A Great Story in American Healthcare

The Vestra Worksite Clinic at the Coushatta Tribe Casino

My last post was so dark, it hurt me to write it. It pointed to major problems in our healthcare system. Today is another matter altogether. Vestra Health is showing what can be done in a rural community in southwest Louisiana. It is a great story, and I am proud of them. They have the most effective worksite clinic that I know of if your goal is better health at lower cost.

Many of you have heard about the advanced primary care provided by the Southcentral Foundation in Alaska. There is another primary care solution owned by a Native American Tribe that is equally successful and more scalable. The Coushatta tribe owns a worksite clinic on their casino campus in Louisiana. Vestra Health runs the clinic for them and members who are seen in the clinic are much less likely to be hospitalized or visit the emergency room. Their care costs half that of members seen in the community. Coushatta received the small employer of the year award last week from the Validation Institute at their thIN360 Conference in DC. Boeing, AutoZone, and Coushatta were the award winners for “Employers of the Year” for their efforts to improve employee health.

I have worked with Dr. Heinen, Daniel Boudreaux and their staff for about five years. Here is what they have to say about that engagement: “We at Vestra Health have worked with Dr. Bestermann to consistently provide optimal medical therapy (OMT) to our patients with cardiovascular and related diseases like diabetes for several years. All our clinicians have been trained in OMT and it has become a fundamental part of our culture now. We have leveraged Congruity Health, and its robust analytics program, to support OMT delivery and effectively measure clinical and financial outcomes from our efforts.

Congruity has delivered us a platform to get detailed, custom, and accurate advanced claims analytics that we were not able to get from two previous data and analytics vendors.  In addition, we now have a data dashboard landing page, that we can access any time, that provides analytics on hospitalizations, ER visits, urgent care visits, imaging, labs, office visits and specialty referrals by disease category and site of service.  Using Congruity, we at Vestra have coordinated direct contracting for many of these services to improve health outcomes and reduce spending for our members. These contracts and specialty referral networks have been designed around the detailed reporting Congruity built analyzing health spending by category, vendor, and service site. Claims data has shown the spending for patients who are treated for Primary Care in our clinic and access these services through our clinic is roughly half compared with other members who are treated in the community.

This is not an estimated or projected number. It is based on real claims data.” The cost comparison includes the cost of running the worksite clinic.

They lower costs because they provide better care. Their patients are healthier. Check out the snip that I pulled today from their dashboard.

Healthier patients don’t need the emergency room as often and they are hospitalized less frequently. The middle line shows visits per thousand patients for comparison purposes. Look at the difference in ER visits and inpatient hospitalizations per thousand between patients who are seen in the clinic and in the community. On average over the last three quarters, clinic patient emergency room visits are 64% less and hospitalization 80% less than patients care for in the community.  These differences are very dramatic, and they account for a great part of the reduction in cost. The Vestra clinic is a great example of the healthcare we should all have. They have shown that we can have better health at lower cost in the lower 48 states.

As they expand, I would expect their costs to come down and they are learning every day how to do this work more effectively. They will continue to improve health and lower costs even more effectively. There is nothing magic about what happened here. The secret sauce is this. The clinic owners decide what the clinic priorities are. County governments, school boards, unions, or a collaboration of small local employers could set up a clinic like this where you live or work and have healthier employees at less cost. By employing a clinic like this, they would automatically meet the requirements of the Consolidated Appropriations Act.