As PacificSource marks our 90th anniversary, we’re looking at how the original, cooperative vision of our founding group of 13 doctors continues to define us. A fine example is our ongoing collaboration with Summit Health—a physician-led, patient-centric healthcare network with more than 170 providers and ten locations in Central Oregon.

Summit Health is Central Oregon’s largest primary care and multispecialty group. We spoke with Dr. Russ Massine, Summit’s Chief Physician Executive, and Justin Sivill, Summit’s Regional Chief Operating Officer, about some of the breakthroughs PacificSource and Summit have created together.

Using transitional care to ease crowding and reduce readmissions

In early 2020, as the pandemic set in, Central Oregon faced unprecedented inpatient capacity challenges. Hospitals were flooded with patients and, due to staffing challenges, bed capacity was extremely limited. As these challenges mounted, Summit Health reached out to PacificSource for support with the launch of a first-of-its-kind program in Central Oregon designed to help patients transition from hospitals to skilled nursing facilities (SNFs) and then back to their homes—all in one coordinated system of care.

The program launched with Summit’s population health and hospitalist team managing patients in the hospital and designing discharge plans for every patient upon admission. Patients transferred to skilled nursing facilities were treated there by the same care team they saw in the hospital. The SNF team continued the discharge and care plan from the hospital, and planned patients’ returns home and follow-up visits. While in the facility, patients received extra attention from Summit Health’s hospitalist team, registered nurse care management team, physical medicine and rehabilitation providers, wound care services, and if needed, physical therapy and mobility support.

Summit staff embedded at the SNFs focused on preventing readmissions, and created care plans to dramatically improve the quality of care. From medication reconciliation to food insecurity to gait and mobility issues, Summit teams cut readmissions by 17% and length of stay by 23%. Once discharged from the SNF, patients were assigned to Summit Health’s population health team, who managed their care for 60 days or more while making sure patients saw their primary care providers within a few days.

The program was and is extremely successful, getting patients home to heal, improving the quality of life, lowering the total cost of care, and opening beds for a community in a crisis.

“The extra support Summit received from PacificSource for the SNF program has been priceless,” said Justin Sivill. “We approached PacificSource during an amazingly challenging time and asked for help launching a first-of-its-kind practice. They said yes immediately and have been with us every step of the way since our launch. It’s worth noting that PacificSource did not dictate that the program, which they helped subsidize, could be used only for PacificSource members, but rather is available to the entire community. Our hospitalists, population health team, SNF program, and discharge planning process are on par with the best programs in the country, and we wouldn’t have been able to do it without PacificSource.”

PacificSource’s Chief Medical Officer Dr. Edward McEachern commented, “What Summit has done with the SNF program is to design and launch an innovative chronic/complex system of care during a pandemic and national staffing crisis. They’ve refined and expanded the program over the past three years to include multiple additional services, offering Central Oregon a path for people to do private complex care in a way that makes sense for everybody. And I think that’s fantastic.”

Medications conserved with a multifaceted approach

Also on Summit Health’s list of care improvements: better management of lifesaving, high-cost oncology, and rheumatology medicines. Name-brand versions of these drugs can cost tens of thousands of dollars per treatment (though lower-cost biosimilar versions may be available). A big issue: infusion facilities across the country routinely dispose of millions of dollars’ worth of high-cost medications annually based on discrepancies between provider ordering and manufacturing packaging.

“Together with PacificSource, Summit established a pharmacologic program, the first of its kind in Central Oregon. The program focuses on high-cost medication waste reduction, formulary management, and the use of biosimilars,” said Justin Sivill. Biosimilars are like generic drugs in that they act in the same way and are tested with the same FDA process, but frequently cost much less than name-brand options.

Summit Health’s approach to reducing prescription waste was particularly compelling due to its simplicity and effectiveness. Sivill explained their thinking: “A medication may come in vials of an amount, say 5ml, but you may find that a patient needs 6ml. What happened before is we’d use two 5ml vials to reach the 6ml dosage, leaving a leftover amount that went unused, but patients still paid for. To address the waste issue, our pharmacy team found that in many cases we could adjust the way we dose a patient over a four-week period and significantly reduce waste with zero impact on patient care.”

Sivill added, “We’ve been quantifying every single vial and every single dose for a year, and we’ll have about $450,000 in savings just from pharmacists adjusting dosages in small ways. We were able to build a better way to do it with PacificSource—and help our patients avoid unnecessary costs.”

Dr. Russ Massine, Summit Health’s Chief Physician Executive, commented, “In the next few years, Summit will launch even more innovative new projects and programs designed to enhance the quality of life for our patients, transform healthcare delivery, and reduce the total cost of healthcare. PacificSource has been at the table with us every step of the way, and is one of the very best partners we have in Central Oregon. I believe the 13 physicians who founded PacificSource would be exceptionally proud of the company’s leadership and staff for living the original mission of the organization.”

Summing up PacificSource’s relationship with Summit Health, Dr. McEachern observed, “It’s aspirational. As we move into the next generation of relationships, this is exactly what we’re looking for. While not every provider has the bandwidth to take on programs such as these, it’s been really refreshing to have Summit Health say ‘Sure, let’s go, let’s do it.’”