Dartmouth-Hitchcock receives $26 million health care innovation grant
The Dartmouth Institute for Health Policy and Clinical Practice and the Dartmouth-Hitchcock health system will share in a $26 million Innovation Grant announced Friday by the Center for Medicare and Medicaid Innovation (CMMI).
The CMMI Innovation Awards were issued through a highly competitive process, with more than 3,000 proposals submitted. At $26.1 million, the Dartmouth/HVHC award was the second highest to be made across the 107 Innovation Grant recipients.
The grant will fund a program to implement shared decision making for patients across the 15 health system members of the High Value Healthcare Collaborative. The Dartmouth Institute (TDI) and Dartmouth-Hitchcock (D-H) are founding members of the Collaborative, whose institutions collectively have a patient population of 50 million across 17 states.
According to the CMMI announcement, the project will result in savings of $64 million over 3 years, largely due to reduced utilization and costs that have been shown to occur when patients are engaged and empowered to make health care decisions based on their own values and preferences.
Dr. James N. Weinstein, CEO and President of the Dartmouth-Hitchcock health system, will serve as the Principal Investigator for the grant. Dr. Weinstein started the first-in-the-nation Center for Shared Decision-Making at Dartmouth-Hitchcock Medical Center (DHMC) and conducted the first large scale clinical trial to incorporate the concept. Shared decision making is a key component of patient care at D-H.
“We know from our experience at D-H that involving patients and families in their treatment decisions, with evidence-based, objective information, results in higher patient satisfaction, superior clinical outcomes, and often, lower costs,” said Weinstein. “When patients are well-informed about the risks and benefits of a test, procedure, or treatment, they have more confidence in their decisions and are more satisfied with their outcomes. Our studies have shown that the process also greatly reduces the decisional regret that can occur when patients make treatment choices without good information.”
Under the grant, $26 million will go to the High Value Healthcare Collaborative (HVHC), housed at TDI. The bulk of the funding will be used to hire and train Patient and Family Activators (PFAs) at the 15 member organizations of the HVHC. Over the three year grant period, 1,845 health care workers will be trained and an estimated 48 PFA positions will be created.
According to the CMMI grant announcement: “The PFAs will be trained to engage in shared decision making with patients and their families, focusing on preferences and supply-sensitive care choices….It is anticipated that this intervention will lead to a reduction in utilization and costs and provide invaluable data on patient engagement processes and effective decision making-leading to new outcomes measures for patient and family engagement in shared decision making.”
Weinstein said the project is particularly significant because of the population it will reach: “The greatest beneficiaries of this project will be high-cost patients with multiple chronic conditions who have been disenfranchised because of poor health literacy, poverty, minority status, or poorly managed care. Through patient engagement and activation and use of decision aids, HVHC members will ensure that these patients are partners in their care decisions.”
ABOUT DARTMOUTH-HITCHCOCK: Dartmouth-Hitchcock is a national leader in patient-centered health care and building a sustainable health system. Founded in 1893, the system includes New Hampshire’s only Level 1 trauma center and its only air ambulance service, as well as the Norris Cotton Cancer Center, one of only 40 National Center Institute-designated Comprehensive Cancer Center in the nation, and the Children’s Hospital at Dartmouth-Hitchcock, the state’s only Children’s Hospital Association-approved, comprehensive, full-service children's hospital. As an academic medical center, Dartmouth-Hitchcock provides access to nearly 1,000 primary care doctors and specialists in almost every area of medicine, as well as world-class research at the Audrey and Theodor Geisel School of Medicine at Dartmouth.
ABOUT THE HIGH VALUE HEALTHCARE COLLABORATIVE: The High Value Healthcare Collaborative was formed in 2010 by Dartmouth-Hitchcock, Denver Health, Cleveland Clinic, Mayo Clinic, Geisinger, Intermountain Healthcare, and The Dartmouth Institute. Its aim is to improve health care quality and lower costs by identifying and disseminating best care practices across nine high-cost, increasingly common health conditions. The Collaborative now has 16 members including Baylor Health Care System, Beaumont Health System, Beth Israel Deaconess Medical Center, North Shore–LIJ Health System, MaineHealth, Providence Health and Services, Scott and White Healthcare, Sutter Health, UCLA Health System, University of Iowa Health Care, and Virginia Mason Medical Center.
LEBANON, NH - 6.18.2012