disease registries;
- Partnered with insurers for pay-for-performance incentives to accelerate change;
- Redesigned care around teams;
- Hired and trained health coaches to support patients in self-management;
- Restructured patient visits around pre-visit, encounter and post-visit segments;
- Allowed for greater transparency of results whether good or bad.
Results:
- 97% of patients identified as needing care sought care when presented the opportunity.
- Coumadin (Warfarin) patients at INR goal increased from 60 – 85%.
- 65% of Diabetic patients had an HgA1c< 7.0, 70% had an LDL < 100, and 63% had a BP < 140/80.
- Office visit average cycle time reduced from 80 minutes to 45 minutes.
- 1.6 FTE Health Coaches increased net revenues.
- $866,500 was paid in incentive payments from insurers.
***For further information, please contact Julie Sanderson-Austin, VP of Quality, American Medical Group Association, JSanderson-Austin@amga.org.
Published: January 26, 2009
