Join us at HAS 17 – September 12-14, 2017 in Salt Lake City

Karen Tomes, RN, MA, PHN

Vice President Care Management & Coordination, Allina Health

Karen Tomes has been a leader in the health care industry focusing on new models for delivering patient care, improving the patient experience, and employee engagement outcomes. Karen has worked within multiple venues in the health care arena including patient care, operations, regulatory compliance, performance improvement and payer relationships for hospitals, clinics and home care in her 30 year career. Her undergraduate is a Bachelor of Science degree in Nursing, followed by a Master's degree in Organizational Leadership. Karen is responsible for the development and execution of the Allina Health strategic plan for Care Management & Coordination with Triple Aim goals across the care continuum of the organization.

6 - Predictive Analytic Models – a Must in the Journey to Reducing Readmissions (Case Study)

Karen Tomes, RN, MA, PHN (Vice President Care Management & Coordination, Allina Health)

Session Overview

Allina Health—a 13-hospital health system serving Minnesota and Wisconsin—believes that patients deserve to receive optimum follow-up care and support after discharge from the hospital, an approach that helps to minimize readmissions. Like many health systems nationwide, Allina Health had to prepare for the potential of CMS penalties for poor readmission performance and for emerging pay-for-outcomes reimbursement model.

This session will review the multipronged approach that Allina Health employed to successfully reduce its 30-day potentially preventable readmissions (PPRs). Allina Health will outline the specific actions they took including the development of a predictive analytic model that supports the identification of at-risk patients. The session will also highlight additional actions they identified as key success factors in their journey to reduce readmissions including redesigned care management processes and education programs for patients, families, and clinicians. The results Allina Health has achieved to-date validate that this multipronged approach is a model worth following.