ND/MN – Fargo Division

Success strategy: Managing across the miles in a rural region

The sprawling geography of the ND/MN region presents a unique obstacle: The miles and hours of travel time between sites — many of them in rural areas — make cohesion and collaboration challenging.

The closest site to the Fargo division office is an hour away, the furthest is six hours away, and most sites have at least a two-hour drive between them. But the region is working to bridge these gaps and move toward a value-based model. Here’s how:

1. Taking the leap into value-based care. They started by working with Blue Cross Blue Shield’s Blue Alliance program, a venture into value-based care with a non-risk model that’s appropriate for their smaller facilities, many of which are critical-access hospitals.

2. Finding ways to connect and standardize. By using a regional occupational health network and the SYSTOC EMR software, they’ve linked patients to primary care across large rural areas.

3. Making communication a priority. Driving strategy across such a broad market takes communication at every level, and they work to ensure it’s happening. That requires physicians and front-line staff in the remote offices talking to one another as well as using one-on-ones with managers to transfer information.

Reaping the rewards

Their efforts are already garnering results, including:

• Childhood immunizations for 0 to 3 increased 17 percent to 93 percent.
• Mammography rates climbed from in the 40th percentile to above the 90th percentile.
• Well-child visits for children over 3 rose above the 90th percentile.
• One site was on the state’s honor roll for wellness visits and immunizations, including adult immunizations.

“We see the future of value-based programming on a rural level, and we’ve really been able to start optimizing that,” says Marvin Smoot, ND/MN Division president for the Physician Enterprise. “We’re starting to align our system in a way that we never have.”