By Laura Toraldo
(April 11, 2017 — BALTIMORE, Md.) In the middle of meaningful reform and daily changes in policy, Maryland Chamber member Johns Hopkins HealthCare LLC aims to stay ahead of the curve.
For JHHC, the population health and managed care arm of Johns Hopkins Medicine, it means taking advantage of access to research, innovation and discovery.
“We are one of the leading research institutions in the country,” said JHHC President Patricia M.C. Brown, Esq. “Large groups of researchers are studying populations, disease, and what can be done to improve the health of a person as well as their community. Incorporating this know-how into our business model is our differentiator.”
Brown said that drilling down on this data helps JHHC target efforts and improve processes at every point of service. It has also prompted a host of preventive services offered to their employees, like Healthy at Hopkins, a program dedicated to educating employees, identifying behavioral health issues, and providing incentives for healthy choices.
Brown said that these types of preventive programs can be key to healthier communities when paired with access to healthy options and good government policy around social determinants of health—like exposure to crime and violence or poverty-related stresses to the community.
“Eighty percent of health care outcomes are driven by social and economic factors, physical environment, and health behaviors,” she explained. “By integrating health care with public health activities, you can improve outcomes and ensure optimal use of health care resources.”
JHHC is committed to innovation with their Medicare Advantage plans as well. “As the federal government looks to contain health care costs,” Brown said, “it only made sense for Hopkins to leverage its insurance experience for the Medicare (over 65 years of age) population.”
JHHC partnered with Adventist HealthCare, Anne Arundel Medical Center, Frederick Regional Health System, LifeBridge Health, Mercy Medical Center, and Peninsula Regional Health System, to form the largest collaboration of provider-insurer regional health systems in the state. As partners, the health systems can each benefit from the insurance revenue stream.
Partnering with the Hopkins plan gave the other regional providers the leverage they needed without having to do the heavy lifting of managing insurance.
“The rising tide enabled all boats to rise with the alignment of care, access, networks, the mix of providers, and matched goals to improve quality and reduce costs,” Brown said.
Now in their second year, JHHC’s Medicare Advantage plan has seen the fastest growth of any plans. Brown says their membership has doubled, and she is certain it will continue to grow.
Only 10 percent of Medicare eligible people in Maryland enroll in Medicare Advantage plans, compared to the average 40 percent in the rest of the country. Brown attributes this slow growth to retiree benefits and available income for supplemental plans. She feels now, as people begin to recognize Medicare Advantage as the total package, it will grow faster.
Policy changes have both helped and hurt. Electronic medical records have required billions in investments in the last few years. Health Insurance Portability and Accountability Act (HIPPA) requires patient privacy compliance, but the increased digitalization of health information has shifted the focus for plan administrators to security of data.
“In today’s environment, it’s not a matter of if our systems will be breeched, it’s a matter of when,” Brown said. “The challenge becomes how do you ensure the security of data that is so necessary to target your interventions and improve the care delivered? We have to remain as nimble as we can while not compromising on our commitment to patient privacy.”
While Brown believes the reforms are meaningful, she recognizes that changes and challenges in health care will continue to evolve.
“We’ve been on this journey for some time.”