New Model of Care: 1 Year Post IHI
|
|
- Norah Sullivan
- 5 years ago
- Views:
Transcription
1 New Model of Care: 1 Year Post IHI BY: Kristie Genzer, System Vice President of Physician Development President of Ochsner Physician Partners Robert Hart,MD Regional Medical Director D16/E16 This presenter has nothing to disclose Here is text for the textbox December 11, :30 a.m./11:15 a.m. 1 Session Objectives Transition from a volume-based to a value-based practice Develop strategies to implement the Triple Aim model 2 1
2 Ochsner Health System Jan 2, Ochsner Health System: Physician-led, not-for-profit healthcare system Clinical Integration Network of 1100 MD s 1 st Artificial Heart Transplant in Gulf South Region 1 st in utero surgery in the Gulf South region Ochsner Clinical School affiliation with University of Queensland Programs: EICU, Stroke and Psych Tele-medicine EPIC Integration:8 hospitals and 49 health centers 4 2
3 Why Ochsner Exists. Our Goal is to Keep People Well and Functioning -Alton Ochsner, MD Ochsner Strategic Direction STRATEGIC IMPERATIVES Community: Serving the greater need People: Our most valuable asset. Quality: Error-free care that s affordable Academics: National leader with global Impact. Stability: Financially sustainable and growing Loyalty: Patients, families & physicians 3
4 Our Nation s Healthcare.. The US pays over 2 trillion dollars, considerably higher than any other developed country (Kumar and Nash 2011) Ascent of health care expenditures to approx 18% of GDP is not sustainable 38th on the World Health Organization s rankings of world s health systems? $700 billion of care is characterized as waste or unnecessary. Patient Protection and Affordable Care Act (PPACA) signed into effect on March 23, 2010 by President Obama 7 The Health of Louisiana Highest rates of obesity, diabetes, chronic renal disease, and heart disease. Louisiana consistently ranks in the top 90%ile of health care spending. The state is challenged economically with a low per capita income, large Medicaid population, and a financially-strained state economy. 8 4
5 Ochsner Baton Rouge Region One Hospital, 9 Health Centers, 101 MD s, 41 APC s and 1100 Employees Only fully integrated multi-specialty group practice in Baton Rouge to include a hospital facility Largest area certified nurse midwife program Ochsner Medical Center - Baton Rouge received the Gold Level Hospital Quality Award from the Louisiana Health Care Review (LHCR) in 2008 and of 23 GYN Epicenter sites in the nation for roboticassisted surgery Now offering general surgery options such as GERD treatment and colon cancer removal with the da Vinci
6 Leaders will need to optimize income in the fee-for-service delivery system In order to fund long-term investments in their physicians, IT systems, process redesign, clinical integration, and other improvements". N. Kaufman,
7 Barriers that Effect Speed of Change Local politics Physician resistance to change Slow movement of payors to adapt Payment methodologies to reward an emphasis on quality. 13 One Ochsner Network Center of Excellence Patient Health Management By providing patients with unparalleled access to clinical programs nationally recognized in quality, safety, and patient experience, in partnership with physicians and hospitals, we will grow regional, national, and international referrals By providing patients and physicians with unparalleled access to healthcare nationally recognized in quality, safety, and patient experience that controls medical cost below national trend, we will grow patient health management to care for over 250,000 Fee For Service Global Payments 7
8 Tightly Integrated Network with Coordinated Care is best approach for Managing Cost & Quality Post Acute Hospital Specialist Surgery Center Imaging Center PCP Specialist Community Hospital Patient Tertiary Hospital Urgent Care Center PCP Selection of Primary Care Physician Navigate the Healthcare System, Coordinate Care Aggressively Manage Chronic Conditions Proactive Outreach for Wellness Accurate Accounting of Cost, Quality & Utilization Ochsner Baton Rouge.. Journey to Care Coordination Three Roads to Travel 16 8
9 Pursuing Healthcare Value: What Care Model do you use? PCMH: This model frequently involves a care team working to manage all aspects of the patients' care and utilizing resources to maximize quality metrics, prevent readmissions, and improve quality of life. RN Health Coach: Team approach to manage populations in group treatment settings, comprehensive 1:1 visits both in the ambulatory or home setting. 17 What Model Did We Choose? The Care Coordination Model Define Scope: To improve the quality of care for the patients by: increasing the appropriate preventative screening rates, decreasing care performed outside our system, and increasing the star ratings for our HEDIS measures. We understand first hand that our model needed to be sustainable with a payment model that rewarded us for providing a higher quality of care. This model would act as a bridge towards the new era when payors and providers would all be aligned with payment incentives rewarding quality and no longer piecework units of care that might be considered meaningless 18 9
10 Coordinated Care: How Did We Build it? Perform Gap Analysis Learned more about our patients and the level of involvement in their care. Many were not managing their diseases when they were away from our care. Created a Shared Vision: PC Leads/Administration Practice Efficiency Review(every dept/every provider) Design Coordinated Care Model: Care Provider Team Manager 7 LPN s embedded into the practice Social Worker Access to Care Quality Service Financially Sustainable Model 19 Coordinated Care: How Did We Build it? Coordinated Care Pilot: Identified Physician Champion/Partner Global Process to serve All Patients/All Payors Performed pre-visit chart audits on patients (all payors) scheduled for 6 and 12 month follow ups/physical and focused on HCC and HEDIS service gaps Contacted all patients due for a 12 month physical. Education: Care Team Packets created and use as a vehicle to educate patient about their care provider team, our system, services and how to access care Hospital Readmission Process: Patient contacted and scheduled within 24/48 hours of admit Ongoing Tracking/Monitoring of our Progress External Benchmarking 20 10
11 Two Worlds of Healthcare Healthcare delivery system will not change overnight Physicians in critical specialties must be willing to participate and standardize clinical practices to minimize variation Pursuit of Value Initiatives: ORTHO/CARDIO Healthcare Systems must secure one EHR platform with hardwired point-of-care protocols EPIC Integrated throughout Organization 21 Criteria for Success Build sufficient primary care capacity using physician extenders as well Midlevel deployment, Practice Efficiency etc Develop physician champions to drive the process Primary Care Lead Physicians A programmatic approach to chronic diseases Accredited Diabetes Management Program, CHF Clinic, COPD 22 11
12 Criteria for Success Physicians who do not meet key cost and quality metrics must be sanctioned. Foster a culture of accountability amongst the physician group practice a. Patient Engagement: Tied to Compensation < 25%tile improvement class required b. OPE: Build internal relationships c. Quality Timely actionable data HEDIS Core Measures 23 Ochsner Baton Rouge (2012) 24 12
13 Baton Rouge Year over Year Comparison 25 Hierarchical Condition Category (HCC) Dashboard Closed HCC's Average HCC's Closed/Member 2012Baseline: CMS Accepted 2012 Baseline: HG2.22 and PHN ,000 60,000 50,000 40,000 HG: Prior Year 62,701 48,232 40,670 41,535 30,043 62,703 50,198 53, HG: 2.18 PHN: ,000 20,000 10, ,859 24,298 11,562 13,190 13,681 15,523 15,938 6, ,695 4, Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct HUMANA GOLD PHN HG Prior Year HUMANA GOLD PHN Strategy: Members with OC PCP Office Visits YTD Average HCC's Closed/Region 100% 95% 90% 85% 80% 75% 70% 65% 60% 55% 50% 2013 GOALALL: 95% 84% 82% 85% 86% 82% 85% 83% 84% 85% 83% 82% 83% 83% BAPTIST BATON ROUGE KENNER NORTHSHORE SOUTHSHORE Humana Gold PHN Goal Average Risk Score ST ANNE WESTBANK SYSTEM HUMANA GOLD AVERAGE HCC COUNT 9/30/ /18/ /25/ /1/2013 BATON ROUGE KENNER NORTHSHORE SOUTHSHORE ST ANNE WESTBANK SYSTEM PHN AVERAGE HCC COUNT /30/ /18/ /25/ /1/2013 BATON ROUGE NORTHSHORE SOUTHSHORE WESTBANK SYSTEM * Rpt in SS = Included in Southshore Data 13
14 Re-Admissions(Oct 2012-Sept 2013) 25.0% 20.0% 15.0% 10.0% 5.0% ALL READMIT RATE READMIT THRU ER RATE ADMIT COUNT ALL READMITS READMIT THRU ER ALL READMIT RATE READMIT THRU ER RATE % 18.2% % 14.3% % 9.7% % 23.0% % 17.5% % 16.7% % 17.6% % 8.1% % 12.7% % 8.0% % 7.8% % 15.4% 27 Outside Provider Expense: $1.2M Top 25 Service Categories Full Year 2011 Full Year Jan-July Actual 2012 Jan-July Actual 2013 Jan-July Actual Jan-July Trend (2011 to 2012) Jan-July Trend (2012 to 2013) IP HOSPITAL $12,847,938 $11,960,960 $7,808,642 $6,938,908 $5,359,795-11% -23% HOME HEALTH $3,753,118 $3,605,353 $2,308,066 $2,187,794 $1,304,454-5% -40% OP HOSPITAL $3,250,124 $3,210,539 $1,882,388 $1,928,906 $1,525,167 2% -21% SNF $2,449,477 $2,514,500 $1,487,226 $1,401,814 $1,504,412-6% 7% EMERGENCY DEPARTMENT $1,692,423 $1,757,106 $1,004,363 $1,002,333 $814,548 0% -19% DME $1,241,918 $1,091,783 $716,778 $679,271 $495,030-5% -27% HOSPITALIST $1,012,264 $940,642 $601,247 $569,549 $389,543-5% -32% KIDNEY CENTER $918,308 $1,119,089 $429,639 $585,895 $534,080 36% -9% PHYSICAL MEDICINE $873,980 $966,986 $495,770 $581,416 $455,317 17% -22% OPHTHALMOLOGY_RETINAL OPTOMETRY $770,956 $864,906 $442,014 $485,052 $408,341 10% -16% RADIATION ONCOLOGY $681,867 $652,084 $344,727 $474,338 $269,974 38% -43% AMBULANCE $705,947 $552,329 $432,130 $318,317 $286,195-26% -10% RADIOLOGY $630,952 $538,243 $358,209 $317,417 $285,527-11% -10% ORTHOPEDIC SURGERY $516,063 $557,543 $316,264 $308,454 $293,111-2% -5% DERMATOLOGY $514,422 $523,788 $290,137 $293,748 $247,465 1% -16% CARDIOLOGY $479,925 $487,811 $298,733 $287,130 $224,532-4% -22% NURSE ANESTHETIST $539,772 $516,652 $318,472 $304,184 $56,024-4% -82% UROLOGY $407,233 $407,601 $235,457 $250,920 $140,406 7% -44% LABORATORY $387,308 $395,576 $235,334 $206,603 $173,277-12% -16% GENERAL SURGERY $437,142 $287,202 $285,213 $165,998 $126,178-42% -24% ANESTHESIA $187,120 $214,168 $116,233 $129,153 $319,428 11% 147% THORACIC AND VASCULAR DISEASE $322,728 $287,003 $201,527 $153,144 $176,658-24% 15% HOSPITAL OTHER $294,817 $233,040 $234,974 $201,753 $88,884-14% -56% UNKNOWN $306,343 $321,043 $187,327 $154,258 $167,703-18% 9% INFUSION THERAPY $316,288 $281,783 $188,093 $183,988 $115,735-2% -37% $35,538,433 $34,287,730 $1,250,
15 Quality Continuously improving and this past year Ochsner Medical Center was named to US News & World Report s Top 50 hospitals in 8 of 16 categories. Our six acute care community hospitals have led the region in Risk-Adjusted Mortality Index (RAMI) the last two years according to data from CareDiscovery. 29 OHS & Compare Group RAMI: FY OHS and Selected La. Hospitals: Risk Adjusted Mortality Index (RAMI) Adult, All Payor Discharges: FY 2012 from DOJ/LHIN Dataset Mortality Index Ordered Lowest (Best) to Highest (Worst) Thomson Reuters methodology change in 2012 does not exclude palliative care patients from risk-adjusted mort calculations. Mortality Index (RAMI) Mortality Index 1.0: Expected = Actual OHS 2012 Ave Index Competitor 2012 Ave Index For FY 2012, OHS average RAMI of 0.73 was approx. 37.3% lower (better) than the average RAMI of 1.16 for selected hospitals in Louisiana. Avg Competitor Index (FY2012 ): At RAMI of 1 Actual Mortality Rate = Expected Mortality Rate 0.6 Avg OHS Index (FY 2012): Data source: DOJ/LHIN dataset in CareDiscovery Risk Adjustment Methodology: Truven (fm. Thomson Reuters) Most recent data renormalization occurred in June 2012 Presented to Name Month, Day, Year 15
16 OHS & Compare Group ECRI: FY OHS and Selected La. Hospitals: Expected Complication Rate Index (ECRI) Adult, All Payor Discharges: FY 2012 from DOJ/LHIN Dateset Complication Index Ordered Lowest (Best) to Highest (Worst) Thomson Reuters methodology change in 2012 adds 17 Adverse Drug Events to riskadjusted comp calculations. Complications Index (ECRI) Complications Index 1.0: Expected = Actual OHS 2012 Ave Index Competitor 2012 Ave Index At ECRI of 1 Actual Complication Rate = Expected Complication Rate For FY 2012, OHS average ECRI of 0.88 was approx % lower (better) than the average ECRI of 1.01 for selected hospitals in Louisiana. Avg Competitor Index (Q1-Q ): Avg OHS Index (Q1-Q3 2012): Data source: DOJ/LHIN dataset in CareDiscovery Risk Adjustment Methodology: Truven (fm. Thomson Reuters) Most recent data renormalization occurred in June 2012 Presented to Name Month, Day, Year Medical Practice Baton Rouge Med Prac Overall (Benchmark Group: OHS 100+ Providers) Baton Rouge % % % 91.0 BR 2012 Perc Rank Goal 70% % 89.0 Q2-09 Q3-09 Q4-09 Q1-10 Q2-10 Q3-10 Q4-10 Q1-11 Q2-11 Q3-11 Q4-11 Q1-12 Q2-12 Q3-12 Q4-12 Q1-13 Q2-13 Q3-13 Raw Score Perc Rank 68% 66% 88% 78% 84% 87% 87% 91% 94% 95% 96% 99% 94% 89% 87% 95% 83% 60% 50% Top Priority Question (Q2-12) Our sensitivity to patients needs Presented to Name Month, Day, Year Standard questions only. 16
17 Criteria for Success Infrastructure must be built to monitor, manage and report outcomes. Care Coordination Team 33 Criteria for Success Hospital Based Physicians (Hospitalists, intensivists, etc.) must be trained in the latest care delivery techniques and evaluated based on cost, quality, and service metrics. Telemedicine: Tele-Stroke, E-ICU and Improved Critical Care Model 34 17
18 It is our belief that in addition to operational efficiency, improved quality and lowering costs.. We have driven Cultural Transformation Commitment Degree of organizational Support Awareness Understanding Acceptance Yields Results Collaboration Transparency of Results Meetings with PC Leads and Staff Time 35 Success: Focus on Focusing: Laser Focus Accurate, Actionable Data Breaking Down the Silo s through: Collaboration Communication Commitment Eliminated Variation Strengthened the Physician/Administrative Dyad Relationships and Leadership Celebrate success Our Secret Sauce 36 18
19 Questions? 37 Learn More About Ochsner Ochsner Health System: History of Ochsner: Katrina: MyOchsner Patient Portal: MyOchsner 38 19
Managing Risk Through Population Health Initiatives
Managing Risk Through Health Initiatives Vicki DeBaca, DNS, RN Vice President, Health & Provider Services Sharp Rees-Stealy Medical Centers 1 Sharp Rees-Stealy Medical Centers San Diego s Multi-Specialty
More informationDesigning Reliable Value-based Systems of Care for Chronic Disease and Prevention
Designing Reliable Value-based Systems of Care for Chronic Disease and Prevention Frederick J. Bloom, Jr. MD MMM President, Guthrie Medical Group 1/23/15 Where We Want to Be 1. Affordable coverage for
More informationMedicare / Accountable Care Organization CHS Finance Division CPE Day November 2, 2015
Medicare / Accountable Care Organization CHS Finance Division CPE Day November 2, 2015 Steve Neorr Chief Administrative Officer, Triad HealthCare Network Jeff Jones Chief Financial Officer, Cone Health
More informationValue Based Care An ACO Perspective
Value Based Care An ACO Perspective NCIOM Task Force on Accountable Care Communities January 24, 2018 Steve Neorr Chief Administrative Officer 2 3 4 5 Source: Banthin, Jessica. Healthcare Spending Today
More informationBundled Payments to Align Providers and Increase Value to Patients
Bundled Payments to Align Providers and Increase Value to Patients Stephanie Calcasola, MSN, RN-BC Director of Quality and Medical Management Baystate Health Baystate Medical Center Baystate Health Is
More informationACOs: California Style
ACOs: California Style ACO Congress John E. Jenrette, M.D. Chief Executive Officer Sharp Community Medical Group November 2, 2011 California Style California Style A CO California Style California Style
More informationStrategy Guide Specialty Care Practice Assessment
Practice Transformation Network Strategy Guide Specialty Care Practice Assessment 1/20/2017 1 Strategy Guide: Specialty Care PAT 2.2 Contents: Demographics Tab: 3 Question 1: Aims... 3 Question 2: Aims...
More informationCentral Ohio Primary Care (COPC) Spotlight on Innovation
Central Ohio Primary Care (COPC) Spotlight on Innovation BY BETTER MEDICARE ALLIANCE MARCH 2017 Central Ohio Primary Care Spotlight on Innovation 1 Central Ohio Primary Care (COPC) Spotlight on Innovation
More informationUsing EHRs and Case Management to Improve Patient Care and Population Health
Using EHRs and Case Management to Improve Patient Care and Population Health Session #211, February 22, 2017 Thomas Schiller, MD and Jennifer Kuroda, SwedishAmerican Health System A Division of UW 1 Speaker
More informationEmblemHealth Advocate for Quality
EmblemHealth Advocate for Quality 2013 Average Health Care Spending per Capita, 1980 2009 Adjusted for differences in cost of living 1 Dollars Source: OECD Health Data 2011 (June 2011). THE COMMONWEALTH
More informationPOPULATION HEALTH PLAYBOOK. Mark Wendling, MD Executive Director LVPHO/Valley Preferred 1
POPULATION HEALTH PLAYBOOK Mark Wendling, MD Executive Director LVPHO/Valley Preferred www.populytics.com 1 Today s Agenda Outline LVHN, LVPHO and Populytics Overview Population Health Approach Population
More informationJourney in managing practice variation in Diabetes and Hypertension (Part 2/2)
Journey in managing practice variation in Diabetes and Hypertension (Part 2/2) For Part 1 of this presentation, go to http://rightcare.berkeley.edu/sacramento-university-of-best-practices Parag Agnihotri,
More information4/9/2016. The changing health care market THE CHANGING HEALTH CARE MARKET. CPAs & ADVISORS
CPAs & ADVISORS experience support // ADVANCED PAYMENT MODELS: CJR Eric. M. Rogers MEd. RT(R) Managing Consultant The changing health care market THE CHANGING HEALTH CARE MARKET HHS goal of 30% of traditional
More informationHealthcare Financial Management Association October 13 th, 2016 Introduction to Accountable Care Organizations and Clinically Integrated Networks
Healthcare Financial Management Association October 13 th, 2016 Introduction to Accountable Care Organizations and Clinically Integrated Networks Agenda Define ACO, CIN, and Coordinated Care Review ACO/CIN
More informationThe Physician s Perspective
The Physician s Perspective How the Changing Role of the PCP is Leading Healthcare Reform May 22, 2015 Carman A. Ciervo, DO Chief Physician Executive Our Vision To transform the healthcare To transform
More informationMedicare Shared Savings ACOs: One Organization s Lessons Learned. Gregory A. Spencer MD FACP Chief Medical Officer Crystal Run Healthcare LLP
Medicare Shared Savings ACOs: One Organization s Lessons Learned Gregory A. Spencer MD FACP Chief Medical Officer Crystal Run Healthcare LLP Learning Objectives Identify organizational strengths and weaknesses
More informationHealthPartners and the Triple Aim. IHI Open School August 23, 2012 Beth Waterman, RN MBA Chief Improvement Officer HealthPartners
HealthPartners and the Triple Aim IHI Open School August 23, 2012 Beth Waterman, RN MBA Chief Improvement Officer HealthPartners HealthPartners Not for profit, consumer governed Integrated care and financing
More informationPhysician Performance Analytics: A Key to Cost Savings
Physician Performance Analytics: A Key to Cost Savings Session #90, February 21, 2017 Jim Gera, SVP of Business Development, Signature Medical Group, Inc. 1 Speaker Introduction Jim Gera, MBA SVP of Business
More information4/10/2013. Learning Objective. Quality-Based Payment Models
Creating Best in Class Perioperative Services under Accountable Care and Value- Based Purchasing Becker s Healthcare Jeffry Peters Learning Objective How ACA/VBP changes how we measure surgical services
More informationLSU Health Public-Private Partnership Report Card FY th Quarter
Statistics Percent Patient Mix by Service Offender Care *CEA Core Clinical Services Our Lady of the Angels Hospital - Bogalusa, Louisiana Measure BMC Monthly Avg FY 12 OLOAH Monthly Avg FY 14 Jul 2014
More informationPresentation Outline
Chronic Disease Toolkits: Spreading Quality Outcomes Simply Gerald H. Angoff, MD, FACC, MBA Steve Sarette, BA Presentation Outline It Introduction ti Setting the scene Quality Improvement Project Details
More informationUsing Data for Proactive Patient Population Management
Using Data for Proactive Patient Population Management Kate Lichtenberg, DO, MPH, FAAFP October 16, 2013 Topics Review population based care Understand the use of registries Harnessing the power of EHRs
More informationCIGNA Collaborative Accountable Care
CIGNA Collaborative Accountable Care Connecting in ways that help make achieving health easier, more effective and more affordable October 14, 2016 Michael L. Howell, MD, MBA, FACP Market Medical Executive/Sr.
More informationWinning at Care Coordination Using Data-Driven Partnerships
Idriz Limaj, LNHA, RN Chief Operating Officer Winning at Care Coordination Using Data-Driven Partnerships Session #166, February 22, 2017 1 Steven Littlehale, MS, GCNS-BC EVP & Chief Clinical Officer Speaker
More informationFrom Implementation to Optimization: Moving Beyond Operations
From Implementation to Optimization: Moving Beyond Operations Session 260, March 8, 2018 Scott Aikey, Sr. Director, Core Clinical Applications Children s Hospital of Philadelphia 1 Conflict of Interest
More informationProgram Overview
2015-2016 Program Overview 04HQ1421 R03/16 Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health Service
More informationAdopting Accountable Care An Implementation Guide for Physician Practices
Adopting Accountable Care An Implementation Guide for Physician Practices EXECUTIVE SUMMARY November 2014 A resource developed by the ACO Learning Network www.acolearningnetwork.org Executive Summary Our
More informationThe Future of Healthcare Credit Analysis - Seven Emerging Ratios
The Future of Healthcare Credit Analysis - Seven Emerging Ratios Kevin F. Fitch Director, Strategic Financial Planning & Analysis Adam D. Lynch Vice President Robert A. Henley Director, Analytics Learning
More informationWhat s Wrong with Healthcare?
What s Wrong with Healthcare? Dan Murrey, MD, MPP Chief Executive Officer Agenda What s wrong with healthcare in the US? What would make it better? How can you help? What s wrong with US healthcare? What
More informationThe Cost of Care: Understanding the Next Generation of Payment Models
The Cost of Care: Understanding the Next Generation of Payment Models Presented by: Debbie Welle Powell, MPA, Vice President Sisters of Charity Health System and Exempla Healthcare September 27 th, 2012
More informationClinical Program Cost Leadership Improvement
Clinical Program Cost Leadership Improvement December 2017 Presbyterian recently developed a rapid-cycle process for integrating sustainable cost and quality improvements within clinical programs. Population
More informationPSI-15 Lafayette General Health 2017 Nicholas E. Davies Enterprise Award of Excellence
PSI-15 Lafayette General Health 2017 Nicholas E. Davies Enterprise Award of Excellence Rachel Brunt, RN, BSN, MBA-HCA, CIC, CPHQ, Director Quality Jessie Hanks, BS, RHIA, Director HIM Lafayette General
More informationEssentia Health. A View on Information Technology. ND HIMS Conference April 12, Tim Sayler, COO Essentia Health - West
Essentia Health A View on Information Technology ND HIMS Conference April 12, 2017 Tim Sayler, COO Essentia Health - West Me Discussing Information Technology Who is Essentia Overview Why: Information
More informationJumpstarting population health management
Jumpstarting population health management Issue Brief April 2016 kpmg.com Table of contents Taking small, tangible steps towards PHM for scalable achievements 2 The power of PHM: Five steps 3 Case study
More informationHeart Failure Order Sets. Standardizing Care for the Heart Failure Patient 2012
Heart Failure Order Sets Standardizing Care for the Heart Failure Patient 2012 Objectives: Standardize care for all heart failure patients in Legacy Base Practice on American Heart Association Guidelines
More informationSucceeding in a New Era of Health Care Delivery
March 14, 2012 Succeeding in a New Era of Health Care Delivery Building Value-Based Partnerships LeadingAge Pennsylvania Kathleen Griffin, PhD, National Director Post-Acute and Senior Services 1 Your Presenter
More informationFrom Reactive to Proactive: Creating a Population Management Platform
Session D9 / E9 From Reactive to Proactive: Creating a Population Management Platform Richard Gitomer, MD Director, Brigham and Women s Primary Care Center of Excellence Vice Chair, Primary Care, Dept.
More informationCOPD & Pneumonia Readmission Reduction Program. October 25, 2017
COPD & Pneumonia Readmission Reduction Program October 25, 2017 Susan J. Bowers, MBA, BSN, RN Chief Quality Officer Mercy Health - Lorain 2 Locations Mercy Health Lorain Hospital Lorain, Ohio 250 bed community
More informationRebalancing the Cost Structure: Progressive Health Systems, Inc. Bob Haley, CEO Steve Hall, CFO
Rebalancing the Cost Structure: Progressive Health Systems, Inc. Bob Haley, CEO Steve Hall, CFO THE MARKET & PHS S POSITION 2 Progressive Health Systems, Inc. (dba Pekin Hospital) Pekin, IL 3 4 5 Nearby
More informationHealth System Transformation. Discussion
Health System Transformation Patrick Conway, M.D., MSc CMS Chief Medical Officer Deputy Administrator for Innovation and Quality Director, Center for Medicare & Medicaid Innovation Director, Center for
More informationHealth Care Systems - A National Perspective Erica Preston-Roedder, MSPH PhD
Health Care Systems - A National Perspective Erica Preston-Roedder, MSPH PhD Outline Quality Overview Overview and discussion of CMS programs Increasing transparency Move from P4R to P4P Expanding beyond
More informationCMS Oncology Care Model s Standards for Patient Navigation
CMS Oncology Care Model s Standards for Patient Navigation Nikolas Buescher Executive Director of Cancer Services Penn Medicine, Lancaster November 13, 2017 Ann B Barshinger Health Cancer Institute scale
More informationL8: Care Management for Complex Patients: Strategies, Tools and Outcomes
The Triple Aim 16 th Annual Summit: Institutes for Healthcare Improvement - Improving Patient Care in the Office Practice and the Community March 16, 2015 Dallas, Texas L8: Care Management for Complex
More informationReadmission Project 2017 Janice M. Maupin, RN, MSN, CPHQ. A Catholic healthcare ministry serving Ohio and Kentucky
Readmission Project 2017 Janice M. Maupin, RN, MSN, CPHQ A Catholic healthcare ministry serving Ohio and Kentucky 1 Mission, Values and Promise Our Mission We extend the healing ministry of Jesus by improving
More informationAdvancing Primary Care Delivery
Advancing Primary Care Delivery Tenth National Pay for Performance Summit March 3, 2015 Simeon Schwartz, MD CEO, WESTMED Medical Group, P.C. WESTMED Medical Group Established 1996 by 16 physicians 300
More informationThe Alternative Quality Contract (AQC): Improving Quality While Slowing Spending Growth
The Alternative Quality Contract (AQC): Improving Quality While Slowing Spending Growth Dana Gelb Safran, ScD Senior Vice President, Performance Measurement and Improvement Presented at: MAHQ 16 April
More informationPRISM Collaborative: Transforming the Future of Pharmacy PeRformance Improvement for Safe Medication Management
PRISM Collaborative: Transforming the Future of Pharmacy PeRformance Improvement for Safe Medication Management Mission: To improve the health of the people of Connecticut through safe and effective medication
More informationEmbedded Case Manager
Embedded Case Manager Joann Sciandra, RN, BSN, CCM Medical Home Summit ProvenHealth Navigator Geisinger Health System An Integrated Health Service Organization Provider Facilities Managed Care Companies
More informationACHIEVING THE TRIPLE AIM THROUGH LARGE SCALE IMPROVEMENT EFFORTS JASON FOLTZ, D.O. TEACHERS OF QUALITY ACADEMY QI SYMPOSIUM MARCH 2, 2016
ACHIEVING THE TRIPLE AIM THROUGH LARGE SCALE IMPROVEMENT EFFORTS JASON FOLTZ, D.O. TEACHERS OF QUALITY ACADEMY QI SYMPOSIUM MARCH 2, 2016 OVERVIEW: WHAT, WHO, HOW? What: How do you move a large multi-specialty
More informationManaging Healthcare Payment Opportunity Fundamentals CENTER FOR INDUSTRY TRANSFORMATION
Managing Healthcare Payment Opportunity Fundamentals dhgllp.com/healthcare 4510 Cox Road, Suite 200 Glen Allen, VA 23060 Melinda Hancock PARTNER Melinda.Hancock@dhgllp.com 804.474.1249 Michael Strilesky
More informationupdate An Inside Look Into the EHR Intersections of the Updated Patient-Centered Medical Home (PCMH) Care Model May 12, 2016
update An Inside Look Into the EHR Intersections of the Updated Patient-Centered Medical Home (PCMH) Care Model May 12, 2016 Agenda PCMH: 360 o PCMH to date o Evidence based results o Updated Standards:
More informationMercy Virtual. Transforming Medicine and Value Through Virtual Care. Randall S Moore, MD, MBA. Orlando, FL. September, 2017
Mercy Virtual Transforming Medicine and Value Through Virtual Care Randall S Moore, MD, MBA Orlando, FL September, 2017 The opinions expressed are those of the presenter and do not necessarily state or
More informationAccountable Care and the Laboratory Value Proposition. Les Duncan Director of Operations Highmark Health - Home and Community Services
Accountable Care and the Laboratory Value Proposition Les Duncan Director of Operations Highmark Health - Home and Community Services Agenda The Goals and Status of Delivery System Reform and Alternative
More informationPost-Acute Care Networks: How to Succeed and Why Many Fail to Deliver JULY 18, 2016
Post-Acute Care Networks: How to Succeed and Why Many Fail to Deliver HEALTH FORUM AND AHA LEADERSHIP SUMMIT JULY 18, 2016 SAN DIEGO, CALIFORNIA Please note that the views expressed are those of the conference
More informationCAUTI Reduction A Clinton Memorial Presentation
CAUTI Reduction 2016 A Clinton Memorial Presentation Clinton Memorial Statistics Rurally situated in a primarily agricultural community with a population of 42,000 The hospital is licensed for 165 beds
More informationWhy Focus on Perioperative Services?
1 Why Focus on Perioperative Services? 80% 60% 40% 20% 0% Perioperative Services are key to a hospital/system's success 68% % better performers revenue from perioperative services Perioperative Services
More informationLong term commitment to a new vision. Medical Director February 9, 2011
ACCOUNTABLE CARE ORGANIZATION (ACO): Long term commitment to a new vision Michael Belman MD Michael Belman MD Medical Director February 9, 2011 Physician Reimbursement There are three ways to pay a physician,
More informationInnovative Business Activities in Health Care with Commercial Partners
Innovative Business Activities in Health Care with Commercial Partners Steve Witman, CPA, MBA Vice President of Business Development / Financial and Capital Planning LifeBridge Health March 4, 2014 Business
More informationQIO Care Transitions Activity: the Good News so far
QIO Care Transitions Activity: the Good News so far Kim Irby, MPH; kirby@cfmc.org Senior Project Director Colorado Foundation for Medical Care www.cfmc.org/integratingcare This material was prepared by
More informationTopics for Today s Discussion
MICAH Quality Network Population Insights Reporting and 2017 2018 PG5 P4P Program Year Updates Blue Cross Blue Shield of Michigan Hospital Incentive Programs August 18 th, 2017 Topics for Today s Discussion
More informationRoadmap to accountable care: The chicken or the egg technology investment or clinical process improvement?
Roadmap to accountable care: The chicken or the egg technology investment or clinical process improvement? August 29, 2012 Meet the Presenters Michael Griffis CIO Innovative Practices Tucson, AZ Beth Hartquist,
More informationMinnesota Perspective: Fairview Health Services. National Accountable Care Organization Congress October 25, 2010
Minnesota Perspective: Fairview Health Services National Accountable Care Organization Congress October 25, 2010 Fairview Overview Not-for-profit organization established in 1906 Partner with the University
More informationHumana Group Medicare
Humana Group Medicare Presentation to East Baton Rouge Parish School System Health Insurance Advisory Committee Meeting - May 1, 2013 Scott Westbrook, Shane Swenson and Jeff Fernandez Humana Group Medicare
More informationDriving the value of health care through integration. Kaiser Permanente All Rights Reserved.
Driving the value of health care through integration February 13, 2012 Kaiser Permanente 2010-2011. All Rights Reserved. 1 Today s agenda How Kaiser Permanente is transforming care How we re updating our
More informationBreaking Down Silos of Care: Integration of Social Support Services with Health Care Delivery
Breaking Down Silos of Care: Integration of Social Support Services with Health Care Delivery Betty Shephard Lead VP, Care Management HealthCare Partners National Health Policy Forum October 19, 2012 HCP
More informationThe Triple Aim. Productivity: Digging Deep Enough 11/4/2013. quality and satisfaction); Improving the health of populations; and
NAHC Annual Conference October, 2013 Cindy Campbell, BSN, RN Associate Director Operational Consulting Fazzi Jeanie Stoker, BSN, RN, MPA, BC Director AnMed Health Home Care Context AnMed Health Home Health
More informationPost Acute Continuum Lessons Learned from Geisinger s ProvenHealth Navigator
Post Acute Continuum Lessons Learned from Geisinger s ProvenHealth Navigator Janet Tomcavage, RN, MSN VP Health Services, Geisinger Health Plan Danville, PA February 3, 2012 Patient-centered primary care
More informationACOs: Transforming Systems with New Payment Models & Community Integration
ACOs: Transforming Systems with New Payment Models & Community Integration Sunnah Kim PNP (Moderator), American Academy of Pediatrics Herbert Druilhet, RN, DNP, FNP-BC Lafayette General Medical Doctors
More informationTransforming Care Delivery: Redesigning Case Management and Primary Care Roles in Population Health Management
Transforming Care Delivery: Redesigning Case Management and Primary Care Roles in Population Health Management PCPCC June 26, 2014 Karen Jones MD FACP VP, Chief Medical Officer, WMG Laurie Brown BSN, MBA
More informationOvercoming Psycho-Social Hurdles to Transitional Care
Overcoming Psycho-Social Hurdles to Transitional Care Matt Eisenhower Director, Community Health Development Peter Rice, M.D. Medical Director Overcoming Psycho-Social Hurdles to Transitional Care This
More informationThe Minnesota Statewide Quality Reporting and Measurement System (SQRMS)
The Minnesota Statewide Quality Reporting and Measurement System (SQRMS) Denise McCabe Quality Reform Implementation Supervisor Health Economics Program June 22, 2015 Overview Context Objectives and goals
More informationPost-Acute Care Networks: How to Succeed and Why Many Fail to Deliver JULY 18, 2016
Post-Acute Care Networks: How to Succeed and Why Many Fail to Deliver HEALTH FORUM AND AHA LEADERSHIP SUMMIT JULY 18, 2016 SAN DIEGO, CALIFORNIA Please note that the views expressed are those of the conference
More informationPricing Transparency and Patient Education
Pricing Transparency and Patient Education Ochsner Health System Wendy Burns and Katherine Cardwell January 22, 2018 Agenda OHS Background Revenue Cycle Structure Consumerism at OHS Patient Education Initiatives
More informationCreating a Culture of Quality and Safety Gordon C. Hunt, MD, MBA Sr. Vice President & Chief Medical Officer, Sutter Health
Creating a Culture of Quality and Safety Gordon C. Hunt, MD, MBA Sr. Vice President & Chief Medical Officer, Sutter Health M2 This presenter has nothing to disclose December 2012 Blue Ribbon I & II In
More informationQuality Management Report 2017 Q2
Quality Management Report 2017 Q2 Quality Management Program CMS STAR Ratings Member Satisfaction (CAHPS & HOS) HEDIS Risk Adjustment DHS Member Incident Reporting Member Satisfaction Surveys Pay for Performance
More informationProgress Notes NEwS YOU CAN USE
Progress Notes NEwS YOU CAN USE FIRST QUARTER 2011 www.azphysicians.org (623) 623.215.9500 215.9500 16155 16155 N. 83rd N. 83rd Avenue, Avenue, Suite 201 Suite Peoria, 201 Arizona Peoria, 85382 Arizona
More informationConnected Care Partners
Connected Care Partners Our Discussion Today Introducing the Connected Care Partners CIN What is a Clinically Integrated Network (CIN) and why is the time right to join the Connected Care Partners CIN?
More information2017 HIMSS DAVIES APPLICANT
2017 HIMSS DAVIES APPLICANT Introduction of NOMS Team Members Melissa Thomas IT Project Director Joshua Frederick, CPA, MT Chief Executive Officer Jennifer Hohman, MD Executive Vice President, NOMS Healthcare
More informationAMGA Webinar: MSSP Final Rule. Scott Hines, MD Chief Quality Officer Crystal Run Healthcare July 16, 2015
AMGA Webinar: MSSP Final Rule Scott Hines, MD Chief Quality Officer Crystal Run Healthcare July 16, 2015 Crystal Run Healthcare Physician owned MSG in NY State, founded 1996 >350 providers, >30 locations
More information7/7/17. Value and Quality in Health Care. Kevin Shah, MD MBA. Overview of Quality. Define. Measure. Improve
Value and Quality in Health Care Kevin Shah, MD MBA 1 Overview of Quality Define Measure 2 1 Define Health care reform is transitioning financing from volume to value based reimbursement Today Fee for
More informationQuality, Cost and Business Intelligence in Healthcare
Quality, Cost and Business Intelligence in Healthcare Maitri Vaidya Population Health Executive DBA, MHA, CPHQ May 2016 Where are we going? IHI Triple Aim Improve the patient experience of care Lower
More informationCAMDEN CLARK MEDICAL CENTER:
INSIGHT DRIVEN HEALTH CAMDEN CLARK MEDICAL CENTER: CARE MANAGEMENT TRANSFORMATION GENERATES SAVINGS AND ENHANCES CARE OVERVIEW Accenture helped Camden Clark Medical Center, (CCMC), a West Virginia-based
More informationSandra Robinson, RN, MSN, ACM, CEN
Developing and Measuring Care Coordination Outcome Goals and Objectives ACMA National Conference April 28, 2015 Cleveland Clinic Care Management Sandra Robinson, RN, MSN, ACM, CEN (robinss12@ccf.org) Joan
More informationA Bigger Bang Patient Portal Strategy: How we activated 100K patients in our First Year
A Bigger Bang Patient Portal Strategy: How we activated 100K patients in our First Year Saturday March 25 th, 2017 Lindsay Altimare, MPA Director, LVPG Operations Lehigh Valley Health Network Michael Sheinberg,
More informationReducing Readmission Case Stories Discussion of Successes
Reducing Readmission Case Stories Discussion of Successes University of California, San Francisco Maureen Carroll RN, CHFN Transitional Care Manager Heart Failure Program Coordinator UnityPoint Cedar Rapids
More informationCurley s Secret of Life : VBID and Payment Reform
1 Curley s Secret of Life : VBID and Payment Reform Lewis G. Sandy MD SVP, Clinical Advancement, UnitedHealth Group UnitedHealth Center for Health Reform and Modernization University of Michigan Center
More informationCreating the New Care Design L2. George Kerwin, CEO Patient of Bellin Health Bellin Health Team. Objectives
Creating the New Care Design L2 George Kerwin, CEO Patient of Bellin Health Bellin Health Team Objectives Identify the five views of the Production System necessary to Create a Connected Personal Experience
More informationA legacy of primary care support underscores Priority Health s leadership in accountable care
Priority Health has been at the forefront of supporting primary care, driving accountability, improving quality and improving care for patients. A legacy of primary care support underscores Priority Health
More informationBuilding an Ambulatory System of Care: Using Population Health to Combat Secular Trends & Achieve the Triple Aim
Building an Ambulatory System of Care: Using Population Health to Combat Secular Trends & Achieve the Triple Aim Christopher T. Olivia, MD, President June 11, 2014, All Rights Reserved and CONTINUUM HEALTH
More informationBuilding a Stronger Work Marriage
PROVIDER ENGAGEMENT Building a Stronger Work Marriage Lessons in Dyad Leadership Karim Botros MetroHealth Matt Garabrant The Advisory Board Company Fred Neis The Advisory Board Company Road Map 2 1 2 MetroHealth
More informationCulture Change. Bryan J. Weiner, Ph.D.
Culture Change Bryan J. Weiner, Ph.D. bjweiner@uw.edu WHAT IS ORGANIZATIONAL CULTURE? The way things are done around here. WHAT KIND OF CULTURE SUPPORTS PERFORMANCE IMPROVEMENT? Learning Organization:
More informationA Brave New World: Lessons Learned From Healthcare Reform. Brandy Shumaker, MBA, LPTA, LNHA Regional Vice President HealthPRO/Heritage
A Brave New World: Lessons Learned From Healthcare Reform Brandy Shumaker, MBA, LPTA, LNHA Regional Vice President HealthPRO/Heritage 1 Learning Objectives Participants will understand: The impact health
More informationVHA Transformation to a Patient Centered Medical Home Model of Care
VHA Transformation to a Patient Centered Medical Home Model of Care Joanne M. Shear MS, FNP-BC VHA Primary Care Clinical Program Manager Office of Primary Care Operations & Policy Washington, DC Joanne.shear@va.gov
More informationA Care Coordination Model for Value-Based Performance Programs
A Care Coordination Model for Value-Based Performance Programs Richard S. Chung, MD Chief Clinical Officer APS Healthcare 8th National Pay for Performance (P4P) Summit February 20, 2013 Hyatt Regency Hotel,
More informationImprovement and Assessment Framework Q1 performance and six clinical priority areas
Governing Body 30 th September 2016 Improvement and Assessment Framework Q1 performance and six clinical priority areas Agenda item 16 Paper 10 Summariser: Authors and contributors: Executive Lead(s):
More informationTransitioning to a Value-Based Accountable Health System Preparing for the New Business Model. The New Accountable Care Business Model
Transitioning to a Value-Based Accountable Health System Preparing for the New Business Model Michael C. Tobin, D.O., M.B.A. Interim Chief medical Officer Health Networks February 12, 2011 2011 North Iowa
More informationAdvisory Board Fellows
Talent Development Advisory Board Fellows Delivering impact through a signature initiative Talent Development s marquee leadership program, the Advisory Board Fellowship, is an accelerated two-year, MBA-like
More informationNational Readmissions Summit Safe and Reliable Transitions: An Integrated Approach Reducing Heart Failure Readmissions
National Readmissions Summit Safe and Reliable Transitions: An Integrated Approach Reducing Heart Failure Readmissions Michael Kanter, MD, Medical Director Quality and Clinical Analysis Patti Harvey, RN,
More informationThree C s of Change in the Value-Based Economy: Competency, Culture and Compensation. April 4, :45 5:00 pm
Three C s of Change in the Value-Based Economy: Competency, Culture and Compensation April 4, 2014 3:45 5:00 pm 1 Introduction Kevin McCune, MD Chief Medical Officer Advocate Medical Group Peg Stone Vice
More informationPredicting 30-day Readmissions is THRILing
2016 CLINICAL INFORMATICS SYMPOSIUM - CONNECTING CARE THROUGH TECHNOLOGY - Predicting 30-day Readmissions is THRILing OUT OF AN OLD MODEL COMES A NEW Texas Health Resources 25 hospitals in North Texas
More information