When a health system like HealthPartners works together, outcomes improve

Any hesitation in accepting an invitation to attend a HealthPartners senior leaders' meeting earlier this month was a fear that a morning might go by without hearing any real news.

No organization the size of HealthPartners shares in a meeting with its 300 top managers big stuff like a merger or any sort of serious business problem. Instead, a CEO more likely would try to inform and maybe lead a few cheers.

The prediction bore out: There didn't turn out to be any news at this meeting. Yet it was still well worth the time.

Here was a rare opportunity to see and hear how the managers inside a big health system think and talk to each other. You could hear how important it was to work better as a system and how progress had to be celebrated but always with an acknowledgment of how much hard work still lies ahead.

Similar meetings likely happen at Allina Health and other big organizations, but no visitor to this HealthPartners meeting could have missed just how ambitious and confident HealthPartners is.

Bloomington-based HealthPartners has about 26,000 employees, working in an organization that operates both health care services — hospitals, dental clinics and the like — and health insurance. The senior executives, directors, department heads and other top managers attended this meeting in St. Paul.

What was completely missing in about two hours of presentations was talk of revenue goals, market-share gains or other measures normally important in business management.

"What we know today is that if we canvas the community and ask if there is a system or a health plan or care system that stands out, that clearly stands above others, there's not," Walsh said. "We do great work. But we are not differentiated — yet."

Walsh had peppered her half-hour or so presentation with quotes from basketball coaching legend John Wooden. And if she had a mantra for HealthPartners staff, it was health care that's simple and affordable.

That's not a new concept, and it sounds, well, pretty simple. But being able to deliver as promised is also not easy.

As Walsh defined it, simple might mean an easily understood process or a hassle-free experience.

Affordable does not mean cheap. It means costs that are predictable and can be managed by the HealthPartners member. It also means providing care or health insurance that members think is a good value.

What's just as important, though, is the work patients likely never notice, leading to a smooth and intuitive process for booking appointments and a consistent way of being treated once appearing at the clinic.

Relying on a system also means there's a refined set of decisionmaking support tools to guide physicians on what might be the best practices. Or it might mean patients easily find their way to physical therapy or other additional care that might be needed.

One initiative Walsh mentioned was a phone line for members to find out what something is really going to cost. This service can't make much of a difference in making health care simpler and more affordable if no member knows about it. So, steps to increase awareness are planned.

Another great example that morning of system-level thinking came from Dr. Andrea Singh, the Park Nicollet Clinic chair of pediatrics and a leader of a HealthPartners children's health initiative.

One task stemming from the 2013 merger of Park Nicollet into HealthPartners was to make the pediatric practices more uniform between various clinics, as variations, especially in outcomes, is generally not a healthy sign.

Not long ago, she said, "if you lived in Stillwater and then moved over to Lakeville, you didn't get the same exact same patient education material, training and guidance. And we said, 'Well, we need to fix that.' We had to do everything from assess clinic process, to the information in [health records], to patient education, to work flows."

The three-year project, she said, needed a small team of carefully selected employees to work on the problems, from different parts of the organization.

"We were actually able to provide evidence-based, consistent care no matter where you brought your child … within our organization," she said. "No. 2, guess what? We improved provider efficiency. We made clinicians' and nursing staffs' lives easier."

When she popped up summary data on progress — including how HealthPartners now knows from better documentation practices that developmental screening for kids is happening on 84 percent of visits rather than 44 percent — the room responded with spontaneous applause.

The meeting ended with what Walsh called "grab the mike" time, with managers in the room standing up to volunteer information.

There were a few hiccups in what they decided to try, but 30,000 simple, at-home screening kits eventually were mailed to members who had been identified in the system as not having been screened for colon cancer.

About a quarter of the kits were returned for testing. Of those, 186 came back positive. After more testing three people were found to have a serious cancer.

At least two of those three patients today were reportedly cancer-free.