Improving Care Quality Through Meaningful Partnerships

Ben Park, MD, president and CEO, American Health Network, part of Optum Care, discusses a recent partnership with Suburban Health Organization that will improve health care quality for Medicare Advantage members and reduce costs, and shares insight into AHN’s response to the COVID-19 pandemic.

Please introduce yourself including title affiliation and a bit about your background.

I am a primary care physician by training, and I am president of American Health Network (AHN). AHN is now a part of Optum Care, which is the largest medical group in the world.

Our particular group is responsible for the Midwest for Optum Care. We’re in Indiana, Kentucky, and Ohio currently.

Can you tell me about AHN’s new partnership with Suburban Health Organization? What is significant about this collaboration?

This is really a unique partnership with a hospital system that contains 13 hospitals and a large group of high quality primary care physicians. We’re both involved in Medicare Advantage, and in particular, in the UnitedHealthcare Medicare Advantage Program.

As part of Optum Care, we have lots of resources for this. We have over a million people currently in Medicare Advantage programs across the country. With that expertise, we bring a lot of knowledge and systems to the relationship. They bring a delivery system that covers most of the counties around Indianapolis.

We have a lot of overlap there as well. We are a physician-only organization, but we also care for quite a number of Medicare Advantage patients.

How will this care coordination program improve care quality for members? How will it affect costs? 

The only way, really, to improve the outcomes in Medicare Advantage programs is to focus on quality. We take a quality first approach to that. By keeping healthy, minimizing the burden of chronic disease, then we’re able to do well financially as well, because those people don’t go to the hospital.

No one really wants to be admitted to a hospital. Well, rarely. I think maybe somebody does, but mostly, people want to stay out of the hospital. They want to stay healthy. We both care for them medically and empower them from a behavior standpoint to achieve a high level of health.

What is the Wellness Starts Within initiative? 

There are a lot of what are called non medical determinants of health. Our program is built on the fact that only 11% of your health status is determined by your medical care. Thirty-eight percent of your health status is determined by your behavior.

Our program, Wellness Starts Within, says it all, really. It starts within. We are supporting people in making healthy lifestyle choices so that they don’t end up with chronic illnesses and those kinds of things that are a burden on their life, and also expensive from a health care standpoint.

What steps has AHN taken during the COVID-19 pandemic to ensure members continue to have access to quality care?

It is really interesting, because we’ve been in telehealth for some time. Prior to the COVID crisis, we were doing about 500 telehealth visits a month. We were pretty busy compared to a lot of people. Well, six weeks into COVID, we were doing 1500 a day.

We were seeing a ton of people via telehealth. That was really critical to getting access for people who couldn’t come to the office. From a standpoint of the other people who really needed to see, we were blessed by being part of this larger organization, because we had plenty of personal protective equipment.

We never had a shortage. We had all kinds of sanitizing supplies. We were able to keep our practices open. We didn’t close any of our practices during the pandemic. We had reduced volume, because we were seeing people under very protected
environment.

We had face masks, and we had eye shields and gowns, gloves, the whole nine yards. It looked like you were entering a space program there when you walked in one of our offices, but it allowed us to stay open safely and see our patients while at the same time providing a lot of telehealth care.

Is there anything you’d like to add?

Another thing, I think, that’s really unique is that we have about 4000 nurse practitioners across the country who are part of our house calls program. We were doing some house calls using those folks before, but throughout the COVID pandemic, we have done a lot more.

We had people who could go out to the home and visit patients. I think some of these changes are  going to stick post COVID. We’re still doing, I would say, 10% of our visits now via telehealth. There are things like a guy who works construction who takes off 15 minutes and walks over to the construction trailer and has a visit.

I think that’s going to change forever some of the ways that we practice medicine. I think we’re going to do more house calls, too, because it is a burden for some of these people to get out and to get to the office.

If we can send one of our nurse practitioners or physician’s assistants there, or even some of our physicians now are making house calls, it’s a really good service that we happened upon, accidentally, because COVID made us.