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Welcome to the Group Practice Improvement Network

GPIN is a nonprofit organization created in 1993 by the founders of the Institute for Healthcare Improvement to provide a vehicle through which medical groups achieve and sustain performance excellence by sharing knowledge of best practices.

Our Mission

GPIN serves as a catalyst for large multi-specialty group practices to achieve performance excellence through shared learning.

Our Vision

GPIN member groups will be leaders in quality of care, patient experience and cost effectiveness.

GPIN Membership Information

Interested in an overview of GPIN? Click here to review a short presentation.

Click here for GPIN member Frequently Asked Questions.

Click here for GPIN website orientation documents and video recordings.

GPIN Members in the News

HealthPartners receives CMS Health Equity award
February 04, 2019

BLOOMINGTON, Minn.--(BUSINESS WIRE)--HealthPartners is one of only two organizations in the nation to receive the Health Equity Award from the Centers for Medicare and Medicaid Services. The award recognizes areas where HealthPartners has implemented new models to increase access to care and reduce health disparities.

“It's a great honor to be recognized for our deep commitment to health equity, and the progress we've made to improve health and access to care for everyone,” said Andrea Walsh, president and CEO, HealthPartners.

Examples of HealthPartners work to promote health equity include:

Clinics: more patients get lifesaving test for colon cancer. Screening for colon cancer is important because it can find and remove abnormal growths before they turn in to cancer. To help more patients of color get this life-saving test, HealthPartners began offering a fecal immunochemical test (FIT) kits. The FIT test is more comfortable and convenient than a colonoscopy. As a result of this effort, there was a significant increase in the number of people of color getting tested. That reduced the screening rate gap between white patients and patients of color.

Health plan: more patients get needed medication for depression. Patients need to stay on anti-depressant medication for at least six months to get the most benefit from it. But among members enrolled in Medicaid, there were more members of color who were not getting this care compared to white members. HealthPartners launched a program that helped more patients of color complete medication treatment.

Regions Hospital: better care for mental illness. At Regions Hospital, patients with limited English proficiency (LEP) needed to stay in the hospital longer than patients whose preferred language is English. One reason is because patients who spoke languages other than English could not participate in group therapy which can help people recover more quickly. To correct this, Regions trained staff interpreters to provide simultaneous interpreting. This method is used for interpreting for world leaders and it enabled patients to participate in group therapy. This technology is helping patients with LEP recover more quickly so that they can return home about four days sooner.

Go to healthpartners.com for more information about our work to promote health equity.
https://www.businesswire.com/news/home/20190204005694/en/HealthPartners-receives-CMS-Health-Equity-award


Advocate Aurora Health planning to use 100% renewable energy by 2030
by Paige Minemyer

Advocate Aurora Health is the latest health system to bet big on renewable energy. 

The system intends to operate fully on renewable energy sources by 2030, it announced this week. Advocate Aurora Health runs 27 hospitals and more than 500 outpatient facilities in Wisconsin and Illinois.  

Reaching this goal, according to the system, would reduce its carbon emissions by 392,657 metric tons per year, equivalent to removing 84,000 cars from the road each year. 

“As the 10th-largest not-for-profit integrated health system in the country, it’s imperative that we help lead the way toward a health environment that can support healthy people,” Mary Larsen, Advocate Aurora Health’s director of environmental affairs and sustainability, said in a statement. 

“Transitioning to clean energy reduces air pollution that is responsible for many chronic health conditions and mitigates the health impacts of climate change,” she said. 

Other health systems have taken similar pledges. Kaiser Permanente announced in September that it would be carbon neutral by 2020.

Meanwhile, Boston Medical Center and the Massachusetts Institute of Technology teamed up in 2016 on a wide-ranging renewable energy plan. In 2016, Universal Health Services' George Washington University Hospital joined a purchasing consortium in D.C. aimed at building 52-watt solar capacity to meet an 80% greenhouse gas reduction target by 2040.

Kathy Gerwig, vice president of employee safety, health and wellness for Kaiser and the system’s environmental stewardship officer, told FierceHealthcare in an interview in the fall that the such a shift can have immediate public health benefits. 

“It’s an immediate win—this isn’t something that’s going to pay off in 10 or 20 years from now,” she said. 

Doctors, medical researchers and industry groups have also become increasingly vocal about the public health risks associated with climate change and pollution. 

Advocate Aurora Health said it considers its efforts as part of an overarching response to asthma, which is a common chronic condition in the Midwest. The system will also evaluate any major construction or renovation projects to see where on-site renewable energy could be implemented. 

It’s expected to use a combination of on-site, off-site and purchased energy sources for the initiative. Advocate Aurora Health’s hospitals will also focus on being more energy efficient, the system said. 

“Clean power produces clean air, and clean air saves lives,” Bill Santulli, chief operating officer, said. “This commitment builds upon our strong track record of leadership in sustainability and environmental stewardship.”
https://www.fiercehealthcare.com/hospitals-health-systems/advocate-aurora-health-planning-to-use-100-renewable-energy-by-2030

Fresh Food Program Makes a Difference in Type 2 Diabetes
Patients see drops in HbA1c, reductions in medication
by Joyce Frieden, News Editor, MedPage Today

WASHINGTON -- Giving patients with type 2 diabetes access to healthy food at no charge can result in large improvements in their disease and overall quality of life, Allison Hess said here.

"We're seeing on average a two-point reduction [in HbA1c] across the board -- and we don't have any side effects," Hess, who is associate vice president for health and wellness at Geisinger Health System, in Benton, Pennsylvania, said at the World Health Care Congress. "And in fact we have people coming off of their medications."

Geisinger's journey with food as medicine began after the health system looked at its results for treating type 2 diabetes patients. "Despite all the resources and all the effort, we still didn't feel like we were moving the needle quite as much as we had hoped," said Hess. "We also looked at the cost and we were concerned with our growing spend" on these patients.

So the health system began looking at social determinants of health as a possible reason for why so little progress was being made; they zeroed in on diet and exercise, particularly diet. To find out whether patients were food insecure, the plan embedded two food insecurity statements into their type 2 patients' medical record to get patients' responses while they were being roomed:

  • Within the past 12 months, we worried whether our food would run out before we got money to buy more (Yes or No)
  • Within the past 12 months, the food bought just didn't last and we didn't have money to get more (Yes or No)

If any patient answered "yes" to either question and met other criteria, they were referred to a Geisinger program called "Fresh Food Farmacy." The program, which began in July 2016, provides patients with two meals' worth of food per day, 5 days per week, to the entire household for as long as is needed. The food is available at a 3,000-square-foot facility on a Geisinger hospital campus in Coal Township, Pennsylvania. The Farmacy, which looks much like a supermarket, also includes a food warehouse and a classroom for offering nutrition classes.

At the beginning of the program, participants are limited mostly to food that allows them to prepare certain specific healthy recipes, but after a while they can have free choice among the foods offered, Hess said. The selection mostly includes "diabetes appropriate" food such as fresh fruits and vegetables; "we try to limit canned food." Almost all of the foods are sourced from local food banks, and those that aren't come from "vendor partners" of the health system.

The partnership with the food banks makes the food very inexpensive -- the cost is about $1,200 per year to feed a family of four, said Hess. "We couldn't do it without them as our partner."

Criteria for being referred to the program include:
  • Ages ≥18
  • Diagnosis of type 2 diabetes
  • HbA1c of ≥8%
  • Food insecurity
  • Patient of Geisinger specialty or primary care

Patients who express interest in the program are encouraged to come to a "welcome class" at which they also meet their care team: an RN health manager, a pharmacist, a dietitian, a wellness associate, and a community health associate. "What's interesting is all of the care team members were already available, but because we put it into a program and added a food component, all of a sudden they're taking advantage of things they always had access to but may not have realized," said Hess. Patients who decide to enroll must meet again with the care team and enroll in a diabetes self-management class.

Each team member plays a specific role in taking care of the patient's needs, she continued. For example, the community health worker can address transportation and other non-medical needs. "We found out there were other social determinants of health -- [some people] had housing issues, and there were also people struggling to pay their heating bill in the winter."

"We're catching people at the point where they're kind of giving up," she added. "They have very high A1cs -- 10%, 11%, 12%, 13% -- and they're frustrated. Every time they go to the doctor, they [hear] they need to [change their diet] but they can't afford it." One patient in the program actually cuts up fruits and vegetables at his regular job, but he couldn't afford to buy them.

The program, which is currently funded through foundation grants, is also saving money for the health system. Rita, age 55, is one of the patients in the program. She is raising three grandchildren, and caring for a husband on dialysis. She weighed 181 lbs and had an HbA1c of 13.8%. When she came into the program in January 2017, she had "given up on herself completely," said Hess.

Nine months later, her HbA1c stood at 5.8% and her weight was down to 155; she is now a champion of the program. With Geisinger experiencing an average $8,000-$12,000 cost savings for each percentage point reduction in HbA1c, there were "huge" cost savings in Rita's case, Hess said.

Another patient who joined the program started with costs of more than $200,000 annually; that cost is now down to $40,000, according to Hess. In addition to the blood glucose changes, patients frequently experience decreases in cholesterol and blood pressure, and some early results are also showing decreases in emergency department visits, she added.

Geisinger doesn't promote its program as being for weight loss. "We do that very intentionally," said Hess. "We wanted this to be a nutrition program. [But] the byproduct is that they ask, 'What do you have for weight loss?' So we have put other programs in place that now have people continuing to lose weight."

Geisinger is hoping to eventually expand the program outside the health system campus, and to structure the program as a long-term covered benefit, she said.
https://www.medpagetoday.com/endocrinology/diabetes/72640



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