How it Works

As a clinically integrated network of providers, the ultimate goal of Inspire Health Partners is to enhance the value of the services provided to patients. All of Inspire’s network providers are engaged in initiatives focused on increasing patients’ access to healthcare services, coordinating care within the health network, and increasing the value, in terms of quality and cost, of the healthcare services provided to patients. The American Medical Association (AMA) describes clinical integration as “the means to facilitate the coordination of patient care across conditions, providers, settings, and time in order to achieve care that is safe, timely, effective, efficient, equitable, and patient-focused.” Clinical integration is important because too many health care providers and organizations practice “in silos,” meaning that they lack meaningful connections and information exchange with other health care entities.  Without coordination across multiple settings, patients are more likely to receive duplicative diagnostic tests, have adverse prescription drug interactions, and get conflicting care plans.

For employers and their workforces, Inspire’s clinically integrated network may translate to:

  • Improved employee health status;
  • Increased employee productivity;
  • Decreased employee absenteeism;
  • Increased employee health benefits plan satisfaction; and
  • Increased employer ability to control health benefits expenses.

 

Physicians within the Inspire Health Partners network are using the Patient-Centered Medical Home approach to provide coordinated, holistic care and long-term healing relationships for patients, instead of the more traditional approach of episodic care. Primary care practice redesign initiatives are driving improvements in clinical outcomes, patient satisfaction, provider satisfaction, and utilization  of services.  Inspire primary care practices are high-functioning primary care teams, bringing better health outcomes for patients, quicker access for appointments, and overall improved experience to strengthen the physician-patient relationship.

Inspire measures the effectiveness of our clinically integrated network, and drives improvement in our clinical outcomes, using the following key metrics at all our primary care practices.

Statin Therapy for Cardiovascular Disease

Cardiovascular disease has been reported to be responsible for the death of one in three individuals in the United States. (1) Studies have shown that coronary heart disease is the most common type of cardiovascular disease where it takes 380,000 lives annually. (2) On average, coronary artery disease (CAD) kills a person every 60 seconds. (3)

Recognizing the rising effect of cardiovascular disease on mortality rates, many studies have been conducted to analyze the efficiency of statin therapy on reducing mortality rates as a result from reducing cardiovascular events. Since its introduction in 1987, statin therapy has been proven to substantially reduce cardiovascular events in an extensive variety of patients (4): those who have increased cholesterol levels without CAD, patients who are diagnosed with CAD, patients diagnosed with other cardiovascular diseases, and those who are susceptible to the disease.

Recognizing the importance of statin therapy and its effect on mortality rates for patients who are being either treated for or at risk for CVD, Inspire is monitoring the percentage of patients on statin therapy for the prevention and treatment of a cardiovascular disease by reporting the percentages of patients receiving a statin medication among those identified as high risk for a cardiovascular event.

Hypertension

Hypertension is a disease impacting the lives of many people around the world. In the US alone, 29% of individuals over the age of 18 have hypertension, approximately 70 million people. (5) It has been estimated that there are more than 44 billion physician office visits for hypertension annually.

Hypertension has a huge impact on cardiovascular morbidity and mortality rates. According to the Health Resources and Services Administration, hypertension is the most important modifiable risk factor for coronary artery disease, stroke, congestive heart failure, and end-stage renal disease. (6) Moreover, blood pressure reduction has been associated with lower risk of developing complications from hypertension such as myocardial infarction, and stroke. As a result, hypertension control has been used as a measure to assess cardiovascular health in a defined population.

Aside from the impact of hypertension on population health, treating hypertension is extremely costly. CDC published an estimated 46 billion dollars annual cost of high blood pressure, which includes the cost of health care services, medications to treat high blood pressure, and missed days of work. (7) It is crucial for organizations to document and measure the effectiveness of care for patients diagnosed with hypertension.

Because of the importance of measuring hypertension and its effects, Inspire Health Partners reports on the attainment of a well-controlled blood pressure for those patients diagnosed with hypertension.  Inspire tracks the percentage of patients over the age of 18 diagnosed with hypertension whose blood pressure was well controlled (under 140/90), taking into account both age and the presence of diabetes. (*note that Joint National Committee hypertension guidelines recommend a relaxing systolic blood pressure target of 150 mmHg for patients over 60 years of age without diabetes mellitus or chronic kidney disease.)

Ischemic Vascular Disease and Antithrombotic Therapy

It has been estimated by the American Heart Association (AHA) that ischemic vascular disease (IVD) and illnesses associated with it had costs of $393.5 billion in 2005. (8) The US Centers for Disease Control and Prevention (CDC) has reported that cardiovascular disease (CVD) is the most highly prevalent disease in the US, where it remains the cause of death for 800,000 individuals annually. Moreover, the CDC states that the majority of people dying from CVD had an underlying atherosclerosis.

The CDC affirmed in their 2012 article “Recommended Use of Aspirin and Other Antiplatelet Medications Among Adults – National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, United States, 2005–2008” that over 7 million adults in the U.S have a history of heart attack, 7 million adults have a history of stroke, and, approximately 16 million have a diagnosis of coronary heart disease. (9)  In 2010, the estimated (direct and indirect) cost of CVD in the United States was around $450 billion, including $109 billion for CHD and $54 billion for stroke alone.

Studies have shown that preventive care, such as aspirin therapy or other antiplatelet medications use along with lifestyle change has proven to be effective in reducing atherosclerotic CVD and beneficial to patients with IVD. It’s been evident that the use of aspirin or other antiplatelet medications according to established guidelines for patients with ischemic vascular disease tend to reduce incident and recurrent myocardial infarction and stroke.

Inspire health Partners acknowledges the importance of aspirin use for IVD patients and the impact of its utilization on reducing CVD events. Therefore, Inspire Health Partners monitors the percentage of IVD patients on antithrombotic therapy by assessing the percentage of IVD patients 18 years of age and older, with documented use of aspirin or another antithrombotic medication.

Colorectal Cancer Screening

According to the American Cancer Society, colorectal cancer is the third most common diagnosed cancer, excluding skin cancers, for both men and women. (10) One of the common reasons for developing colorectal cancer is the presence of colorectal polyps that go undetected and progress into cancers. Regular screening for colorectal cancer is recommended to detect any abnormal growth prior and deal with it before it can become malignant. Early screening tests help detect colorectal cancer at an early stage where it’s easier to treat, which can save thousands of dollars, if not more, per year due to early detection and treatment.

Due to its importance, Inspire measures, reports, and promotes colorectal cancer screening for individuals over age 50, including, where appropriate, annual fecal occult blood tests, and a screening colonoscopy every 10 years.

Control of Glycated Hemoglobin Among Diabetics (Poor Control is HbA1c > 9%)

The American Diabetes Association advocates the goal of keeping A1c levels at or below 7% for diabetic people to properly manage their diabetes, and to avoid serious complications such as CVD, nephropathy, retinopathy, and neuropathy. (11) Moreover, additional complications that can result from uncontrolled diabetes include periodontal disease, ketoacidosis, hyperosmolar coma, and birth defects or spontaneous abortions of babies as a result of a pregnancy with uncontrolled diabetes. It has been recommended that people with diabetes have regular screening tests for their A1c levels, blood pressure, and cholesterol levels to prevent or delay the onset of complications. (12)

Inspire Health Partners recognizes the importance of periodic screening tests to keep diabetic population as healthy as possible, and measures and reports the percentage of patients whose most recent HbA1c level is >9%, or who have not had the test performed within the past 12 months.

Kidney disease (nephropathy)

According to the American Diabetes Association, diabetes is the most common cause for renal failure. (13) Clinical guidelines recommend annual screenings for all diabetes mellitus patients (type 1 and type 2) over the age of 18, with at least one test for urine microalbumin, or documentation of medical attention for existing nephropathy, during each measurement period.

Inspire tracks and reports this measure for each primary care physician in our network, encouraging the appropriate testing for all members.

Inspire and our physician and hospital partners regularly seek input from area employers and take action to make healthcare improvements. We live and work here in the region and are committed to making our region even better. Our member hospitals are not only healthcare providers, but are the top employers too in their communities, so they understand both sides of the healthcare costs concerns.

Adding Inspire Health Partners to your employee health plan is simple. You do not need to leave your current insurance provider to join Inspire.  Getting quick access to seamless, coordinated care across the healthcare delivery system in our region is just a telephone call away at: 812-376-5444 or 812-524-4204, or email at: mrothbart@inspirehealthpartners.com.

What physicians are saying about Inspire:

Dr. Eric Fish

Practicing obstetrician and gynecologist and Chairman of the Inspire Board of Managers

“As a physician, I am excited about Inspire Health Partners. The goal to deliver seamless care that results in superior patient experiences and outcomes is perfectly aligned with why I chose to practice medicine. I think Inspire will provide significant benefit to patients in terms of better outcomes and patient satisfaction. In addition, I expect Inspire will increase convenience by streamlining paperwork and avoiding redundant testing.”

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What employers are saying about Inspire:

Jim Bickel

President & Chief Executive Officer, Columbus Regional Health

“As members of Inspire, Columbus Regional Health and Schneck Medical Center are committed to transforming our communities’ healthcare delivery model. Care will be patient-centered focusing on engagement, satisfaction, and shared accountability for health outcomes. We are working on that for our own employee base who are now using the Inspire network, and also to provide that to other employers for their employee health plans.”

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What employers are saying about Inspire:

Warren Forgey

President & Chief Executive Officer, Schneck Medical Center

“As two of the major employers within our communities, Schneck Medical Center and Columbus Regional Health are acutely aware that a healthy population provides both a direct benefit to our patients and an indirect benefit to our communities’ employers. Aligning the efforts of physicians & hospitals and coordinating care will provide patients and communities’ employers with access to a higher value healthcare system that ultimately should result in a more productive and satisfied workforce.”

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