Holy Spirit News

Coventry HealthAmerica and Holy Spirit Health System partner to improve care for chronic illnesses

Posted: 25 July 2012

Coventry HealthAmerica, a Coventry Health Care plan, and Holy Spirit Health System have formed a new physician partnership program that will improve management of diseases and access to care for Coventry HealthAmerica members, particularly those who suffer from chronic illnesses. The goal of the program, which Holy Spirit has successfully offered to other patients, is to improve patient health and quality of care. This will result in the added benefit of decreasing the need for emergency room visits and hospitalization for patients with chronic conditions, such as diabetes and congestive heart failure.

Through this program, the patient’s personal physician will work with members of a clinical team in the office who together take responsibility for the patient’s ongoing care throughout their lifetime. The team works to integrate care across all elements of the complex health care system, including subspecialty care, hospitals, home health agencies and nursing homes.

This program is based on the Patient Centered Medical Home model established by the national Family Practice, Pediatric, Internal Medicine and Osteopathic associations. In a patient centered medical home, the healthcare team empowers and motivates the patient in the medical, motivational and social aspects of his or her health care needs.  Patients benefit from the highly coordinated care. Employers benefit from the cost savings generated by improved outcomes and avoiding duplicate or unnecessary tests and procedures. Provider incentives for coordination of care and quality help keep costs down and support the new work that is needed to further improve prevention strategies and the management of patients with chronic diseases.

 “While the physician leads the care team, the patient plays a key role in decision making,” said Peter Cardinal, MD, medical director of Holy Spirit’s medical practices. The team takes responsibility for following up with patients between visits, and appropriately arranging care with other qualified professionals when necessary to ensure that patients get the right care when and where they need and want it. This partnership builds on similar programs that Holy Spirit and HealthAmerica began in 2011.

“This arrangement will allow patients and families to more fully participate in their medical care and equip their physicians with data they didn’t have access to before,” said Dr. Robert S. Mirsky, chief medical officer for Coventry HealthAmerica. “Coventry HealthAmerica will play an important role because of the data we track on quality and cost measures, which is critical for coordinating care and reporting on the results. Our data will be key to using some decision-support tools to guide clinical decision making.”

“Under this partnership program, we will continue to expand the patient centered medical home in our offices and emphasize the goal of excellent patient health,” said Dr. Cardinal. “This partnership will help us to place a stronger focus on preventing illnesses and improving the coordination of care. Our new electronic health record will support excellent patient care by allowing us to measure performance, provide patient education and enhance our communication with patients.”