CHA’s transformational strategies
Cambridge Health Alliance (CHA) implemented four major transformational strategies, including establishing patient-centered medical homes, launching complex care engagement, creating alternative payment arrangements with management care organizations, and partnering with tertiary care institutions. These strategies had diverse implications on cost, quality, and access to healthcare services at CHA. Based on the cost assessments performed two years after the implementation, the per-member per-month (PMPM) payments for Medicaid and Commonwealth care reduced. The finding implies that CHA’s strategy for creating alternative payment arrangements with managed care organizations was effective in increasing efficiencies in payment and lowering costs. However, despite the reduced cost of healthcare, CHA did not report an overall change in financials due to the high cost of implementing the strategies.
The strategies of establishing patient-centered medical homes, transforming the workforce, and launching complex care engagement, all had positive impacts on quality. Within the two years after launch, the Early Level III NCQA-recognized sites reported improvement in the quality of ambulatory services, diabetes control, and cancer screening. Additionally, CHA realized an increase in the patient experience scores as more patients accessed better services and cost-efficiencies. Furthermore, access to CHA increased through the strategy of partnerships with tertiary care institutions. The partnerships enabled CHA to contribute towards improving lifestyle-related conditions such as diabetes and cancer. For instance, CHA’s inpatient admissions declined from nearly 134 admissions per 1000 patient population in 2011 to 127 admissions per 1000 patients in 2013. By the first quarter of 2013, the admission rate had declined to 113 per 1000 patient population. The decline in admissions indicates an improvement in lifestyle and health, as fewer patients experience severe illnesses prone to admissions.