After serving as CEO of Aspen Valley Hospital from 2004-2013, Dave Ressler became chief strategy officer and chief operating officer at Tucson Medical Center. He left that position to lead an organization that formed two accountable care organizations, working with dozens of rural hospitals in Colorado, California, and Washington and adding to his knowledge about the best path for small hospitals in a changing health care industry. He returned to his current role as CEO of Aspen Valley Hospital in 2016.
The Ascent: How does screening for social determinants of health fit with Aspen Valley Hospital's accountable care strategy?
Ressler: Population health innovation is a key element in our long-term strategic plan. We believe it will ultimately reduce the cost of health care—and increase access—through more affordable insurance options. With that in mind, we recognize that over 80 percent of the cost of health care is driven by adverse social determinants of health, and we need to take a leadership role in the community to assure those needs are being assessed.
It will also benefit the San Juan Accountable Care Organization, for which we have the incentive of realizing shared savings. I can see how it can be complimentary to the initial investment we’ve made in the competence and capabilities we’re going to need to be successful in the ACO.
The Ascent: What role do hospitals play in the accountable healthcare community model?
Ressler: I believe hospitals have both a direct and indirect role. The direct role is to be able to provide the screening to identify patients of the hospital who are at risk, whether they come through the ER or the obstetrics department. That’s why we believe philosophically that it makes sense to be able to screen patients within the accountable healthcare community model.
The Ascent : And the indirect role?
Ressler: Indirectly, we support primary care practices in the community who are also doing the screening. We partner very closely with Pitkin County and our federally-qualified health center in the region, Mountain Family Health Center. Together, we provide financial and in-kind support to offer a full breadth of medical, dental and behavioral health services in the community.
For screening obstetrics patients, we expect nearly all the Medicaid patients will come through Community Health Services, the contractor to our local health department that provides prenatal screening and services through a local obstetrics practice. That would be the most appropriate place to identify and meet unmet social needs. We don’t often have precipitous deliveries presenting at the hospital who haven’t had prenatal care, thanks to that program.
We also support Mind Springs Health, which is instrumental in assisting with mental health services. These are competencies we don’t have as an organization, but by partnering with Mind Springs, we have continuity of care in the community. We recently pooled resources with Pitkin County, its sheriff’s department, the city of Aspen and its police department and the school district to award Mind Springs a contract for crisis services. They are locating counselors in the schools as part of this program.