Delivery of Care

Engaging with the community as a competitive strategy

South County Health invests in expanding its reach out into the community

Photo by Richard Asinof

Lou Giancola, president and CEO of South County Health, and Eve Keenan, board chair, on his left, cut the ribbon to open South County Health's new urgent care facility on Post Road in Westerly.

By Richard Asinof
Posted 5/23/16
Rhode Island’s only remaining unaffiliated acute care community hospital, South County Health, is pursuing a strategy of community engagement as a way to survive in the age of consolidation.
What is the definition of an engaged community when it comes to health care delivery? How does the design of the new urgent care facility in Westerly reflect the changing needs of health care delivery? Will Taylor Swift seek out care at the new urgent care facility in Westerly if and when she or her family and friends need such immediate health care? How is the relationship between private group practices and hospital systems changing the nature of reimbursement, risk and the opportunities for shared savings?
The quickening pace of new contracts to establish accountable entities as part of managed care under the Rhode Island Medicaid office raises some important – if not impertinent – questions around exactly what is an accountable entity.
More than signing contracts and receiving the stamp of approval from the state, accountable entities, to work, require a sophisticated use of population health analytics and integration of care within a capitated reimbursement system.
How big is the pool of shared savings? And how will those shared savings be distributed? How much money will go to the insurance companies? How much money will go back to the state’s general revenue fund? Will the bulk of the savings go to reward the accountable entities with the best performance on per member per month rates?
Further, moving forward, is there a way to differentiate between better health outcomes and cost-cutting efforts? In many cases, better health outcomes translate into increased access to health care. Is the state willing to make more, better investments in achieving better outcomes and access to services for behavioral health care, even if it costs more money?

WESTERLY – It was a big week for South County Health, the last remaining unaffiliated acute care community hospital in Rhode Island.

First, on Saturday, May 14, South County hosted its annual board and medical staff retreat, attracting more than 120 participants to an event focused on strategies to improve the delivery of behavioral health care.

Then, four days later, on Wednesday, May 18, South County Health cut the ribbon on its new 30,000 square-foot urgent care medical facility on Post Road in Westerly, offering 24/7 urgent care, lab and imagining services, including ultrasound and 3-D mammography, as well as primary care, orthopedics, physical therapy, dermatology and OB-GYN services. The new facility is officially scheduled to open on May 23.

Taken together, the two events offer insights into the community-based strategy being pursued by South County Health as a way to survive the ever-increasing pressures to consolidate within a larger health care delivery system.

The creation of a outpatient health facility in neighboring Westerly, offering a combination of services in a convenient, one-stop shopping location on the well-traveled Post Road, speaks to the way that South County Health is expanding its footprint and broadening its definition of the community it serves.

At the same time, the willingness to grapple with the difficult issues surrounding the delivery of mental health and behavioral health – and to involve its board and medical staff in that process – speaks to the priority given by South County Health to responding to the community’s most urgent needs.

“We’re very excited,” Eve T. Keenan, board chair of South County Health, told ConvergenceRI amidst the hubbub of the reception following the ribbon-cutting ceremony in Westerly. “We’ve been thinking about this [expansion] for two, three years, and finally, to have it all come together, it’s extraordinary. So many people have worked on it.”

Keenan discussed the strategy and goals behind the new facility. “We have many goals,” she said. “One is to provide health care for the Westerly community, close to home and convenient to them, providing a special level of customer and patient interaction.”

South County Health, Keenan continued, has very high expectation about what it wants to achieve in the patient experience.

“In our new vision, we talk about forging extraordinary connections with our community that support health in all stages of life,” she explained. “We have a big program for palliative care and a lot of work being done in preventative health.”

South County Health, Keenan said, “is really trying to forge relationships with the community. We want partners throughout all of Washington County.”

A tour of the facility
Martha Murphy, director of marketing and communications at South County Health, took ConvergenceRI on a brief tour of the new facility.

On the first floor, Murphy explained, there will be a “concierge” desk, where someone will be able to greet patients, answer any questions, give directions, and help people as they are leaving.

“We’re calling that the concierge, just like in a hotel,” Murphy said.

The urgent care division, which has eight exam rooms, is located right next to the diagnostic imaging center, a conscious choice in the design of the new facility, according to Murphy.

“It’s a very deliberate decision to have urgent care on the first floor, right next to your diagnostic imaging and your lab people,” she said.

The new facility will serve as one of the satellite offices for both the South County Orthopedics, a private group, and the private dermatology practice of Dr. Robert Dyer, according to Murphy. Both practices are affiliated with South County Health and the doctors are members of the hospital staff.

The second floor of the new facility features a conference room that will be available for use by community groups in the Westerly area.

Community needs
South County Health President and CEO Lou Giancola set an ambitious agenda for the health system’s 2016 board and medical staff retreat.

Giancola also extended invites to an inclusive, statewide list: in addition to the hospital’s board of trustees and medical staff, invitations were extended to the leaders at Butler and Bradley hospital leaders, state officials from the R.I. Department of Health and the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, primary care physicians in South County, school systems, and community mental health center leaders.

The retreat speakers included: Kathryn Power, the regional administrator for the federal Substance Abuse and Mental Health Services Administration, or SAMHSA; Susan Orban, director of the South County Healthy Bodies, Healthy Minds initiative, developed as part of an Health Equity Zone project; and Nellie Burdette, director of Integrated Behavioral Health Care at the Providence Community Health Centers.

In breakout groups, the participants then wrestled some of the key challenges confronting efforts to deliver care: the role of community mental health centers, the integration of behavioral health in primary care practices, societal factors in children’s behavioral health, and the role of providers in the prevention and treatment of substance abuse.

Over lunch, there was a performance of “Four Legs To Stand On,” a short play by the group, Creating Outreach About Drug Addiction Support Together, or COAAST, to use community-engagement practices to create an ongoing dialogue about addiction, loss and recovery.

What the next steps will be following the retreat are still very much a work in progress, Giancola told ConvergenceRI.

But South County Health’s willingness to engage its board and its medical staff in an in-depth conversation about the development of strategies to improve the delivery of behavioral health care – and to open up the discussion to allow the broader community to participate – emphasized the community engagement strategy that the hospital has undertaken.


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Ted Almon

As a Trustee of South County Health, I couldn't be more proud of our health system's leadership in forming a truly local model of community health that stands in stark contrast to the corporatization of the healthcare system we see in other parts of the nation and even our State. In my opinion, this effort and model is worthy of an energetic and deep commitment of community resources, both public and private, to prove its value and relevance in the evolution of the health delivery system. I am eager to do my part...

Monday, May 23, 2016

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