Each year, we update our strategic plan not only to chart our progress and create a vision to share with our community, but also because it causes us to carefully consider our role in the shifting landscape that is health care today.
In creating the Hospital’s 2016 Three-Year Rolling Strategic Plan, our fifth such plan, two things became clear. First, we’ve made considerable progress in addressing the fundamentals, and second, the Hospital’s role in our community continues to evolve.
Over the past few years, we have significantly improved quality outcomes, safety scores and satisfaction scores related to patients, staff and physicians. Notably, we’ve transformed our physical plant, modernizing and expanding the Hospital with the generous support of our community.
We’ve also expanded service lines and increased market share and revenues, while reducing expenses. While we are not yet out of the woods financially, we’re in a stronger position to continue serving the Sonoma Valley. How we do so in the future is rapidly changing.
The new plan identifies several trends that will play an even larger role in our thinking in the years ahead. Two of these, which are closely linked, are population health and expanding Hospital partnerships.
Population health is not a new idea in health care – it’s been around for at least 20 years – but it’s becoming much more important for community hospitals because it is tied to emerging compensation models, especially the move from fee-for-service to value-based models.
Population health addresses the need to improve the health care of a defined population while managing the costs of that care. Both commercial and government payers, notably the Centers for Medicare and Medicaid Services, increasingly are declining to pay for hospital visits considered avoidable, while linking quality with efficiency in care.
Looking at it from a community hospital perspective, population health is the right thing to do, especially for a hospital like ours with a well-defined population which depends on it. Not that we are solely responsible for providing this care. As I will discuss, close partnerships are integral to a successful population health program.
As our new strategic plan reports, from 2010 to 2014 we have seen inpatient admissions decline by nearly 30 percent, from 1,658 to 1,168, due to regulatory changes on how to qualify a patient for admission. This has had significant impact on revenue. Fortunately, recent inpatient admissions seem to have stabilized around 1,200.
This is coupled with an increase in Medi-Cal patients as a percentage of our total volumes, especially with regard to the Emergency Department. Medi-Cal patients have very low reimbursement rates, which places even more pressure on hospital margins.
Increasingly, it is in a hospital’s interests to actively work to keep its community healthy. In the coming years, you will see us expand our efforts in population health and community health awareness and education.
Planned efforts include expanding our Employer Wellness pilot program, opening our Wellness University staff program to the community, implementing a disease reversal program, launching a Community Care Network, educating the community about the importance of Advanced Health Directives, and working more closely with community partners on health and wellness initiatives, such as our Compass program with Parkpoint Health Club.
We cannot do it alone nor do we intend to, so we continue to explore opportunities to partner with others, ranging from community organizations to large hospital systems and health plans providing cost-effective access to specialized services.
We did so in supporting the introduction of SCAN, a senior advantage health plan, which came to Sonoma County last year. Not only does SCAN offer an excellent program for seniors, it provided access to SVH services for many new patients, including some in our community who switched from Kaiser.
We have long had a productive relationship with Marin General Hospital, which we are continuing. We also are continuing our relationships with Western Health Advantage, and two physician networks, Prima Medical Group and Meritage Medical Network. Locally, we maintain a strong relationship with the Community Health Center, especially in the area obstetrics, as well as several organizations serving the Latino community. We also are exploring a relationship with UCSF.
These and other directions discussed in our new strategic plan are integral to the sustainability of small hospitals like ours. With all that the Hospital and medical staff have achieved in recent years, I believe that SVH is in the forefront in redefining the role of small hospitals, actively working to create the model for a new type of community hospital.
The new strategic plan and copies of previous plans can be found on the hospital website at sonomavalleyhospital.org/strategic-planning.
In good health.
President and Chief Executive Officer
Sonoma Valley Hospital