Dr. Tiomthy G Ihrig is the Chief Medical Officer of Crossroads Hospice & Palliative Care. He also acts as a private consultant through his role as Chief Executive Officer of Ihrig MD & Associates.
Dr. Ihrig is internationally recognized for combining clinical and administrative experience to system design around population health management, care coordination and care delivery for the most vulnerable population. He is an expert in understanding risk as applied to healthcare contractual entities, micro- and macro- healthcare economics, population health, regulatory compliance from a system perspective and the interaction of all three. He combines a visionary approach to care delivery through a unique philosophical perspective modeled into methodology which can be strategically implemented into any healthcare system to meet the needs of patients, systems, and payers. This has led to unparalleled success in across-the-continuum population health and community-based palliative care and hospice program development and innovation.
- Created, de novo, one of the most successful population healthcare models in the country and executed clinically and operationally in this healthcare space across all settings
- Successfully reproduced care model with similar results across variable settings and systems
- Near 94% zero hospital admissions for live outpatient palliative care patients
- 40% reduction in 30-day readmissions
- 70% per-capita reduction in expenditures estimated on pre- and post- palliative care involvement over comparative 12 month periods
- Decrease in acute hospitalization days from above 4 to 1.79 with Palliative Care involvement; and persistent coordination of care through our Cancer Center, Emergency Department, and EMS services
- An inpatient Palliative Care consultation rate of nearly 28%, greater than three times the national average
- Consistently rated at the top of “patient satisfaction” and “likely to recommend to others” via Press Ganey throughout the Unity Point Health System – 2013 overall patient satisfaction mean score of 95 compared to 85 for overall system
- Decreased symptom burden, per patient subjective response
- Ubiquitous discussion and near similar attainment of advanced care planning and/or completion of Iowa Physician Orders for Life-Sustaining Treatment [IPOLST]
Challenges met demonstrated that Dr. Ihrig’s program model and philosophy are successfully responsive and reproducible to meet the needs of the highest risk individuals and any organizations goals.
Prior to joining Crossroads, he served as the medical director for Palliative Medicine at the Trinity Regional Medical Center (TRMC) within the Unity Point Health System. He also served on the Accountable Care Organization (ACO) Development Board of Managers of Unity Point Health. With a total operating budget just over $4 billion, Unity Point offers care in eight large regions across Illinois, Iowa, and Wisconsin. The health system includes 15 owned and 14 affiliated hospitals, 280 physician clinics, and home care and hospice locations. The Trinity Regional Medical Center was a Pioneer ACO organization through the Centers for Medicaid and Medicare Innovation. It is located in North Central Iowa and serves a rural eight-county area with a combined population of approximately 120,000 with approximately 35.2% between the ages of 75-84. The area is disproportionally elderly and ill when compared nationally and has a palliative appropriate population exceeding 42,000 lives. All counties in the service were designated as medically underserved areas.
His program became an apparatus for population health management within the region. Pre- and post-acute care services were operationalized to support the delivery of care. He worked closely with home care and hospice to ensure timely transitions of care and to avoid duplication of services. Approximately 97% of patients transitioned seamlessly into hospice when appropriate with their goals of care.
While at Unity Point Health, his role was the conceptualization, design, integration, implementation, and expansion of palliative medicine within the Pioneer ACO. Through a true dyad partnership with the administration and clinical partners, a program was established which broke down the vertical silos and service lines of care delivery. He built upon existing relationships within and outside of Unity Point Health System and established new ones to develop “palliative partners”. Patients were seen across all sites of care: acute care inpatient consultation service; palliative medicine ambulatory clinics adjacent to TRMC, as well as, clinics established and embedded in local long-term care facilities and care facilities in adjacent counties and rural primary clinics; patient homes; long-term care facilities without embedded palliative clinics including skilled care, intermediate care, memory units, semi- and independent residential facilities. Additional partners included the Cancer Center, Pain Center, emergency department and EMS. On-call coverage was also provided 24 hours/day by palliative physicians.
Predicated upon his unique philosophical approach of care delivery which differs from the historical linear algorithmic healthcare model, his population health / palliative paradigm focused on discovering real problems that needed to be resolved, identifying the most probable or highest impact failures that could occur and finding elegant solutions to the problems for the most vulnerable, most sick, highest utilizers, most expensive and generally most unsatisfied patients. His philosophy moved the perceived spectrum of palliative care upstream and beyond it being a service line for hospice or pain management. This was a discovery and delivery process quite unlike traditional healthcare models and unlike all other palliative programs. He supported the care of thousands of individuals from diagnosis across the care continuum. This approach transitioned away from the linear care delivery process which focuses on repetitive activities that fail to achieve high-quality outputs with minimum cost or time for this population.
In addition, concurrent focus included: Curriculum development - providing population health/palliative care education in over twenty nursing facilities in the region and moving toward creating a certified graduate nursing program in palliative care, lecturing and mentoring through regional Community College’s Allied Health Professional and Business departments recognizing the need to integrate clinical and business /economic awareness of healthcare; Tele-health - working to expand tele-medicine program to all five LTC facilities within Fort Dodge, all five rural critical access hospitals, outlying primary care clinics and other clinical leaders within the region and; Healthcare Provider Advocacy - continue to promote and endorse the use of ARNPs and RNs in the field of population health/palliative care across the continuum and through the ACO network. He also participated in the development of a system-wide Palliative Care Affinity Group whose purpose was to promote palliative care best practice and the standardization of metrics and analytics to measure program effectiveness in meeting Unity Point strategic initiatives.
His efforts as Palliative Care and Hospice Medical Director were seminal in Unity Point Heath being granted the 2013 Circle of Life Award by the American Hospital Association. One of nine institutions that year across the country to receive this prestigious award, it recognizes innovative programs in palliative and end-of-life care. Dr. Ihrig’s program continues to be recognized as a national leader in integrating palliative care across the healthcare continuum with the development and implementation of innovative mechanisms for managing this most vulnerable population.
Among his many appointments include, content expert to the Accountable Care Learning Collaborative (ACLC), consultant to the Center To Advance Palliative Care, positions on numerous advisory boards of organizations serving the palliative and hospice community, as well as a primary investigator in palliative care - accountable care organization interaction in collaboration with the ACLC and The Dartmouth Institute.
Dr. Ihrig has given a TED talk which has over 1.2 million views globally, and National Public Radio’s, “All Things Considered” featured him in a story on the development and transformative nature of his philosophy of care. He has lectured all over the country and is endorsed by the Center to Advance of Palliative Care (CAPC) as a national level clinician-educator. He most recently has joined CAPC as an advisor on their healthcare Policy Committee. In addition, he has co-authored, Palliative Care: Symptom Management.
He served as an Expert Source for Palliative Care Development in an Accountable Care Organization in a Rural Community for the Brookings Institution in Washington D.C. and was the sole practicing physician assisting the Iowa General Assembly in raising minimum standard requirements for Iowa physicians with respect to end-of-life care and oversight of the use of prescriptive narcotics. He also acted as an expert clinician in support of Iowa Physician Orders for Life-Sustaining Treatment bill. He is a prior Clinical Adjunct Professor in the Department of Medicine at the University of Iowa Carver School of Medicine and acted as Palliative Care clinical instructor. He served on the board of the Hospice and Palliative Care Association of Iowa for six years and is the former chair of the Advocacy Committee and the Palliative Care Advisory Committee.
Dr. Ihrig attained a degree in medicine from the University of Nebraska College of Medicine and a Masters degree in Molecular Biology from the University of Nebraska at Omaha. He completed his residency in internal medicine at the University of Iowa, Des Moines and a fellowship in Hospice and Palliative Medicine at Stanford University in Palo Alto, California.
Other interests of Dr. Ihrig include sexuality at the end of life and Global Health. He is the former Medical Chair of the Health Services Committee for Empower Tanzania Incorporated whose mission is the development of sustainable healthcare solutions in sub-Saharan Africa for individuals suffering from HIV/AIDS, cancer, and other life-limited illnesses.