The Turning Point. As You Transform Care.

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1 The Turning Point As You Transform Care Miami February 20-22, Jointly sponsored by the University of Pittsburgh School of Medicine Center for Continuing Education in the Health Sciences and HortySpringer Seminars.

2 Topics HortySpringer s new seminar, The Turning Point As You Transform Care, has been developed to help hospitals and physicians change the direction of patient care based on new reimbursement and delivery models. Our strategy is to enable community hospitals to move beyond silo-based health care and remain strong, provide better care, and control costs. The cost of care, particularly for patients facing the challenges of chronic illnesses, compels hospitals to rethink how that care can be delivered on a continuous basis. Today, up to 2/3 of the cost is actually accumulated after the patient is discharged. Much of this cost can be attributed to poor or disorganized post-discharge follow-up. Many patients admitted with chronic conditions require a lifetime of care. In most communities, the hospital is the only organization with the skills and resources to provide centralized coordination of care. Numerous legal issues are at play as well and require the board to gain additional knowledge and exercise more control. The hospital s patient care responsibilities traditionally began and ended at the front door. The need to coordinate care, inside and outside, will move the hospital into the community. As new payment methods and cost constraints change how hospitals regard volume and quality of care, payment will be affected as well. Neither the government nor insurers can transform and modernize the organization of care. It must be developed and managed locally. The Turning Point is about hospitals changing their culture and joining the community in a new way and shifting malpractice liability from individuals to organizations. It means greater transparency and patient collaboration. And it shifts the focus on quality from process to outcomes and avoiding unhelpful care. Improved patient outcomes Improved care experiences Improved clinical resource utilization Improved medication reconciliation Improved support for physicians Improved communications among providers Improved patient engagement and adherence, while respecting patient choice Improved fiscal performance Reduction of unnecessary procedures, admissions and readmissions Reduction of medical errors Elimination of care gaps Care Coordination Ensuring effective care coordination requires shared, ongoing responsibilities and cost-effective, continuous care strategies. A hospital without walls is the only rational approach for achieving Triple Aim goals. A key feature of this program is training and mentoring volunteer health coaches serving under a hospital-based, interdisciplinary care coordination network (CCN) team. From a care coordination perspective, the CCN is not an institutional appendage it is all-encompassing and enables staff to work together effectively for patients well-being. Care Coordination Goals The first step in achieving these goals is understanding how to operate a care coordination network. Your team will also learn to reduce readmissions and function effectively under an Accountable Care Organization (ACO) or bundled payments model. Our seminar also covers negotiating with Medicaid and commercial carriers to help pay the costs of care coordination while producing savings to partially offset Medicaid losses. Bundled Payments and ACOs In order to achieve and sustain successful operations, hospitals and physicians must decide how they will work together to manage both the cost and quality of patient care. Learning the details of bundled payments and ACOs is particularly important, since the Medicare payment system is moving in the direction of a fixed global payment system. Medical Staff Health care transformation changes are both sweeping and dramatic accomplished only through forged relationships of mutual trust and respect. While these relationships are not always characteristic of medical staffs and hospitals, it is crucial to join forces for the greater good. This seminar will examine changes in hospitalphysician relationships, the new organizational tools required by physician employment and new medical staff models. Teaching How to Negotiate Reimbursement Contracts Traditionally, payment has been structured by fee-for-service contracts between hospitals and payers. Commercial carriers are now seeking closer affiliations with hospitals and physician groups. Medicaid-managed care companies are moving toward risk-based contracts with hospitals. Medicare is experimenting with ACOs and bundled payment strategies. Insurance Exchanges are certain to change the face of reimbursement. Hospitals must also learn to work with payers differently. And community hospitals must discover how to leverage their low costs relative to tertiary care in contract negotiations. The Turning Point will show you how. Bringing the Board Up to Speed How does the hospital board deal with care delivery and payment change? Board leadership must begin to develop an understanding of the changes in payment system. While hospital boards typically equate increased volume with increased profits, this will not be the case in the future. Bundled payments, ACOs, value-based payments, global payments, and penalties for readmissions are clearly not based

3 Topics (continued) on increased volumes. The move away from fee-for-service reimbursement toward a fixed fee per patient per month payment is rapidly setting the stage for the evolution of our payment system. These changes in reimbursement will clearly serve to move hospitals beyond their walls into the community. Hospitals must become more responsible for outcomes and costs in both acute and post-acute patient care. Coordination of hospital and post-acute care is the central change in hospital responsibility fiscally, organizationally and legally. It clearly alters community and physician relationships. And it will move hospitals and their boards into a no discharge strategy in the future. These changes cannot take place without the board. Positively transforming the hospital culture and relationship with the medical staff requires board leadership. Date & Location February 20-22, 2014 Ritz-Carlton Key Biscayne Miami Bask on the calm golden sands of Miami s Key Biscayne. Cross the picturesque causeway to an island destination seemingly a world away. The Ritz-Carlton Key Biscayne awaits your arrival with the perfect blend of relaxation, culture, and adventure. For reservations, please call Room Rates: $419/Superior; $459/Partial Ocean View Seminar Schedule Day One 6:30 to 8:00 am Registration & Continental fast 8:00 am to 9:20 to 9:50 am Day 1 Adjourns 5:30 to 6:30 pm Informal Reception Registration Day Two $1,495 individual $995 each for registrants 2 and 3 $3,950 for a team of four $850 for each additional registrant The registration fee includes: A USB drive, which includes slide text, case studies, faculty bios and more Medical Staff Leader Monthly newsletter for one year 7:00 to 8:00 am Continental fast 8:00 am to 10:00 to 10:30 am Day 2 Adjourns Day Three 7:00 to 8:00 am Continental fast 8:00 am to 10:15 to 10:45 am Seminar Adjourns Who Should Attend? Hospital CEOs and Senior Management Board Members Physician Leaders Participation by all individuals is encouraged. Advance notification of any special needs will help us provide better service. Please notify us at least two weeks in advance of the program. Educational Intent Upon completion of this program, participants should be able to: Identify the positive forces behind delivery reform; Identify strengths and weaknesses in current relationships between hospitals and physicians and other members of the health care team, and adopt tools to accentuate the strengths; Identify clinical integration models that have and have not been successful, as well as those that have been proposed but are as yet untested; and Better lead their health care organization through reform. Continuing Education Credit This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Pittsburgh School of Medicine and HortySpringer Seminars. The University of Pittsburgh School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. The University of Pittsburgh School of Medicine designates this live activity for a maximum of 10.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other healthcare professionals are awarded 1.05 continuing education units (CEUs), which are equal to 10.5 contact hours. NAMSS Accreditation This program has been approved by the National Association Medical Staff Services for up to 10.5 hours continuing education credit(s). Presenter Disclosure Statement In accordance with the Accreditation Council for Continuing Medical Education requirements on disclosure, information about relationships of presenters with commercial interests (if any) will be included in materials, which will be distributed at the time of the conference.

Faculty John Horty B.A., Amherst College LL.B., Harvard Law School One of the founders of the law firm of Horty, Springer & Mattern, P.C., Mr.

Through HortySpringer Seminars, he has educated board and medical staff leaders for decades on topics such as governance, medical staff leadership, compliance, quality, and strategic planning for

Horty s reputation in the health care industry especially his support of community hospitals is well-established.

medical societies, hospital associations, and various hospitals and health care systems. Ms.

She regularly advises hospitals and physician leaders on matters such as mission, credentialing and physician/system integration strategies and processes.

Bittman pioneered a new paradigm for comprehensive integrative strategies that engage patients and communities in the active pursuit of health and well-being.

4 Faculty John Horty B.A., Amherst College LL.B., Harvard Law School One of the founders of the law firm of Horty, Springer & Mattern, P.C., Mr. Horty now serves as managing partner of the Pittsburgh, PA firm. Through HortySpringer Seminars, he has educated board and medical staff leaders for decades on topics such as governance, medical staff leadership, compliance, quality, and strategic planning for hospitals. He is past chair of the boards of directors of St. Francis Central Hospital and St. Francis Hospital. He has also served on the boards of Mercy Hospital and Mercy Health Care System. Mr. Horty s reputation in the health care industry especially his support of community hospitals is well-established. Linda Haddad, JD Senior Partner, Horty, Springer & Mattern Linda Haddad has presented at hundreds of educational conferences, including programs conducted by the American Health Lawyers Association, medical societies, hospital associations, and various hospitals and health care systems. Ms. Haddad works extensively on board and physician leadership issues, medical staff bylaws, physician contracts, system credentialing, and physician organization matters. She regularly advises hospitals and physician leaders on matters such as mission, credentialing and physician/system integration strategies and processes. Barry Bittman, MD Health Care Innovations & Management Barry Bittman, MD, is a neurologist, author, international speaker, and researcher. As Chief Innovations Officer of Meadville Medical Center, Dr. Bittman pioneered a new paradigm for comprehensive integrative strategies that engage patients and communities in the active pursuit of health and well-being. Through numerous innovative, disease-based projects and programs funded by leading health care insurers, he has developed a novel series of coordinated care inpatient and outpatient models. Steven J. Tringale President & CEO, Tringale Health Strategies LLC (THS) Steven J. Tringale is President and CEO of Tringale Health Strategies LLC (THS), a company developed to provide a wide range of professional services, including strategic planning, network and contract development, product development, benefits consulting, and crisis management to health care industry clients. Mr. Tringale founded and was managing director of Hinckley, Allen & Tringale, LP, a health care consultancy. He also has held a number of senior executive positions in large health care companies, including the position of President, Senior Division of Blue Cross Blue Shield of Massachusetts. Mr. Tringale has served as chair of the Massachusetts State Health Coordinating Council for seven years. He frequently speaks on health care and has testified before many state legislatures and Congressional committees. Jennifer Bell Co-Founder of Chamber Hill Strategies Jennifer Bell advises a wide variety of clients, including acute and post-acute care hospitals, skilled nursing facilities, home health agencies, hospices and physician groups. Her public sector work included serving as majority health policy advisor for the Senate Finance Committee, where she developed and managed legislative initiatives regarding Medicare fee-for-service programs, including passage and implementation of the Medicare Modernization Act of Jennifer has strong bipartisan relationships within the Senate Finance Committee, the Senate HELP Committee, the Senate Judiciary Committee, the House Ways and Means Committee, and the House Energy and Commerce Committee, as well as the Senate and House leadership. She works regularly with political appointees and civil servants at the Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS), the Medicare Payment Advisory Commission (MedPAC), the Government Accountability Office, and the Congressional Budget Office. Tracy Meure, RN, BSN Clinical Director for Meadville Medical Center s Community Care Network (CCN) Over the past two years, Tracy Meure led the Community Care Network (CCN) clinical team under the direction of Barry Bittman, MD. She was instrumental in the development and implementation of the CCN utilizing unique care coordination strategies to meet the Triple Aim objectives better patient outcomes, better care experiences, and lower per capita cost. Her areas of expertise include clinical service, education, quality assurance, and administration. Tracy assisted in the design and opening of the first outpatient dialysis clinic geared toward ventilator-dependent and morbidly obese patients.

5 Registration The Turning Point: As You Transform Care Hospital Name Street Address City/State/Zip Phone # Fax # Contact Person Title Names of Registrants (Please give full names and titles as you would like them to appear on name tags.) 1. Name/Degree/Title 2. Name/Degree/Title 3. Name/Degree/Title 4. Name/Degree/Title Payment ($1,495 individual, $995 each for registrants 2 and 3; $3,950 for a team of four, $850 for each additional registrant) Visa Mastercard Am. Express Card Number Name on Card Security Code Exp. Check enclosed. (Please make payable to HSM Enterprises.) Please bill. How did you hear about this HortySpringer seminar? Marketing Brochure Colleague Other How to Register Fax Phone Mail HortySpringer Seminars, 4614 Fifth Avenue, Pittsburgh, PA Online

Physician-Hospital Contracts Clinic

Physician-Hospital Contracts Clinic Dan Mulholland Henry Casale Jointly sponsored by the University of Pittsburgh School of Medicine Center for Continuing Education in the Health Sciences and HortySpringer