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.

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 Overview 170,000 physicians Approximately 430 Medical Group Members 75% of members are IDS/Health System Affiliated Deliver health care to 120 million (1 in 3 Americans) Average group size is 348 MDs Median group size is 140 MDs 24 of the Original 32 Pioneer ACOs and over 100 MSSP ACOs

5 2015 AMGA Board of Directors Executive Committee Chair: Don L. Wreden, M.D. - Senior Vice President for Patient Experience, Sutter Health Chair Elect: Donn E. Sorensen, M.B.A., FACMPE - President, East Region, Mercy Secretary: Jeffrey W. Bailet, M.D. - Executive Vice President, Aurora Health Care, President, Aurora Medical Group Treasurer: Barbara A. Walters, D.O., M.B.A. Executive Vice President & Chief Population Health Officer, Trinity Health Member At Large: Ashok Rai, M.D. - President and Chief Executive Officer, Prevea Health Immediate Past Chair: Howard B. Graman, M.D., FACP - Chief Executive Officer, PeaceHealth Medical Group President and Chief Executive Officer: Donald W. Fisher, Ph.D., CAE - President & Chief Executive Officer, American Medical Group Association Directors: Joseph E. Bisordi, M.D., FACP - Executive Vice President & Chief Medical Officer, Ochsner Health System Sharon R. Gabrielson, MHA Chair of Global Products and Services, Mayo Clinic Health System Matthew D. Gibb, MD, FACC, FACP, FSCAI - Chief Medical Officer & Executive Senior Vice President, Carle Physician Group Michelle A. Koury, M.D. - Chief Operating Officer, Crystal Run Healthcare Mark E. Mantei, M.H.S.A., FACHE - Chief Executive Officer, The Vancouver Clinic Christopher J. Sclafani, P.E.M.B.A. - Chief Administrative Officer, Mount Kisco Medical Group Aric Sharp, MHA, CMPE, FACHE - Vice President of Accountable Care, UnityPoint Health C. Todd Staub, MD, FACP - Chairman, ProHealth Physicians 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

6 Members by Organization Type Academic 9% IPA 4% IDS 24% Group Practice 63%

7 Members by Hospital Affiliation Owned/Affiliated 35% IDS 40% None 25%

8 Members by Number of MDs % Over % 50 and under 19% % %

9 What Does AMGA Do for Your Group? We Advocate We Educate We Equip

10 Advocate Your Voice in the Federal Legislative/Regulatory Arena An Effective Corporate Shield to Protect Your Interests Defining and Advocating for 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

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

12 Networking and Educational Opportunities: Institute for Quality Leadership Annual Meeting October 20-23, 2015, Gaylord National Resort, National Harbor, MD (DC metro area) Annual Conference; Learning from the Best, March 8-12, 2016, Orlando, FL Leadership Council Meetings Regional Meetings Solutions Library Educate

13 Educate (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

14 Educate (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

15 Educate (cont.) AMGA Solutions Library Best Practice Webinars Best Practice White Papers

16 Educate (cont.) Medical Group Learning Collaboratives Current Adult Immunization Best Practices Collaborative Best Practices in Managing Patients with Rheumatoid Arthritis Best Practices in CHF Care Past Best Practices in Managing Patients with Multiple Chronic Conditions Best Practices in Managing Chronic Obstructive Pulmonary Disease Best Practices in Diabetes Care Best Practices in Managing Hypertension Accountable Care Organizations

17 Educate (cont.) AMGA Workshop & Retreat Program

18 Equip Tools and Resources to Compare and Improve Performance AMGA s Anceta Collaborative Patient/Provider/Employee Satisfaction Benchmarking Nationally Renowned Compensation and Financial Operations Survey Physician Retention Benchmarking Survey

19 Equip (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

20 Equip (cont.) How Medical Groups Use the Results Public accountability Quality improvement Peer review Marketing Physician/staff compensation or recognition

21 Equip (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

22 Equip (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

23 Equip (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

24 Equip (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

25 Equip (cont.) Medical Group Compensation & Financial 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

26 Equip (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

27 Equip (cont.) Proactive Patient Outreach Solution CG-CAHPS Patient Satisfaction Benchmarking Discounted Credit Card Processing Program Professional Opportunities Page

28 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.

29 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

30 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.

31 AMGA Strategic Initiatives Fostering development of High-Performing Health Systems Anceta, AMGA s Medical Informatics Collaborative

32 AMGA Strategic Initiatives (cont). Defining a High-Performing 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

33

34 AMGA Strategic Initiatives (cont). High-Performing Health System Assessment Program Assess perceptions of proficiency and priority Identify what is going well and what can be improved Prioritize and align resources on initiatives that lead to measurable improvement 2

35 AMGA Strategic Initiatives (cont). Anceta Collaborative - 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 35

36 AMGA Strategic Initiatives (cont). Anceta Collaborative Use data to identify opportunities for improvement and best performance Medical groups: OptumOne Analytics 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 36

37 AMGA Strategic Initiatives (cont). Organization Performance Anceta Collaborative AMGA and Optum: 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 37

38 AMGA Strategic Initiatives (cont). Anceta Participants

39 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) //