Intermountain's Approach to Successfully Implementing Shared Accountability

Intermountain's approach to successfully implementing Shared Accountability involves three major goals:

• Improve clinical quality. Create a more robust mechanism to deliver the most effective, appropriate, evidence-based care. This will occur in large part through our Clinical Programs and Services, as well as through other initiatives and programs.
• Reward quality outcomes and high value. Align financial incentives for healthcare organizations, physicians, patients, and payers so everyone is motivated to achieve the best medical outcomes and better health for patients. (Current payment models often have the unintended consequence of financially penalizing caregivers who try to deliver highly effective care.) In 2012, we plan to begin pilot-testing a payment model (with no actual change in payments) to get plenty of feedback from physicians and others. As we identify a payment approach that can be embraced by physicians, we anticipate testing (on a limited basis) in late 2013. This experience will help us develop a fully vetted and tested model later in 2014 or 2015.
• Better engage patients in prevention and wellness programs and in decisions about their care.

Quality improvement — delivering the best evidence-based care — is the essence of our Shared Accountability approach. This means supporting physicians and other caregivers in their efforts to provide the right care personalized for each patient. By "right care" we mean encouraging treatments likely to be most effective based on the latest studies and the body of medical knowledge and evidence.

This also means avoiding the three types of substandard care identified by the Institute of Medicine:

• Overtreatment (doing too much)
• Undertreatment (doing too little)
• Misuse of resources (making mistakes)

Patient involvement is another key component of Shared Accountability. We'll provide extra counseling and preventive resources to help patients stay healthy, comply with their doctors' treatment plans, and manage any chronic health problems (like diabetes, heart disease, and asthma). We'll provide greater transparency as to treatment options (potential benefits, risks, and costs), so patients and clinicians can make more informed decisions together.

We'll continue to look at ways to incentivize and reward employees and patients who take advantage of programs that encourage healthy behaviors.

We also have projects underway in our Medical Group that advance Shared Accountability concepts. For example, in an initiative called Intermountain Personalized Primary Care, the Medical Group is providing enhanced primary care services, including expanded care management. (See related article below.)

Likewise, SelectHealth is developing a new Medicare Advantage product, as well as a new product for Medicaid beneficiaries. Both are expected to launch in January 2013. These products will help enrollees manage their health and obtain the most effective care.​​