Rare medical alliance boosts care in northwest metro

Ann Losness didn't want to go back to Unity Hospital after a four-day stay for heart problems, and the hospital didn't want her back either. They had gotten along fine — but return visits can be frustrating, expensive and ultimately preventable if hospitals adequately prep patients to go home the first time.

So they agreed that a paramedic would visit Losness at home in Fridley to make sure she was doing OK and taking her meds correctly.

"Right now I take 14 pills in the morning and about 10 pills at night," said Losness, who's 83. The medic "went through all of my pills with me and she made me fill my pill box."

Reducing hospital readmissions through paramedic visits is one of many strategies of the Northwest Alliance, a partnership between two competitors — Allina and HealthPartners medical systems — that is so unusual that health care leaders around the country have a hard time believing it exists.

The health systems last week announced they were continuing the partnership even though the initial seven-year agreement just expired.

"This doesn't happen in all communities," said Dr. Penny Wheeler, chief executive of Allina Health, which operates five clinics and Mercy and Unity hospitals in the northwest metro. "I was talking to colleagues in Houston, where [competitors] are building hospitals across the street from one another."

The collaboration allows the two systems to work together on problems such as hospital readmissions, even if patients visit an Allina hospital but use a HealthPartners doctor for primary care. Readmissions to Allina's Mercy and Unity hospitals declined 25 percent from 2012 to 2015.

Other goals over seven years included increasing use of generic drugs, reducing total costs of back pain treatment and preventing overuse of antibiotics and addictive opioid painkillers.

They also worked with Anoka-Hennepin schools to screen teens for health problems and provide them with referrals for medical or social support.

Cooperation served as a form of competition in one way. By pooling their efforts, Allina and HealthPartners made themselves into stronger competitors with the Fairview and North Memorial health systems, which opened a hospital in Maple Grove in 2009.

Competitive advantage in the region was not the goal, though, Alliance officials said. The primary target was Anoka and southern Sherburne counties, where data showed higher rates of chronic diseases and more per-person spending on medical care than in the rest of the Twin Cities.

"We knew we had an affordability problem in that region," said Andrea Walsh, president and chief executive of HealthPartners, which operates four clinics and health plans that cover 30,000 people in the northwest region.

The alliance, Walsh said, raised the use of generic medications from 75 percent of prescriptions to 91 percent, saving an estimated $3.4 million per year.

Proof of the savings came through special accountable care payment relationships established among the alliance, HealthPartners' insurance company and the state Medicaid program. For roughly 16,000 patients in the region covered by Medicaid, costs declined 16 percent.

"It translates to $850 per patient per year," said Patrick Lytle, employed by both Allina and HealthPartners to run the alliance. "Big dollars that we saved for the community."

Some of the alliance's prevention and cost-saving efforts would have happened anyway. All hospitals in Minnesota started focusing on reducing readmissions after the federal Medicare program created financial penalties for high readmission rates a few years ago.

Similarly, every health system in the region is now focused on reducing prescriptions of addictive opioid painkillers.

But the partnership made these efforts easier in key ways, Lytle said. HealthPartners' experience and Allina's property combined to allow for the opening of a new short-term residential treatment facility for people taken to emergency rooms for mental health crises.

Those beds provide transitions so that mentally ill patients don't tie up costly ER beds for days or weeks when they are ready for a lower-level of care, he said.

Most people haven't heard of the alliance, which isn't a brand on clinic or hospital doors, despite its ongoing health care projects. Losness had no idea, even though she was a beneficiary of its efforts.

Beyond advice on medications, she was connected to a class on healthy living with diabetes, and set up with a follow-up appointment with her cardiologist.

She said she hopes the healthy living tips will allow her to resume the activities she enjoys — volunteering for the steak fry at a local American Legion Post, helping with bingo at a senior home, and taking the occasional bus trip to a casino.

Although all that health information did have one downside when she went to the grocery store to stock up after her hospital stay, she said. "Took me about two hours to look at everything to see how much sodium was in the ingredients."

Jeremy Olson • 612-673-7744