Steven C. Glass Chief Financial Officer Cleveland Clinic May 14, 2013

Transcription

1 Steven C. Glass Chief Financial Officer Cleveland Clinic May 14, 2013

2 Cleveland Clinic Overview

3 From the beginning a unique model of care Founded in 1921 Four doctors with a vision for a new model of medicine Non-profit, physician-led group practice Collaboration across disciplines All physicians are salaried employees Patient-centered mission Dr. Frank E. Bunts Dr. George W. Crile Dr. William E. Lower Dr. John Phillips

4 43,890 employees 5.1 million total visits 157,474 admissions Over 3,000 physicians and scientists Over 1,000 community physicians Over 1,100 residents and fellows in training Cleveland Clinic Fast Facts

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6 Patients First

7 Institutes a key step in achieving our mission We see this new approach to patient care as the wave of the future. It may challenge some existing professional boundaries, but we welcome change when change improves care. Institutes put patients first. - Delos M. Cosgrove, M.D. CEO and President -

8 Institutes physician led Anesthesia Arts & Medicine Cleveland Clinic Lorain Cole Eye Dermatology & Plastic Surgery Digestive Disease Education Emergency Services Endocrinology & Metabolism Glickman Urological & Kidney Head & Neck Heart & Vascular Imaging Lerner Research Medicine Neuroscience Nursing OBGYN & Women s Health Orthopaedic and Rheumatologic Pathology & Laboratory Medicine Pediatrics & Children s Medicine Philanthropy Regional Operations Respiratory Quality & Patient Safety Taussig Cancer Wellness

9 Physician Group that manages a Health System Cleveland Clinic Delos Cosgrove, MD, CEO Hillcrest Hospital Steve Davis, MD, COO Medina Hospital Thomas Tulisiak, MD, President Lakewood Hospital Robert Weil, MD, President Lutheran Hospital Brian Donley, MD, President Euclid Hospital Mark Froimson, MD, President South Pointe Hospital Brian Harte, MD, President Weston, Florida Bernardo Fernandez, MD, CEO

10 Program Rationalization Heart Surgery Obstetrics Behavioral Health Pediatrics Neonatal ICU Trauma Inpatient Rehabilitation Skilled Nursing

11 Program Rationalization Trauma H Euclid Hospital H Ashtabula County Medical Center H Lakewood Hospital H Lutheran Hospital Cleveland Clinic Huron Hospital H H South Pointe Hospital H Hillcrest Hospital H Fairview Hospital H Marymount Hospital H Medina Hospital

12 Program Rationalization Trauma H Euclid Hospital H Ashtabula County Medical Center Lakewood Hospital H H Fairview Hospital H Medina Hospital H Cleveland Clinic H Lutheran Hospital METROHEALTH H Marymount Hospital H South Pointe Hospital H Hillcrest Hospital

13 Northern Ohio Trauma System Before % Mortality After

14 Huron Hospital Closed

15 Stephanie Tubbs Jones Health Center Opened October 2011 Primary & Specialty Care Wellness Education Chronic Disease Management

16 Lou Ruvo Brain Institute Las Vegas Cleveland Clinic Canada Sheikh Khalifa Medical City Main Campus Cardiovascular affiliations Urological affiliations Cleveland Clinic Abu Dhabi West Palm Beach Health and Wellness Center Cleveland Clinic Florida

17 Health Care s Service Fanatics How the Cleveland Clinic leaped to the top of patient satisfaction surveys By James I. Merlino, M.D. and Ananth Raman 17

18 Cleveland Clinic Experience

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20 Cleveland Clinic Overall Rating Mayo (3) Mass Gen (1) Johns Hopkins (2) UCLA (5) CC (4) 50th

21 Patient Safety Indicators Occurrences Jan Apr Jul Oct Jan Apr Jul Oct 2011 Enterprise CC-Main Regional Hospitals Weston 2011 Target: Target: 50 Source: UHC pulled

22 University Hospital Consortium Quality Rank th th th Rank

23 Cleveland Clinic Financials

24 Utilization Statistics Acute Admissions Transfer Admissions Thousands Thousands Health System

25 Utilization Statistics Surgical Cases Thousands Health System

26 Utilization Statistics Outpatient Visits ED Visits Millions Thousands Health System

27 Professional Staff 4,000 3, Year Growth: ` 2,000 1,

28 Statement of Operations FY December 31 ($ in millions) Net patient service revenue $ 5,050 $ 5,213 $ 5,610 Other operating revenue Total operating revenue 5,600 5,827 6,215 Total operating expenses 4,950 5,065 5,507 EBIDA Depreciation and amortization Interest Special Charges Operating income $ 251 $ 301 $ 228 Operating margin 4.5% 5.2% 3.7% EBIDA margin 11.6% 13.1% 11.4%

29 Gross Revenue Payor Mix

30 Cash and Investments 6 Restricted Unrestricted 5.2 $ Billions

31 Investment Allocation $5.2 Billion Cash Fixed income 31% 6% 32% Marketable equity securities 3% Real estate 7% 21% December 2012 Private equity Hedge funds

32 Key Ratios Days Cash On Hand Operating Cash Flow Margin # % Cash To Debt Debt To Capitalization % %

33 Debt Overview 22% 2% 76% Series 2013A Plan of Finance - $20mm of new money projects - Current refund $84.9mm Series 2003A Bonds Series 2013B Plan of Finance - Refund $200mm Series 2004B VRDBs December 2012 Total: $2.85 billion

34 Cleveland Clinic Strategies and Direction

35 Imperatives PATIENTS FIRST Caregiver engagement Innovate the care & business model Financial strength Reduce cost Optimize resources Growth Leadership and management

36 Strategic Direction Striving to be the world s leader in patient experience, clinical outcomes, research and education Referral center Healthcare provider Academic center New models of value-based care

37 Growth Extend capabilities - Cleveland Clinic integrated care model Leverage our current offerings - Clinical care - Intellectual property - Consulting and management

38 Growth Northeast Ohio National International

39 The New World Volume-Based Value-Based Payment Fee-for-Service Outcome Based Incentives Volume Value Focus Acute Episodes Populations Role of the Provider Single Episodes Care Continuum Information Retrospective Real-time & Predictive

40 Four Components of Value Based Operations ( VBO ) Medical Home Shared savings Episodes of Care PAMC

41 Program for Advanced Medical Care (PAMC) Existing Clients:

42 Strategic Alliance - Community Health Systems (CHS) One of the nation s largest publiclytraded hospital companies headquartered in Tennessee 135 hospitals operating in non-urban and mid-size markets in 29 states Focus of collaboration - Quality Alliance - Cardiovascular Services - Clinical and Operational Services Under the terms of the five-year agreement, Cleveland Clinic and CHS will remain independent entities

43 CHS + Quorum Footprint Hospitals 135 Managed 150

44 Network of Affiliated Hospitals Allows Cleveland Clinic to offer high quality, cost effective patient care across the U.S. Current Affiliates National Network Expansion Markets Cleveland Clinic Facilities

45 Cleveland Clinic Abu Dhabi (CCAD)

46 Quality Alliance 5,200 Providers Insurers Quality Metrics

47 National Network Owned & Partnered

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49 Integrated Care Model Retail Venues Home Community - Based Organizations Care System CC Clinic Post-Acute (other) Independent Physician Offices Skilled Nursing Facilities MyChart Rehab Ambulatory D&T Hospitals Emergency

50 Care Transformation Evidence-based Consistency One Cleveland Clinic Across Continuum Leadership & Culture PATIENTS FIRST

51 Our Opportunity Patients and caregivers Aligned model Integrated system Intellectual rigor Culture of innovation

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