President, CEO, Health Choice, LLC
Mitch Graves believes in the power of data, in joint ownership of the effort to achieve better community health, and in a physician-led initiative of healthcare system governance — and he’s pulling together a plan that will prove the value of all three.
Graves, a Memphis native, graduated from Christian Brothers University with a Bachelor of Science degree in business administration, and was awarded CBU’s Distinguished Alumnus Award in 2012. Since 2013, he has served as chairman of their Board of Trustees.
He gained valuable insight and experience during his 25 years as president and CEO of Methodist Le Bonheur Healthcare’s (MLH) Affiliated Service Division, which included five surgery centers, hospice, home care, HME, diagnostic centers, employer clinics and minor medical centers.
That experience has been serving Graves well since his move last year to take the helm as President, CEO of Health Choice, LLC, a physician-hospital organization (PHO) that is a joint venture between Methodist Le Bonheur Healthcare and MetroCare, a locally based not-for-profit Independent Physician Association (IPA).
In 1985, Health Choice was a wholly owned subsidiary of Methodist, Graves said, while today it’s 50 percent owned by MLH and 50 percent by MetroCare’s 1,700 doctors, and serves as a clinically integrated/accountable care organization (ACO) rather than an MCO. The fact that it is physician-led rather than hospital- or health system-led makes the venture unique, he maintains — the only one of its kind in Memphis, bringing partners and elements together to create a network of high quality and low cost.
The decision to transform Health Choice was part of what prompted Graves to make what he calls "a leap of faith," which moved him from the health systems side to the physician hospital organization.
Has Graves’ role switch been challenging?
“On the health systems side, it’s all about trying to increase the volume of your business. My new challenge is going to be to improve outcomes, and that sometimes means not as much volume. We’re developing strategies to keep people out of the emergency department by spending more time at their patient-centered medical homes — their primary-care doctors,” he said.
In pursuit of three primary goals — improving the experience of care, improving the health of the community, and reducing per capita cost — Graves guided Health Choice in recently partnering with Valence Health, a leading provider of clinical integration, population health and value-based care solutions.
“A large part of achieving those goals involves pulling all the pieces together,” he said, “and a large part of that is the data gathering. Valence will help move Health Choice from an administrative company to one that’s knee-deep in data analytics.”
MetroCare is concurrently reorganizing to be the physician governance that will set the metrics and measures, he explained, working with MLH to set standards that will be approved over time. And the process will take time: four or five months to gather enough data, another six months to validate the data, he estimates.
What does such data accomplish?
“The only people who have ever had the full picture of data have been the insurance companies,” Graves said. “This will be the first time that healthcare providers have our hands on it, showing us the big picture.
“We’re all about improving care. Once we find out where our pockets and areas of improvement are, we can really get after population health and try to keep people well and out of the hospital emergency department. That may come from education about eating, exercise or teaching diabetics to take better care of themselves.
“Once we begin to get data, Metrocare will begin to bring the physicians together for the governance and start setting metrics and outcome measures, which our data and analytics will support. Then it’s operationalizing the data — determining how to make and measure improvements."
The biggest obstacle, he said, is that patients aren’t getting any healthier. They’re still accessing care through the emergency department — the most expensive care option — instead of accessing primary care that should have been available to them through the Affordable Care Act.
“We believe the patient-centered medical home is one of the benchmarks that you’ve got to do well to see improvement in any aspect of care. Unfortunately, there are 69,000 people eligible for Obamacare here in Shelby County, and only 10,000 have been accepted into the plan, so that still leaves a lot of uninsured patients. Then there’s the whole other 80,000 of the uninsured that didn’t qualify for Obamacare, but would have qualified for the state Medicaid expansion — which the state of Tennessee turned down.”
Complicating data collection is the limited availability of medical records, he said. “Unfortunately, only about 50 percent of physicians have an electronic medical record. They’ve all got billing systems with charges and diagnoses codes, but a full chart of your last temperature, blood pressure, medications — no. Our long-term goal would be for all physician practices to have electronic medical records, and that’s where we’d go to mine good, rich data.
“I will feel like we have been successful at Health Choice and Metrocare and Methodist LeBonheur Healthcare if we can improve the health of the population that we’re serving, reducing per capita cost, and improving the patient-family experience with healthcare. It’s what every health system ought to be aspiring to.”
He identifies his most important career accomplishment as the development of Methodist Hospice, which opened with a 30-bed residential hospice three years ago. “I watched my mother and grandmother both die in the hospital,” Graves said. “It hit me that the hospital is not the place somebody should have to die.”
The hospice accepts all, regardless of their ability to pay, so fund-raising continues to be ongoing, with more than half a million dollars required in donations each year.
In his rare moments of non-healthcare involvement, Grace enjoys traveling and time with his family. As cheerleader, he supports his wife, Kelly Jo, a personal trainer, in efforts such as a recent relay race from Miami to Key West. His daughter, a sophomore at Ole Miss, is studying journalism.