Pago Pago, AMERICAN SAMOA — There has been a lot of attention brought lately regarding recent changes in management and infrastructure at the American Samoa Medical Center. Many have questioned why are all of these changes are happening, what is the goal and what is the ultimate vision for Lyndon B. Johnson Tropical Medical Center (LBJ). 

The short answer is Value Based Care.  

The adoption of a value-based care model is not optional for a facility like LBJ which relies almost exclusively on payments from Medicare and Medicaid. The Centers for Medicare & Medicaid Services has openly stated that they expected that 100% of their payments to providers will be through a value-based care reimbursement program by 2030. 

What does that mean for the Hospital? 

Value Based Care is an industry wide shift in how medical care is delivered to patients. Most patients understand the traditional fee for service model that has long been the method of reimbursement for healthcare. It is easily recognizable; you have a procedure done and the doctor or hospital get paid for that procedure. This incentivizes the doctor or hospital to focus on doing more procedures so they can bring in more revenue. Value based care is the flip side to that, it is patient focused. Providers are not compensated for the volume of work that is done, but on the value, provided to the patient. 

Value is a hard concept to quantify, because it involves the entire experience that the patient has with the ospital, from interactions with security, cleanliness of facilities, outcome of procedures, and does that patient have to come back to the hospital shortly after they are discharged due to an error on the part of the hospital. Value-based care must be safe, timely, effective, efficient and patient centered. 

LBJ is actively working to make those goals a reality. This model of care requires a rethinking of the use of LBJ’s outpatient clinics focusing on preventative medicine rather than reacting after a patient is already sick.

It is actively implementing the tenants of value-based care and is going through a period of reorganization to make it more efficient to reduce the cost of healthcare and improve patient outcomes. This may appear unmeasured or unsustainable from the outside but it is being undertaken with deliberation and thorough planning. 

This is not any easy adjustment and will take time to implement but it is expected that all of our staff will be certified in their areas of responsibility and will actively participate in moving LBJ toward the goal of a value-based care model of healthcare delivery for American Samoa.

As we undertake this re-organization and shift in our healthcare delivery model, the public should see improvement in the care they receive at LBJ. 

We have numerous infrastructure projects underway and coming up soon. Additionally, in the near term we are updating the scheduling system in our outpatient clinics, patients will no longer be sitting for hours to see a doctor. We are also installing a whiteboard system for the Emergency Department to help reduce wait times and increase patient awareness. This project will be rolled out within the next two weeks. 

Finally, we are working closely with 86Borders to improve community awareness and the timeliness of the care we provide to our patients. 

There are multiple additional projects on the horizon and we will share them with the public as they come closer to implementation.