Lawrence County Rural Health Clinic: Making Big Strides on Their Journey to Value-Based Care

The Lawrence County Health Department (LCHD) is a public health department offering behavioral, environmental, public, and home health services to the residents of Lawrence County, IL, and surrounding communities. LCHD’s services span a geographic area of approximately 55,000 people across seven zip codes. LCHD also operates a rural health clinic, staffed by one physician and two advanced practice providers, largely serving Lawrence County, a population of approximately 15,700 residents.

LCHD was one of four organizations selected to participate in the 2020-2021 Rural Health Provider Transition Project. RHPTP’s goal is to guide small rural hospitals and certified rural health clinics not currently participating in value-based care (VBC), in preparing and positioning their organizations to be effective participants in a health system focused on value.

As a project participant, LCHD participated in an assessment to determine financial risk and identify strategies to address operational cost-efficiency opportunities in preparation to participating in VBC arrangements. LCHD also participated in a quality project around building infrastructure that embeds quality improvement into practice to develop an organizational approach to quality tracking and measuring quality measures and also learned how to implement that approach within a designed framework. Through this process, they are now better positioned for success in a rapidly evolving health care market, preparing to capture value within a population health management system. 

Everyone involved in RHPTP was very helpful! I liked the two-prong approach, with Stratis Health covering Quality Improvement starting from the bottom up and Stroudwater covering the Management Overview starting from the top down. LCHD board and management wish to extend our gratitude to Stratis Health, Stroudwater, and the folks at the National Rural Health Resource Center for the opportunity to participate in the RHPTP project and for all the assistance that we received during the project. Thank you so much!

Amy Marley, Administrator

LCHD's Post-Project Measurable Outcomes

• Increased operating margin by 80%
• Increased the number of unique lives to the patient panel by 9%
• Seventy-one (71) percent increase in the number of diabetic patients on insulin, between the ages of 40-50, having had their HA1c levels completed within a 3-month span
• Improved operating efficiencies by 56%. Efficiencies included optimizing all available revenue-generating opportunities, maintaining an appropriately low-cost structure, embracing a measurement culture, and having effective revenue cycle and metrics
• Ninty-five (95) percent improvement in overall organizational culture
• One hundred eighty-four (184) percent increase in overall improvements to processes and systems to support quality improvement excellence
• Thirty-two (32) percent improvement in overall organizational alignment in areas as patient safety and experience, care coordination, clinical outcomes, community and population health, health equity, process efficiency, and lowering costs

Top Accomplishments

• Hired a psychiatric nurse practitioner, and continuing to expand behavioral health services in the surrounding counties
• Currently applying for a Rural Health Network Grant to purchase new EHR software that accommodates more measurable data
• Moved into a new building that provides more space and continuity among all departments, and allows for all services to be under one roof which is helping to close those gaps
• Implemented chronic care management
• Outreaching to Medicare population to educate them on the importance of annual wellness visits
• Implemented school-based telehealth kiosks that are making a positive impact on the community and population health
• Solidified partnerships within the county
• Clinic now open on Saturdays from 8:00 a.m. to Noon, one to two days per month

LCHD is interested in expanding population health efforts to maximize performance through participation in an ACO and other value-based payment arrangements, as well as to better understand available opportunities that result in improved financial and operational performance today and in the future related to the changing payment system.