The COVID-19 pandemic has laid bare some of the shortcomings of the nation’s health care infrastructure. Health care providers participating in traditional fee-for-service payment arrangements were negatively impacted by the pandemic as they experienced a sharp increase in expenses paired with significantly reduced revenue and a drop in opportunities to provide needed care.
Trinity Health was able to draw from the experience built over nearly a decade of improving population health through APMs to readily respond to the COVID-19 pandemic in communities both clinically and operationally. The clinical team within a population-based delivery model is skilled at assessing and identifying the needs of the whole person. Thus, Trinity Health teams were able to quickly apply the same expertise used to manage patients attributed to an APM to develop a whole-person plan of care for all patients at risk for COVID-19.
For example, care teams in the Syracuse, New York ACOs were able to create patient-centered care plans for more than 13,000 individuals who were at increased risk of morbidity and mortality from COVID-19 due to underlying clinical conditions. These teams taught sign and symptom management, ensured patients had their medications, and took other preventative measures to ensure they stayed safe and healthy. The teams were able to quickly apply the work they regularly do for patients who have chronic disease, to respond to COVID-19 impacts for patients attributed to their ACO and for those in traditional fee-for-service payment models.
Trinity Health has 16 Clinically Integrated Networks that serve as the operational home for APMs in their markets. The existing operational capabilities that Trinity Health developed to support the work of APMs were invaluable to the COVID-19 response. The majority of physicians in the communities served and in Trinity Health APMs are independent providers in their own practice. Trinity Health was able to immediately deploy support to these providers to help them respond to the COVID-19 pandemic. Trinity Health created communication tools to provide physicians access to telehealth, clinical information, guidance for use of personal protective equipment (PPE), access to pricing discounts for PPE, and patient-facing materials and support. In addition, daily communication with updated information from the CDC was provided and the Trinity Health pandemic response team was made available for guidance and support. Among other things, these experts offered understanding in federal and state waivers, funding opportunities, and the expansion of telehealth flexibilities.
Trinity Health’s experience responding to COVID-19 reinforced the importance of APMs—particularly population-based APMs that are based on expected rather than historical costs—to create and support health system resiliency. These payment arrangements scale and translate effectively while fostering innovation and collaboration.