This year, more than ever before, Kentuckians have been reminded they are stronger together. Kentucky health care providers are too, and the 10-member systems of the Kentucky Health Collaborative (KHC) are combining their strengths to provide better health care to patients across the commonwealth.
KHC was the brainchild of Steve Williams, then CEO of Norton Healthcare, and Dr. Michael Karpf, then CEO of UK HealthCare, who agreed communication and collaboration among state health care systems would be key in navigating the constantly changing health care market. The KHC launched in 2016 with its current core member organizations: Appalachian Regional Healthcare; Baptist Health; Ephraim McDowell Health; LifePoint Health; Med Center Health; Norton Healthcare; Owensboro Health; St. Claire HealthCare; St. Elizabeth Healthcare; and UK HealthCare. With 60 hospitals and myriad ambulatory and physician locations, these 10 systems provide more than 55% of Kentucky-based health care, serving patients in all areas of the state and in adjacent regions of Indiana and West Virginia.
“We have goals to improve the quality of care we provide, share insights on the changing health care environment, effectively participate in molding health care policy in the commonwealth, and continue to be strong, respected employers in our communities,” KHC Managing Director David Zimba said.
Staff and leadership of member organizations had informal connections previous to its inception, but membership in the KHC has enhanced these links through frequent meetings and close collaboration. The executive committee, consisting of members’ CEOs and their appointed leadership, meets routinely, as do the CFOs, cost containment groups, and other peer groups.
“You create that collaboration,” said Dr. Mark Newman, who succeeded Karpf as executive vice president for health affairs at UK HealthCare. “If they’re part of the KHC, you know the person and you can call them. It’s a whole lot easier for me to make a call to the head of Baptist or of Norton, because we’re interacting on a regular basis. Or for my CFO to call theirs, or whatever. The advantage of learning from one another is always there, and that kind of respect helps that work well.”
Kentuckians facing serious health issues, whether chronic or acute, have often been sent to hospitals in Lexington or Louisville for many years. The KHC is changing this by developing coordination systems through which providers at a glance can identify the best location to provide each patient with the appropriate level of care.
KHC relationships are facilitating use of programs such as e-CAT ICU, established this year by UK HealthCare to provide distance intensive care monitoring. Through this eICU program, smaller hospitals can benefit from real-time training and advice, enabling them to provide more specialized care for local patients.
Programs like these solve problems across the board. They keep big-city hospitals from being overloaded with patients, which is a real concern, particularly during health crises like COVID-19. They give patients access to top-tier health care close to home, avoiding travel costs and remaining close to supportive family and friends.
They expand treatment offerings at smaller hospitals, many of which face steep financial challenges and may be in danger of closing. Keeping a small-town hospital open and thriving benefits not only its patients and staff but its community, which in many cases counts the local hospital as its largest employer.
Telehealth has become a valuable tool
Telehealth is another major focus for KHC members. While telehealth was already growing before COVID-19, health care providers have been pressed to expand it greatly during the pandemic. This accelerated expansion has been largely successful, and KHC members’ collaboration has been key to that success.
“We learn from one another,” Newman said. “[UK] has now done more than 100,000 telehealth visits; in some areas, like psychiatry, probably 70% of the visits now are telehealth visits. And you can reach out and create more capacity and more access that way. (KHC members) learn from one another about what works and what doesn’t, and not only how you can make it work but how you can potentially make it work financially, in a cost-effective way that you can sustain.”
Building cost efficiency in general is a major KHC goal. Members benefit from combining forces to gain purchasing power, from sharing solutions that reduce costs and from advocating together for measures that save money without sacrificing health care excellence. Four years after its creation, members say the collaborative is producing $20 million in annual savings, benefiting both providers and patients.
Members are also cooperating to broaden health care access for Kentuckians through such programs as Medicaid.
“The KHC has been very supportive of Medicaid expansion in the commonwealth,” Zimba said. “We have attempted to promote the financing of Medicaid (coverage) expansion through strategies of comprehensive tax reform, which lowers taxes while broadening the tax base so all participants share the corresponding costs and benefits.”
Patient education is also important to improving health care access. Newman points out that Medicaid eligibility was recently broadened in response to the COVID-19 pandemic, but many eligible people may not know about the expanded coverage.
All KHC member organizations do educational outreach. Sharing challenges and successes and learning from one another to enhance these programs is a major benefit. Until recently the KHC did not have a centralized patient outreach and education program. This year, however, the collaborative launched the KHC Lung Cancer Screening, Detection and Treatment Initiative.
Kentucky has the highest cancer death rate in the United States. Because the state has the nation’s highest smoking rate, lung cancer—already more prevalent nationwide than breast, prostate and colon cancers combined—is a particular scourge. KHC members are working to cut lung cancer rates by building and implementing effective smoking deterrence and cessation programs.
The initiative is spreading word about screening and early detection measures. Because lung cancer often isn’t detected until its later stages when the survival rate is low, many Kentuckians see diagnosis as an automatic death sentence and feel screening is futile. In fact, though, patients diagnosed and treated at an early stage are five times more likely to survive. The KHC is publicizing this and helping Kentuckians access screening, not only directing them to providers but advising on insurance and other coverage options.
Of course, KHC members are cooperating, too, in helping newly diagnosed patients find the best care.
“The differentiating factor about this initiative and all KHC initiatives is the level of commitment and engagement that each hospital system brings to the table,” said Andrea R. Slone, KHC manager of clinical and advocacy programs. “Each steering committee member is appointed by their CEO and has the authority to speak, act and make changes to their respective programs and services relating to lung cancer screening, detection, treatment and prevention. The clinical and nonclinical leadership that is represented on the Lung Cancer Steering Committee is impressive; from CEOs to lung cancer screening navigators and nationally recognized clinicians, we are very lucky to have such wonderful and highly skilled professionals on this committee.”
The KHC will soon celebrate five years of improving the quality, access and cost of health care for all Kentuckians, and the organization’s executive committee is already working to determine the group’s focus over the next five.
“As KHC staff members,” Slone adds, “it’s very exciting to work with the clinicians and administrative leaders within each hospital system and to play a small part in such a large and meaningful vision that the KHC embodies.”