Issue link: https://beckershealthcare.uberflip.com/i/644565
19 e rate of primary care physicians in Nevada per 100,000 popula- tion is 49th in the nation, while Nevada's rate of physicians in gen- eral surgery per 100,000 population is 50th in the nation, according to the Nevada Legislative Counsel Bureau. To meet the physician need, MountainView Hospital launched a graduate medical education program in 2015 to focus on residency programs in critically needed specialties. MountainView recent- ly received accreditation for its first residency program — internal medicine — from the Accreditation Council for Graduate Medical Education. Residents accepted into the MountainView internal medicine GME program will begin in July 2016. Approximately 20 first-year and 20 second-year residents are expected to be selected. In anticipation of residents joining MountainView, we launched GME clinics, includ- ing internal medicine, general surgery and family medicine. In the long-term, offering medical students more options in Nevada for their residency will attract more physicians in Nevada. We antic- ipate this program will help enhance the local supply of physicians serving southern Nevada and help to improve patient care access for the Las Vegas community. HCA [MountainView's parent system] also recently announced the acquisition of Urgent Care Extra's Ne- vada operations, which include 14 urgent care centers in Las Vegas and six additional urgent care centers that are under development. e acquisition continues to help improve patient access." New Hampshire James Weinstein, DO, President and CEO, Dartmouth-Hitchcock (Lebanon) "e definition of 'population health' is really important. Many people talk about popula- tion health in terms of the population com- ing through their health system. ey're oen thinking about the patients in the neighbor- hoods and areas they take care of. At Dartmouth-Hitchcock, we think about what the population at large needs. is includes issues like housing and nutrition and other things we don't get paid to do. ey're way upstream, but they're the most pressing problems when we think about the real needs of society in this country. We're going way upstream to people who don't even come to us — such as babies, teenagers and kids who have single-parent homes — as well as broader subjects, like gang issues, where the best food stores are located and where the educational opportunities are. All of those issues are about population health. ere's also the issue of payment. We have very nontraditional pay- ment struggles. In New Hampshire, we have Medicaid expansion, but it pays 20 to 30 cents on the dollar. Our state has the lowest Medicaid reimbursement in the U.S. We have very altruistic goals, and want to do things outside the health system, but we also want to get paid when we care for that 15 percent of our population. What we're doing is creating an industrial revolution. I have a book coming out soon on this very issue that talks about what I think the next industrial revolution for our country will be, which is in healthcare. We have to change the models, methods and payment systems to create a sustainable health system — not healthcare sys- tem. We want to design our delivery system and create payment models that allow for those systems to be sustained." New Jersey Brian Gragnolati, President and CEO, Atlantic Health System (Morristown) "Health disparities among our most vulnerable populations are a great concern in our market. We still see lower-income, linguistically iso- lated people have less access to healthcare and community resources. is is poignant in New Jersey, where the cost of living is so high, yet about one-third of people in our area live on an income below the 'survival budget' threshold. is results in dispa- rate health outcomes and alarming mortality rates for disorders like diabetes. We need to do a better job of making sure these populations have proper coverage and access to care. We need to help physicians, clinical staff and healthcare facilities develop population health management skill sets. We need to expand use of patient risk assessment tools and analytics, better understand where our resources should be focused and ensure our efforts result in quality delivery with measurable outcomes. Lack of engaging and activating our patients take the effectiveness out of our efforts in healthcare. Patient noncompliance with med- ical care plans, along with lack of healthy lifestyle choices, have a detrimental impact to the health of our populations. We are provid- ing direct, culturally-tailored services and investing in approaches to improving physical activity and nutrition, partnering with local organizations that serve vulnerable populations, and working to de- crease wait times for specialty care for Medicaid and charity care patients. We also launched a systemwide health literacy initiative to make healthcare communication less complex. In addition, we are working through our ACOs — Atlantic Health System ACO and Optimus Healthcare Partners ACO — to educate providers on implementing team-based population management models. We also need to better wield the power of healthcare information. Information that is accessible, integrated and transparent can bring us the clinical intelligence to ensure gaps in population care are managed while also documenting the value of all interventions. We have invested in the ability to aggregate data from multiple sources, perform advanced analytics and then develop actionable reporting." New Mexico Jason Mitchell, MD, Chief Medical and Clinical Transformation Officer, Presbyterian Healthcare Services (Albuquerque) "I think for us, and the rest of the nation, hy- pertension is the biggest health concern. It is really a pandemic the nation is not treating adequately, with only 50 percent of individu- als in control. What's interesting about it is it's really easy to treat, the medication's inexpen- sive and the interventions are minimal. It affects 1 in 3 adults across the nation, and we can have a profound impact. We started a population health management initiative in 2013 for hypertension. e initiative was about hardwiring standardized in- terventions across the enterprise and at a local level in our practic- es. It involved basic things, like asking, 'How do you take a blood