Doylestown Health’s Value-Based Contracting Strategy Puts Community Hospital at the Center

“Providing safe, effective care with sustainable results, reducing costs in your cost structure, and understanding where your volume comes from are crucial,” says President and CEO Jim Brexler. “Our MEDITECH EHR enables us to achieve all three.”

Doylestown Health encompasses a 232-bed community hospital, a surgery center, 50 employed physicians, 420-member medical staff, outpatient services, a retirement community, skilled nursing and personal care facilities, home health & hospice services, a community outreach kiosk in a supermarket and a child education & daycare center.

Partnership for Population Health Management
Doylestown recently formed Doylestown Health Partners—an equity ownership partnership with primary and specialty physicians—to enter population health management contracts. The organization is building on its 25-year history of collaboration with a physician-hospital organization. It is further leveraging its position as a new member of the Delaware Valley ACO, which operates under the Medicare Shared Savings Plan.

Also, Doylestown Health Partners offers services to independent physician practices, helping primary care physicians to remain autonomous but connected. Strong ties with these community players, as well as other hospitals in the region, are enabling Doylestown to mold itself as a regional referral center for services such as heart care. 

Building on Baby Boomers 
Leveraging years of experience in acute and specialty care services, Doylestown Health is focused on addressing the needs of this fast-growing segment of the population in addition to reinvesting in maternity, pediatric, and family health services to remain relevant. The organization already has a strong base in programs for seniors, with assisted living, skilled nursing, and home care services. Plans for a virtual chronic disease management program highlight a data integration strategy in development that will enable Doylestown Health to adapt to the challenge of managing covered lives. 

“As the industry continues to shift from a fee-for-service model to one based on quality and risk, sharing patient information across the continuum is paramount,” he says. “MEDITECH’s clinical tools keep hospital providers on the same page to meet our goal of delivering high-quality, patient-centered care at a low cost. We’re currently using several IT platforms to connect hospital and community based providers. This is why we think MEDITECH's strategy and solutions to promote interoperability are such a positive development, especially the potential to apply interoperability in the field of population health management,” Brexler says.

Bigger Is Not Always Better
Many community hospitals believe they need to be absorbed by large health systems to compete in new value-based reimbursement models. Doylestown Health has a different strategy—to contract directly and affiliate purposefully rather than merge. It is focusing on community needs and linking to larger contracting networks when it is advantageous as an approach that better serves the community. 

“We have robust clinical IT tool sets, excellent clinicians, and a strong medical staff that provides quality healthcare to our community. We can go at-risk on outcomes-based contracts that don't require us to be acquired by a larger system or send all of our specialty health care to academic medical centers,” says Brexler.

Cultural Reconstruction
Getting staff to accept the new model is a cultural transition. Brexler is working with the medical staff and conducting a number of educational forums and discussions around value-based health care. Doylestown Health Partners—a clinically and financially integrated partnership with medical staff—is a forum for open discussion. As staff and physicians begin to understand the new paradigm and how it fits into Doylestown's vision, they've started to embrace the change. 

“I explained that in the past we weren't in the healthcare business, we were in the illness response business, only getting paid when people were ill,” says Brexler. “The new model defines volume as the number of individuals for which we have responsibility, instead of the number of beds filled. In the future, we will be paid when people are well and stay well.” 

“We’re building on our strong history of trust,” he adds. “We trust our clinicians to deliver the best possible care, they trust that we will work together to figure out the economics. MEDITECH is a big part of the many IT tools needed to deliver care and manage outcomes in this new era for healthcare delivery.”