Collaborating for Success in Rural Communities. Presented by: John Solheim, CEO Cuyuna Regional Medical Center February 10, 2015

Transcription

1 Collaborating for Success in Rural Communities Presented by: John Solheim, CEO Cuyuna Regional Medical Center February 10, 2015

2 Presentation Objectives Discuss critical success factors for collaboration Promote collaboration as a tool to assist with goal of remaining independent Provide practical tactics and lessons learned Please note that the views expressed by the conference speakers do not necessarily reflect the views of the American Hospital Association and Health Forum.

3 Background Overview Historical Relationship Critical Success Factors Future Options Benefits of Collaboration Lessons Learned

4 Service Area Located approximately 120 miles northwest of Minneapolis/St. Paul Facilities are located approximately 15 miles apart Primary market areas combined, Riverwood Healthcare Center (RHC) and Cuyuna Regional Medical Center (CRMC) serve around 28,000 people Both facilities draw patients beyond primary market areas On summer weekends the area swells to around 300,000 people due to the large number of resorts, activities and the 716 lakes

5

6

7 Riverwood Healthcare Center 25-bed Critical Access Hospital integrated health care system with three rural health clinics New hospital was built in 2003 and expanded in (C)3 Organization with net revenue of $60M Primary Care Clinics in Aitkin, McGregor, and Garrison and a specialty clinic in Aitkin

8 Riverwood Medical Staff 11 Family Practice Physicians 8 Nurse Practitioners 5 ER Physicians 2 Internal Medicine Physicians

9 Cuyuna Regional Medical Center 25-bed Critical Access Hospital integrated organization, which has been essentially completely renovated over the past five years Full continuum of care with skilled nursing, assisted living, senior housing, home care, hospice and ambulance Hospital District with net revenue of $100 M Multi-specialty clinic located on the campus in Crosby with outreach clinics in Longville and Baxter

10 Cuyuna Regional Medical Staff 14 Family Practice Physicians 3 Internal Medicine Physicians 2 Anesthesiologists 4 Physician Assistants 2 Nurse Practitioners 5 ER Physicians 5 CRNAs 15 Surgeons

11 Health Care Resources at Both Facilities In-house MRI and CT scanning with mobile PET State-of-the-art operating suites 24/7 MD Staffed Emergency Services 24/7 Hospitalist program CRMC, Part time RHC, E-ICU - CRMC Full service laboratories, rehab services

12 Combined Provider Resources Combined specialists at RHC & CRMC: 4 general surgeons CRMC 2 orthopedic surgeons and 2 orthopedic PAs - CRMC 1 podiatrist - RHC 4 OBGYNs with additional one coming in summer 15 CRMC Visiting Specialists - Pulmonology, Sleep Medicine, Dermatology, Rheumatology, Urology, ENT and Radiology

13 Combined Provider Resources 2 urologists, 1 urology NP - Visiting 4 cardiologists CRMC 3 ophthalmologists - CRMC 1 oncologist - CRMC 15 radiologists - Visiting

14 The CEO sets the tone The Art of Collaboration Doesn t happen overnight Need engaged physician partners Hard work and have to fight the urge to compete Actions speak louder than words

15

16 Historical Relationship Traditional small town rivalries in sports and other activities Proud independent hospitals and the largest employer in the respective communities Worked together on some things and competed on many other levels Some collaboration with general surgery about 25 years ago

17 The Game Changer Significant event occurred with a joint community survey Conclusion: We were fighting border wars with one another while a very large share of our combined market was going to Twin Cities The key to growth in our future was developing capability to provide more specialty care on something other than an outreach model Analyzed outmigration data to develop a business case for recruitment. Data determined need at each location Created a strategic Medical Staff Development Plan

18 Key Components Worked with local medical staff to discuss: adequacy of coverage individual needs satisfaction with current services consensus to move forward with exploring options Consider probability of being successful in expanding clinic time of existing specialists and/or successful in getting them to change their patterns Share recruitment costs

19 Recruitment Presentation of us a sales presentation Request for information from the potential respondents Invitation to a site visit Inform existing specialists of process and include them After site visits and review of RFIs, determine next steps with one or several of the respondents Complete and distribute detailed RFP with expectations

20 Selection Physician participation is key Establish criteria for review of proposals using the RFP Conduct an objective review of each response Respond respectfully to ones not chosen Review changes with your existing specialists Contract guarantees are split proportionally by days at each site

21 Making it Work May have to invest in infrastructure equipment, staffing and training Each facility provides space and staffing Local introductions to medical staff is key Use of local electronic medical record facilitates referrals and follow-up communication Need to constantly review the data Regular communication is needed Success brings other options though word of mouth

22 Critical Success Factors Resist specialists efforts to try to divide and conquer Develop brands that could be promoted across communities and service areas Joint funding of brand development Joint marketing approach with both communities listed Joint community educational speaking events With CEO turnover each facility had their candidates visit the other facility as a courtesy to reinforce the collaboration message

23

24

25 Premier Surgical Associates 4 General Surgeons, 2 Orthopedic Surgeons and 5 OBGYNs 2 Anesthesiologists Surgery research NSQUIP General Surgery Fellowship Program the only fellowship in the country with triple accreditation Bariatric, Laporscopy, Endoscopy Protocols & Procedures Developed Center of Excellence; now referred to as MBSAQIP

26 Financial Arrangements CRMC contracts with Premier Surgical Associates on an RVU basis with a non compete provision RHC contracts with CRMC for surgical services with similar approach and non compete provisions, CRMC does the coding RHC bills for the surgical professional component under their own provider number to show local relationship plus takes advantage of CAH Method 2 Billing Call Coverage costs are split 50/50 RHC also pays a licensing fee to help support infrastructure

27 Joint Venture Instead of Competition Joint ventured Breast Biopsy Stereotactic Equipment Developed collaborative brand and breast health campaign Hired 2 nurse navigators Ongoing sharing of resources and processes Affiliation with Virginia Piper Cancer Institute - Minneapolis Achieved separate Cancer Accreditation for both locations

28 The Future Leverage existing groups stability to other nearby communities Examples: General Surgeon and OBGYNs Additional specialists recruitment ENT, Pain 24 hour Transcription Laundry HIM Coding Business Office Information Services Soon moving to the same IS platform EPIC More integration while remaining independent

29 Collaboration Benefits Captures lost market share from outmigration Assists with recruitment of additional specialists that couldn t otherwise individually support Results in more business for both facilities Share call coverage and associated expense Reduces potential arms war and duplication of services Allows advanced services at affordable rates locally Supports independence of each organization Joint planning initiatives focus on the success of both organizations

30 Lessons Learned Assist physicians with the brand development Stress the fate of one facility truly affects the other Monthly meetings to discuss issues and include other leaders as necessary, Socialize regularly to develop trust Add others to the meetings for broader discussions At times, crucial conversations are necessary

31 Best Wishes on Your Collaboration Efforts! Thank You Contact Information John Solheim CEO Cuyuna Regional Medical Center 320 E Main Crosby MN