Integrated Delivery Networks and ACOs: C-Suite Perspective. Mark D. Dixon, President The Mark Dixon Group LLC October 22, 2012

Transcription

1 Integrated Delivery Networks and ACOs: C-Suite Perspective Mark D. Dixon, President October 22, 2012

2 Meet Mark Dixon Mark D. Dixon, R.Ph, M.H.A., FACHE, leads the Mark Dixon Group, LLC which provides integrated delivery networks and medical suppliers consultative assistance. He specializes in providing services for C-suite perspective, Accountable Care Organization implementation, physician clinical integration, and improving service delivery effectiveness. Prior Experience Regional President for the South Region of Fairview Health Services in Minneapolis, Minnesota from President/CEO of Community Hospitals of Indiana, Community Health Network in Indianapolis, Indiana from Chief Executive of Abbott Northwestern Hospital and other roles with the Allina Health System in Minneapolis, Minnesota from Lectures at national meetings on relevant topics for health care administrators, physicians, and suppliers. He has also served on numerous other local not for profit and for-profit boards of directors. 2

3 Overview of Presentation Why are ACOs forming in the U.S.? What is health reform, and is it here to stay? C-suite perspective Implications for Integrated Delivery Networks (IDNs) and their hospitals Accountable Care Organization (ACO) creation Time for questions and dialogue 3

4 Healthcare Reform is Accelerating and is Here to Stay The American Recovery and Reinvestment Act (ARRA) of 2009 is having a major impact on the U.S. Health Care System The Health Information Technology for Economic and Clinical Health (HITECH) Act Value-based purchasing Accountable Care Organization (ACO) development and implementation Insurance reform coverage for all Over next 6 years, $146 billion in reduced Medicare payments The ARRA is designed to achieve the triple aim reduced cost and improved quality/patient satisfaction (Don Berwick, M.D.) America cannot afford our healthcare system and cannot compete in a world economy if it keeps spending more on healthcare 4

5 Impact on Integrated Delivery Networks (IDNs) Improve operational performance Reduce costs and improve operating margin make money on Medicare, cut costs percent. Average margin on Medicare is a negative 13.9 percent. Changing decision-makers and influencers System level roles will make more decisions CEO, IDN President(s), Chief Nursing Officer (CNO), Chief Quality Officer (CQO), and others Less local decision-making Physician consolidation and integration Primary care, specialists, and hospital-based MDs Development of clinically integrated physician networks 5

6 Impact on Integrated Delivery Networks (IDNs) (continued) IDN/hospital mergers and consolidations Strong get stronger, weaker will have to consolidate Significant changes in the care model to create value Capital/cash investments re-directed to EHRs, physician practice acquisitions, and ACO infrastructure 6 Different sectors of the industry are going to behave differently Academic Medical centers, rural hospitals, children s hospitals, large integrated systems (IDNs), and physician-led organizations

7 IDN Response: Create an ACO to Deliver Enhanced Value for Those We Serve Journey to transform healthcare moving from volume to value Care Creating Value and Outcomes Consumer Provider Patient Activation and Consumer Engagement Experience Value Employer / Plan Payment Realizing Economic Return for New Value 7

8 Care Delivery It is Truly a Journey Value-driven coordinated care Today X Volume-driven fragmented care Discounted fee for service Episode payment Shared savings models Partial capitation Global payment Payment 8

9 Creating Value & Serving More People Using the IDN Collective Capabilities and Capacity Care IDN Medical Group Consumer Value Provider Other Health Systems Clinically Integrated Network Other IDN Physicians Experience Employer/ Plan Payment Other System s Independent Physicians Improve Create Value Cover More Lives More Lives Improved clinical outcome Grow provider network Health status Exceptional experience Improve keepage Well-being Reduced total cost of care Attract new members 9

10 Thank you! The Mark Dixon Group, LLC Phone: office cell 10