An Overview of Member Services and Programs

Transcription

1 An Overview of Member Services and Programs

2 AMGA Mission Statement AMGA supports its members in enhancing population health and care for patients through integrated systems of care. AMGA Vision Statement Dramatically improved population health and care for patients at lower overall costs will be achieved by high-performing and clinically integrated medical groups and health systems. Adopted 2012

3 AMGA Values Physician leadership Fully integrated, efficient, patient-centered care Teamwork across specialties Continuous improvement of patient care systems Total coordinated care through the use of: Interoperable electronic health records Dedicated care managers or care coordinators Evidence-based care guidelines Systematic monitoring of quality and efficiency Transparency and accountability for clinical care outcomes at the group level

4 AMGA Membership Overview 150,000 physicians Approximately 430 Medical Group Members Deliver health care to 120 million Average group size is 348 MDs Median group size is 140 MDs AMGA medical groups treat approximately one in three Americans

5 2014 AMGA Board Members Executive Committee Chair: Howard B. Graman, M.D., FACP - Chief Executive Officer PeaceHealth Medical Group Chair Elect: Don L. Wreden, M.D. Chief Medical Group Transformation Officer, Sutter Health Secretary: Donn E. Sorensen, M.B.A., FACMPE - President, East Region, Mercy Treasurer: Norman H. Chenven, M.D. - Founder and Chief Executive Officer, Austin Regional Clinic Member At Large: Barbara A. Walters, D.O., M.B.A. Executive Medical Director, Dartmouth-Hitchcock Immediate Past Chair: Michael W. Bukosky, MSHA, FACMPE Executive Vice President, USMD Holdings, Inc. President and Chief Executive Officer: Donald W. Fisher, Ph.D., CAE - President and Chief Executive Officer, American Medical Group Association Directors: Jeffrey W. Bailet, M.D. - Executive Vice President, Aurora Health Care, President, Aurora Medical Group Joseph E. Bisordi, M.D., FACP - Executive Vice President and Chief Medical Officer, Ochsner Health System Barry L. Gross, M.D. - Executive Vice President/Chief Medical Officer, Riverside Medical Group A. Marc Harrison, M.D. - Chief Executive Officer, Cleveland Clinic Abu Dhabi Michelle A. Koury, M.D. - Chief Operating Officer, Crystal Run Healthcare Bernadette C. Loftus, M.D. - Associate Executive Director, The Permanente Medical Group Mark E. Mantei, M.H.S.A., FACHE - Chief Operating Officer, The Everett Clinic Ashok Rai, M.D. - President and Chief Executive Officer, Prevea Health Christopher J. Sclafani, PE, MBA - Chief Administrative Officer, Mount Kisco Medical Group Grace Emerson Terrell, M.D., M.M.M., FACP, FACPE - Chief Executive Officer, Cornerstone Health Care, P.A. Susan A. Terry, M.D., FACP - Executive Medical Director, University of Utah Community Clinics Tim Weir, M.H.A., M.B.A., FACHE - Chief Executive Officer, Olmsted Medical Center 5

6 Member Groups by Number of Physicians Over 150 MDs 44% MDs 19% Less Than 25 MDs 5% MDs 32%

7 Member Groups by Specialty Composition 2% Single Specialty 98% Multispecialty

8 AMGA Primary Service Areas Increasing Your Knowledge Base Measuring and Comparing Performance Expanding Advocacy Improving Patient Care Strategic Initiatives

9 Increasing Your Knowledge Base Networking and Educational Opportunities: Annual Conference; Learning from the Best, March 23-26, 2015, Caesars Palace, Las Vegas, NV Institute for Quality Leadership Annual Meeting November 11-14, New Orleans Leadership Council Meetings Regional Meetings

10 Increasing Your Knowledge Base (cont.) PUBLICATIONS Group Practice Journal Flagship publication of AMGA featuring articles on the business of group practice medicine submitted by medical group and industry executives Advocacy E-NewS Weekly analysis on the latest issues affecting medical groups on the federal legislative and regulatory front. Inside AMGA Monthly newsletter highlighting AMGA services, initiatives, and legislative actions; news from member groups; and industry trends involving AMGA members Health Business Daily Practice management and medical group industry trends and toolkit

11 Increasing Your Knowledge Base (cont.) Special networking groups of individuals in leadership positions: CEO/President/Chair Council CAO/COO Council CIO Council CFO Council CMO/Medical Director Council Council of Attorneys Quality Directors/Officers Government Relations Marketing/PR Directors Human Resources Directors/Managers Councils meet up to two times a year in person and interact and correspond daily via a listserv Access to a document sharing page and archives of listserv discussions

12 Measuring and Comparing Performance AMGA s Anceta Collaborative Patient Satisfaction Benchmarking Provider Satisfaction Benchmarking Employee Satisfaction & Engagement Benchmarking Program Annual Compensation and Financial Operations Survey Annual Physician Retention Survey Advanced Practice Clinician Compensation and Pay Practices Survey

13 Measuring and Comparing Performance (cont.) Thoroughly tested survey Comprehensive analysis National, regional, and specialtyspecific norms Regional and best practices benchmarks Networking opportunities Quick turnaround Reasonable cost Electronic and paper reports

14 Measuring and Comparing Performance (cont.) How Medical Groups Use the Results Public accountability Quality improvement Peer review Marketing Physician/staff compensation or recognition

15 Measuring and Comparing Performance (cont.) Providers anonymously rate their satisfaction with: Medical group leadership Office communications Compensation Workload Quality of care Resources Professional autonomy Patient interactions Group collegiality Pre-authorization processes Computer and online availability

16 Measuring and Comparing Performance (cont.) How Medical Groups Use the Results Assess differences in provider satisfaction across departments, sites, or specialties Benchmark results against national norms and similar medical groups Identify system problems that may impact the ability to recruit and retain high quality practitioners Evaluate the relationship between satisfaction and performance

17 Measuring and Comparing Performance (cont.) Measures the job attitudes of accountants, information technology professionals, receptionists, medical assistants, and other non-provider employees Analysis of perceptions on employee engagement, growth opportunities, health benefits, leaves, pay, personal relationships, physician interactions, rewarding work, supervision, and workload Gives thorough insight into how your employees feel regarding their jobs, supervisors, and compensation Understand how committed and motivated your employees are when it comes to the mission and success of your organization Benchmark against other medical groups across the country Secure web-based instrument

18 Measuring and Comparing Performance (cont.) How Medical Groups Use the Results See the Big Picture Evaluate Multiple Facets of Employee Reactions Compare How Your Group is Doing Identify Where Improvement is Needed Look for Trends Enhance Your Efforts to Motivate, Recruit, and Retain High-Quality Employees

19 Measuring and Comparing Performance (cont.) Medical Group Compensation & Financial Operations Survey Compensation section provides Individual compensation and production of experienced physicians in all major specialties Starting salaries of new residents and experienced new hires Physician & non-physician administrative salaries Financial operations section provides Support staff salaries and benefits Staffing ratios & profiles and other key management costs Financial profiles based on varied managed care revenue percentages and further broken down by group type, geographic region, and group size

20 Expanding Advocacy Your Voice in the Federal Legislative/Regulatory Arena An Effective Corporate Shield to Protect Your Interests Defining High Performing Health Systems Aggressive Lobbying for: High Performing Health Systems/Accountable Care Organizations Medicare Physician Payment Update Medicare Reform/SGR Reform Medicare Advantage Information Technology Self-Referral Reform Coordinated Care Model

21 Expanding Advocacy (cont.) Face-to-Face Contact with Key Congressional Representatives Participation in Coalitions Timely Information Compliance Assistance Regulatory Assistance

22 Improving Patient Care Quality Improvement Awards and Grants: AMGA Acclaim Award Medical Group Preeminence Award Medical Group Learning Collaboratives American Medical Group Foundation

23 Improving Patient Care (cont.) Quality Improvement Awards and Grants Acclaim Award Recognizes those organizations that can measurably demonstrate progress toward achieving the six aims of the 21 st Century Health System defined by the Institutes of Medicine Medical Group Preeminence Award Awarded to physicianadministrator leadership teams for: Exceptional leadership Innovation and vision Contributions to the advancement of quality Effective healthcare delivery practices and structure Outstanding contributions to the local public community in which the medical group is located

24 Improving Patient Care (cont.) Medical Group Learning Collaboratives Best Practices in Managing Chronic Obstructive Pulmonary Disease Providing a compendium of best practices in COPD care to help redesign care processes and practice patterns to better serve the needs of patients with chronic lung disease. Best Practices in Diabetes Care Collaborative Examining best practices in care of patients with diabetes. Engages medical groups and expert panel members in examining current standards of care. Best Practices in Managing Hypertension Working with medical groups to implement the new guidelines for hypertensive and pre-hypertensive patients.

25 Improving Patient Care (cont.) Clinical Research and Demonstration Projects Diabetes Risk Model Project A multi-site research and demonstration project to help medical groups identify high risk diabetes patients, and institute changes in care that produce better health Chronic Care Improvement Demonstration Project A project which brings together medical groups dedicated to design and test systems of care that improve quality and satisfaction of chronically ill patients with multiple medical conditions

26 A nonprofit 501(c)(3) foundation whose mission is to foster quality improvement in group practice through education and research programs in clinical quality, patient safety, service, operational efficiency, and innovation.

27 The Foundation s Goal is to Fund Current and Future Programs that Support the Mission Acclaim Award Learning Collaboratives Chronic Care Challenge: Measure Up, Pressure Down

28 AMGA Strategic Initiatives Fostering development of High Performing Health Systems Anceta, AMGA s Medical Informatics Collaborative Chronic Care Challenge: Measure Up, Pressure Down

29 AMGA Strategic Initiatives (cont). Defining a High Performance Health System - to educate legislators, insurers, and the public on the unique attributes of these systems and to aid provider organizations in their efforts to improve patient care, AMGA has defined HPHS as: A multispecialty medical group or other organized system of care that is integrated or has partnerships with other care sites to provide patients with better services and care. HPHS successfully manage the per capita cost of health care, improve the overall patient experience, and improve the health of their respective populations Legislative Action to Reward High-Performing Organizations SGR Stark Exemptions Rules and Regulations Other

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31 Anceta Collaboration to Improve Population Health, Driven by Comparative Clinical Analytics Support members in redesigning the delivery system to manage population health Strategies for moving from one payment model to another Competencies in understanding and managing population health Data resources and analytical tools Humedica partnership Extend AMGA s model for shared learning Anceta Comparative Data Shared Learning What to improve How to improve 31

32 Anceta Collaborative Use data to identify opportunities for improvement and best performance Medical groups: Humedica MinedShare Anceta: provocative analyses systematic exploration Learn the rest of the story from other medical groups Ambulatory setting longitudinal records Expanding scope Detailed models for chronic disease All active patients adult preventive services Population management dashboard Adjudicated claims data all covered services Diabetes Hypertension Dyslipidemia Coronary Artery Disease COPD Congestive Heart Failure Pediatric Asthma 32

33 Organization Performance Anceta Collaborative Humedica and AMGA: Areas of Focus Process outcomes Standardized cost Best practices Shared learning Collaboration Pop. Health, Cost Efficiency Selected Patient Population Individual Patient Focus attention Documentation Provider Performance Reports EHR w/ CDS Patient outreach Care coordination Population perspective Predictive analytics Patient Registry Risk Identif. and Tracking Comparative Data Process Execution Process Improvement Systematic opportunity analysis Exploration (rapid hypothesis testing) Performance reports with comparative data, process/outcome focus Predictive analytics identify potential outliers Real-time Retrospective 33

34 Anceta Participants

35 Chronic Care Challenge: Measure Up, Pressure Down mobilizes AMGA member medical groups to adopt one or more evidence-based care processes that lead to measurable improvements in hypertension outcomes. To further the campaign s reach, medical group interventions will be supplemented with patient education tools, strategic partnerships, special events and a national media and public awareness strategy.

36 Accountable Care Organizations (ACOs) AMGA s ACO Principles Multispecialty Medical Groups and Other Organized Systems of Care Make the Strongest Foundation for ACOs ACOs Must be Physician-Led Accountability for Health Care Services ACO Incentives Must Be Aligned to Foster Voluntary Participation ACOs Must Have a Primary Care Core ACOs Should Be Learning Organizations

37 Accountable Care Organizations (ACOs) Educational Programs Institute for Quality Leadership/ACO Summit Regional Meetings Webinars ACO Best Practices Learning Collaboratives MSSP Boot Camp AMGA All Rights Reserved

38 Value-Added Services Proactive Patient Outreach Solution Discounted Credit Card Processing Program Professional Opportunities Page

39 How AMGA Differs From MGMA AMGA Membership composed of groups, primarily large, multispecialty groups 93% of members are from groups with over 25 MDs Group Membership includes all physicians and staff within the group Benchmarking, education, and legislative/regulatory issues are designed to meet the needs of larger groups Activities directed at the physician and non-physician leaders Programs and activities focus on systems of care and include quality and care process improvement MGMA Membership composed of individuals, primarily from small single specialty groups 75% of members are from groups with less than 25 MDs Only the named individuals are considered members Benchmarking, education, and legislative/regulatory issues must meet the needs of large and small groups Activities directed at the non-physician administrators, managers, finance, and coding/billing staff Programs and activities focused on practice management and operations

40 Annual Cost of Medical Group Membership AMGA Annual Dues Structure Organizations that Employ Physicians (Group Practice, IDS, Academic/Faculty Practice) Organizations that Contract with Physicians (IPA) # of FTE Physicians Dues 3-50 $5, $9, $14, ,000 $19,000 More than 1,000 $25,000 # of Enrollees/Covered Lives Dues Up to 60,000 $5,500 60, ,000 $9, , ,000 $14, ,001-1,200,000 $19,000 More than 1,200,000 $25,000 * Multi-tax ID health systems will need to call AMGA for pricing (703)

41 Please do not hesitate to reach us with any thoughts or questions. Bill Baron Director of Membership Development (703) ext 336 AMGA One Prince Street; Alexandria, VA (703) //